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Committee advances limited EMS reimbursement change allowing staff to ask insurance info for alternative transports
Summary
The Public Safety Committee advanced Bill 125 to permit fire-and-rescue personnel to ask patients about insurance only when offering alternative-destination transport for low-acuity cases; committee members and EMS leaders said emergency transports to emergency departments would not be affected and OMB reported a de minimis fiscal impact.
Montgomery County's Public Safety Committee on March 17 advanced Bill 125, which would allow fire-and-rescue personnel to ask patients about insurance coverage in a narrowly defined situation: to determine eligibility for an alternative destination instead of an emergency-department transport.
Joe Gorzalak, who introduced the bill summary to the committee, said the code currently prohibits asking about insurance. "This bill would allow fire and rescue service personnel to ask for information related to an individual's insurance coverage for the limited purposes of providing transportation to an alternative destination for providing treatment in place," he said.
Ben Kaufman, chief of EMS, told the committee the amendment applies only to a small subset of low-acuity calls where staff can offer clinically appropriate alternatives to ED transport. "This is really a subset, a small, very small subset of the calls that we run," Kaufman said, pointing to protocols that already allow alternative-destination transport.
Kaufman gave the example of a private provider with eligibility limits: "The example I've been using is the Kaiser Advanced Urgent Care. I can only take Kaiser patients there. So if you have Kaiser, I can take you to the Kaiser Advanced Urgent Care, and avoid the emergency department transport." He and other staff emphasized that nothing in the bill changes care in life-threatening emergencies.
County staff said OMB reported the fiscal impact as de minimis. Committee members asked clarifying questions about when personnel would inquire about insurance and how that information would be used to tailor transport options. The committee asked staff to record an official vote for the bill. A committee motion to approve the measure passed 3-0.
The committee forwarded the bill to full Council with the committee's recommendation to advance; staff noted routine operational details and protocols would be developed by EMS.
