961.01 SERVICE FEE, COST OF LIVING ADJUSTMENTS, AND COLLECTION OF INSURANCE.
(a) (1) Basic Life Support (BLS). The Director of Public Safety is hereby authorized to charge a fee for residents of the City of Dover of six hundred dollars ($600.00) to each recipient of basic life support (BLS) services. Basic life support (BLS) is transportation by ground ambulance vehicle and the provision of medically necessary supplies and services, including basic life support services as defined by the State of Ohio. The ambulance must have an individual who is qualified in the State of Ohio as an emergency medical technician-basic (EMT-Basic).
(2) Advanced Life Support, Level 1 (ALS1). The Director of Public Safety is hereby authorized to charge a fee for residents of the City of Dover of eight hundred dollars ($800.00) to each recipient of Advanced Life Support, Level 1 Services (ALS1). Advanced Life Support-1 Services (ALS1) is the transportation by ground ambulance vehicle and the provision of medically necessary supplies and services including the provision of ALS assessment and at least one ALS intervention. Advanced Life Support (ALS) assessment is an assessment performed by an ALS crew as part of an emergency response. An Advanced Life Support intervention is a procedure that is, in accordance with the law of the State of Ohio, beyond the scope of practice of an emergency medical technician-basic (EMT-Basic). Emergency response is a BLS or ALS1 level of service that has been provided in response to a 911 call or the equivalent. ALS personnel are individuals trained to the level of emergency medical technician-intermediate (EMT-Intermediate) or paramedic. An EMT-Intermediate is an individual who is qualified, in accordance with the law of the State of Ohio to perform essential advanced techniques and to administer a limited number of medications. A paramedic possesses the qualifications of an EMT-Intermediate and, in accordance with the law of the State of Ohio, has enhanced skills that include being able to administer additional interventions and medications.
(3) Advanced Life Support, Level 2. The Director of Public Safety is hereby authorized to charge a fee for residents of the City of Dover of nine hundred dollars ($900.00) to each recipient of Advanced Life Support, Level 2 Services (ALS2. (ALS2) is the transportation by ground ambulance vehicle and the provision of medically necessary supplies and services including (1) at least three separate administrations of one or more medications by intravenous push/bolus or by continuous infusion (excluding crystalloid fluids) or (2) ground ambulance transport and the provision of one of the recognized ALS2 procedures as defined by the Department of Health and Human Services (DHHS) Centers for Medicare & Medicaid Services (CMS) or the State of Ohio, as periodically amended (presently defined and applications and procedures contained in Program Memorandum Intermediaries/Carriers, Transmittal AB-02-130).
For purposes of ALS2 definitions, the ALS2 procedures are (and as amended in the future regulations) are:
A. Manual Defibrillation/cardioversion;
B. Endotracheal intubation;
C. Central venous line;
D. Cardiac pacing;
E. Cheat decomprehension;
F. Surgical airway; and
G. Intraosseous line.
Endotracheal intubation is one of the services that qualify for the ALS2 level of payment; therefore, it is not necessary to consider medications administered by endotracheal intubation for the purpose of determining whether the ALS2 rate is payable. The monitoring and maintenance of an endotracheal tube that was previously inserted prior to the transport also qualifies as an ALS2 procedure.
(4) Annual Rate Adjustments. Medicare increases ambulance or EMS allowable charges on a yearly basis based upon a cost of living adjustment provided by Federal law. The rates charged by the city of Dover for all services authorized in subsections (a)(1),(2), and (3) and subsections (c) and (d) shall be adjusted at the same percentage increase as computed by Medicare. The rate adjustment shall be effective on January 1 of each year commencing with January 1, 2023 and each year thereafter and shall be increased by the same amount as authorized in the prior year Medicare increases. Rates shall not decrease without further action of council in the event that Medicare reduced any rates.
(b) Dover Township Citizen Rates. The quarterly payments made by Dover Township in fulfillment of the annual fee assessed by the City of Dover to provided Fire, Rescue and Emergency Medical Service (Ambulance) as spelled out in the contract existing between the City of Dover and Dover Township to provide said Fire, Rescue and Emergency Medical Service (Ambulance) to the residents of Dover Township, shall constitute payment of basic and advanced life support services for Dover Township residents who are transported, except for the permissible collection of Medicare and insurance available for payment of services. So long as Dover Township remains current on its obligations as established by the existing Fire, Rescue and Emergency Medical Service (Ambulance) Agreement, except for Medicare and insurance payments available and collectible for these services, no additional payment for such services shall be required ofresidents of Dover Township.
(c) Mileage Fee. The Director of Public Safety is hereby authorized to charge a fee of twenty dollars ($20.00) per loaded mile for each mile of ambulance transportation rendered to a recipient of life support services, from the point of first contact with said recipient. Said charges shall apply to all individuals, receiving such services, except for residents of Dover Township, who shall be exempt from such payment for the reasons specified in subsection above, unless Medicare or insurance can be billed or collected for this service.
(d) Billing of Dover City Residents. Dover city and Dover Township residents shall be subject to insurance and Medicare only billing.
(e) Contract for Collection Services. Dover, through its Safety Director or Fire Chief, shall be authorized to enter into a contract for billing services, and to enter into an agreement or otherwise arrange for the collection of unpaid accounts of non-residents of Dover and Dover Township with a local outside independent agency for insurance and Medicare only collection. The contract shall allow a service charge that is competitive and equitable with an outside agency in an amount that is within the range of marketable services for this service and would be the best available contract for these services. The collection agency shall make three attempts to collect the bill from available Dover resident or Dover Township resident insurance or Medicare benefits. In the event that those collection efforts are unsuccessful, the Mayor, Safety Director, or Fire Chief shall contract with an outside agency to collect the funds that can be collected pursuant to the authorizations in this ordinance. After a commercially reasonable period, if the amounts remain uncollected, and the agency determines that the amounts probably will not be collected, active collection methods may be abandoned. If the person to whom service was provided has real estate, the agency is authorized to take reasonable steps to cause a lien to be placed on the real estate of the person to whom service was provided by legally authorized methods. Otherwise, collection efforts may be abandoned. If the agency notifies the City of the uncollectable bill, then one year after the last attempt to collect, the amount billed to the Dover city resident or Dover Township resident shall be written off and removed from the books as an amount claimed to be owed by the City of Dover for these services.
The collection service shall provide accounting of revenues collected and charges made on no less than a quarterly basis. The billing shall notify the resident that the bill shall be forwarded to either Medicare or insurance and that no personal liability will be imposed.
(Ord. 57-22. Passed 11-21-22.)