Title
Consideration of and action on adopting an ordinance amending Section 34-25 Emergency Medical Service Fee Schedule.
Body
Summary:
The proposed fee schedule amendment is in response to Senate Bill 2476 that was signed by Governor Abbott on June 18, 2023 and took effect on September 1, 2023. The bill affects insurance payments to Texas Emergency Medical Services agencies and will apply on January 1, 2024.
The intent of SB2476 is to protect consumers against specific medical and healthcare "surprise billing" and eliminates balance billing for out-of-network (OON) patients to all ground ambulance services. Therefore, health insurance organizations will be fully responsible for reimbursing emergency ambulance services for the services provided.
The City of Deer Park's third-party ambulance billing service, Emergicon, has been consulted and the following recommendations are proposed:
The current fee schedule adopted in June 2019 is recognized/identified in the ambulance billing industry as Charge Masters. It is defined as a multi-page document that lists all the individual products, tasks, tools and medications that are provided or administered during patient care in other words, a line-item price for each item used. The recommendation is to implement a Bundled Fee schedule which is the process of creating and billing based on the average cost for certain procedure, tool, medication and other factors during an emergency transport or response.
The Bundle Fee is arrived at by averaging the cost for personnel, tasks, tools and medication. The advantages of Bundled Fee billing:
a. Help the citizens to understand their bill better
b. Increase the probability that commercial insurance companies will pay the bill
c. Semi-annual review of fee schedule instead of every time there is a rate change
Fiscal/Budgetary Impact:
The projected FY2023-2024 of $960,000 is anticipated to be sufficient.
Recommended action
Adopt the ordinance amending Section 34-...
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