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Commissioners reject resolution tied to ambulance billing dispute
Summary
Roosevelt County commissioners voted down Resolution 2026-15, a proposal from Northeast Montana Health Services to formalize ambulance service authority and address mileage-based billing gaps; commissioners cited legal limits and potential county liability.
Roosevelt County commissioners voted down Resolution 2026-15, a proposal from Northeast Montana Health Services (NEMHS) meant to address ambulance billing and mileage eligibility. The motion to adopt the resolution failed after an extended debate about county authority and liability.
The county official presiding over the meeting said NEMHS and its attorney circulated the resolution and urged the commission to sign it to address ambulance-billing mileage rules that left the provider about $150,000 short. The presiding officer described the proposal as coming under legal counsel and said the resolution was submitted under pressure from the provider’s counsel.
One commissioner who identified himself as president of the Montana Association of Counties opposed the resolution on statutory and liability grounds. He cited Montana code language about how a county, city or town ‘‘establishes or maintains ambulance services’’ and argued Roosevelt County does not operate or control ambulance services and therefore has no authority to adopt rules or furnish ambulance service. He warned the resolution would expose the county to liability and that the county’s insurer would likely refuse coverage in a lawsuit, saying, “We do not provide any ambulance service. We have no authority to even sign this resolution.”
Supporters of the resolution, including the presiding officer, said the resolution was intended to correct a mileage-rule problem that prevented NEMHS from billing for certain ambulance transports when neighboring communities’ mileage rules left reimbursement gaps. The presiding officer said the initiative was aimed at recovering roughly $150,000 in missed reimbursements.
After discussion, the presiding officer called the vote. Commissioners who opposed the resolution emphasized the statutory restrictions and insurance exposures; others said they wanted a different legal approach. The motion to adopt Resolution 2026-15 failed and commissioners said the proposal could be rewritten and returned to the board in another form.
The commission did not adopt new ambulance rules at the meeting; members directed that the resolution be reworked rather than approved as drafted.
