Corrected and updated Sept. 19, 2008
Steve Beckman, assistant director of the Harvard Ambulance Service, told the Press this week that he plans to circulate a citizens’ petition to bring the discussion of ambulance billing before residents at a Special Town Meeting this fall.
Beckman, who with other ambulance squad members has been handing out flyers at the transfer station hoping to educate the public on the issues around billing for ambulance services, said that feedback from residents has been “overwhelmingly” in favor of putting the ambulance billing question up for town discussion.
At the Aug. 5 Board of Selectmen meeting, selectmen voted to implement billing the insurers of all recipients of ambulance squad services, which prompted half a dozen resignations from the squad. Squad members who were unhappy with the decision accused the board of going back on an earlier commitment to bill residents for ambulance services only if the town voted to do so. Selectmen, however, said they were unaware of any such prior commitment, and asserted their right and duty to move forward with the decision, in light of the town’s financial circumstances. According to the minutes of the Aug. 5 meeting, selectmen voted unanimously “to adopt a policy whereby the Harvard Ambulance Service will begin billing insurance companies for calls made by [the] service, provided that no person will be billed for charges beyond those paid for by their insurance carriers and that no uninsured person will be billed at all. All funds collected in accordance with this policy shall be placed in a receipt reserved for appropriation account established for the sole purpose of funding the Harvard Ambulance Service.”
In 2007 the ambulance squad voted in favor of billing only the insurers of nonresidents, and began the lengthy process of completing the paperwork necessary to obtain a Medicare provider number, a prerequisite to billing. Then-director of the ambulance service, Alison Lierhaus, told the Press she spent two days of her own time last fall working on completing the 65-page application, before turning it over to Town Administrator Tim Bragan for completion. (The ambulance service’s portion of the 2007 Annual Town Report reflects this decision, as well as the turnover of paperwork to Bragan.)
Bragan told the Press that the paperwork hadn’t been completed because it was discovered that billing only nonresidents “ran afoul” of state laws regarding discrimination in insurance. He added that when a billing service has been selected to implement the selectmen’s decision, that service would complete the lengthy Medicare-required application.
Regarding the question of legality, Town Counsel Mark Lanza issued an opinion in August 2006 to then-Town Administrator Paul Cohen saying that billing only nonresidents was lawful “provided that there is evidence showing that ambulance services received by residents are funded by local property tax revenues or other local funding sources.”
Beckman speculated that there may have been a subsequent ruling saying it was not legal to bill only nonresidents when Medicare is involved. (However, Bragan did not respond by press time to a request for a copy of a legal opinion on this.) Beckman said that, if this is the case, the town could still have moved forward with billing of nonresidents only, opting not to bill Medicare patients.
Beckman said that the citizens’ petition aims to “see if the town will vote to compel the Board of Selectmen to maintain the Harvard Ambulance Service as an all-volunteer, state-certified, citizen-EMT organization whose mission is to provide superior, cost-effective BLS emergency medical services for all residents, without billing.” He said that the petition has the full support of ambulance squad members. Two hundred certified signatures are needed on the petition in order to require the selectmen to call a Special Town Meeting to consider ambulance billing.
Editor’s note: This article has been corrected and updated. Steve Beckman’s role was originally reported as director of the Harvard Ambulance Service. Beckman is actually the assistant director.
