Insurance carriers will now pay for EMS

Budget offers relief from cost of emergency medical service


Gov. Kathy Hochul’s state budget offers savings for volunteer fire departments. The Emergency Medical Service Cost Recovery Act will help fire department ambulances recover the cost of emergency medical services provided by paramedics and emergency medical technicians from insurance companies, Medicare, Medicaid and other agencies instead of footing the bill themselves. The act takes effect on July 1.
The measure also promises savings for taxpayers. There is a line item in property tax bills for fire services, and some fire districts have had to raise taxes due to the high cost of emergency services and the increase in demand for them during the pandemic.
“When the coronavirus pandemic hit,” Dr. Peter Olsen, chair of the Long Island Legislative Committee and a Locust Valley Fire Department firefighter, explained, “many volunteer fire department ambulances couldn’t provide adequate medical care due to an increased volume of calls, increased manpower requirements and the additional costs for [personal protective equipment], which was required when medical personnel entered Covid-infected homes, nursing homes, rehabilitation facilities and schools. Residents are already paying for medical insurance coverage, which includes medical assistance and ambulance services from their residence, work and/or school to a local hospital. This won’t increase taxes, because this will be part of their insurance coverage.”
The act will save local taxpayers over $120 million, Olsen said. Before it was passed, fire departments were using money set aside for protective equipment, and were not replacing hoses and other necessary equipment in order to pay for paramedics and EMS.
Money received from insurance companies will be put into a separate account, to be used only for ambulances, Olsen added.

“In Nassau, the EMS reimbursements are estimated annually to be $11.5 million,” he said. “This was never about sustainability. It was instead about surviving. In many cases, upstate volunteer fire departments’ ambulance service costs were two-thirds of their annual operating budget. These reimbursements are essential for their survival.”
It is not mandatory for fire departments to participate in the EMS Cost Recovery Act, but those that do will have 90 days to develop and implement a process for billing insurance companies, which can include third-party billing-processing companies. And when residents receive a bill from their Fire Department, they can forward it to their insurance company.
State Sen. John Brooks has been a firefighter for 53 years, and now works with the Seaford Fire Department. New York has been the only state unable to bill insurance companies for emergency services, Brooks explained, because of a quirk in a federal law allowing only paid fire departments, police and hospital ambulances to do so. “This adds volunteer fire service with the same billing rights as other agencies,” he said. “Car insurance, health insurance and homeowner insurance policies all include coverage for this in the policy.”
The Long Island Legislative Committee has been proposing an EMS Cost Recovery Bill for 16 years, with the help of Brooks, a Democrat from Seaford, and State Assemblyman Billy Jones, a Democrat from Chateaugay Lake, who were its co-sponsors.
The bill passed in the State Senate four years ago, and again last year. It came close to passing in the Assembly as well last year, Brooks said, but ultimately did not, which prompted him to encourage Hochul to include it in the budget.
“A large number of people in the Assembly were in areas where they don’t have a volunteer Fire Department,” he said. “Hospitals ran the ambulances there, and in the city they have paid firefighters, who were able to bill insurance companies.”
Times have changed, Brooks said. Ambulances used to only take someone to the hospital and then return. Now, with more sophisticated medical equipment and training, many volunteer firefighters are paramedics, and can be out on a call for an hour or more. “Today those with extended training are providing lifesaving care that before could only be done by a doctor,” he said. “Now an EMS can send an EKG strip taken in the ambulance to the doctor so they can look at it while the patient is being transported. Years ago, someone wouldn’t have survived.”
The Sea Cliff Fire Department is run by the village. Chief James Ajamien said he wasn’t sure whether the department would participate in the EMS Cost Recovery Act.
“I’m seeing if the department wants to do it,” Ajamien said. “If they do, we would talk to the mayor and trustees. We haven’t even done step one yet. We need to see the how, where, why and where the funds would go.”
Sea Cliff Mayor Elena Villafane said the Fire Department is not a “stand-alone” department, but rather a village agency. “If they want to pursue it, it will have to be authorized,” she said. “Then we’d have to see if the board wants to do it. What would happen to the people who are uninsured or have very high deductibles?”
Olsen said volunteer fire departments will respond to calls regardless of insurance status, as they have in the past. EMT’s always ask what someone’s insurance is when they arrive. “The bill will be sent, but those without insurance won’t have to pay it,” he said. “We will work out all scenarios prior to moving forward. The goal of any ambulance service is to save lives.”