(a) Definitions. As used in this section and for reimbursement purposes, the following words and phrases shall have the meanings respectfully ascribed to them as follows:
(1) “Basic Life Support (BLS).” Transportation by ground ambulance vehicle and the provision of medically necessary supplies and services, including BLS ambulance services as defined by the State. The ambulance must be staffed by individuals who are qualified in accordance with State and local laws as an emergency medical technician- basic (EMT-Basic). These laws may vary from state to state or within a state. For example, only in some jurisdictions is an EMT-Basic permitted to operate limited equipment onboard the vehicle, assist more qualified personnel in performing assessments and interventions, and establish a peripheral intravenous (IV) line.
(2) “Advanced Life Support, level 1 (ALS1).” The transportation by ground ambulance vehicle and the provision of medically necessary supplies and services, including the provision of an ALS assessment or at least one ALS intervention. An advanced life support (ALS) assessment is an assessment performed by an ALS crew as part of an emergency response that was necessary because the patient's reported condition at the time of dispatch was such that only an ALS crew was qualified to perform the assessment. An ALS assessment does not necessarily result in a determination that the patient requires an ALS level of service. An advanced life support (ALS) intervention is a procedure that is in accordance with State and local laws, required to be done by an emergency medical technician-intermediate (EMT-Intermediate) or EMT-Paramedic.
(3) “Advanced Life Support, Level 2 (ALS2). 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, medically necessary supplies and services, and the provision of at least one of the ALS2 procedures listed below:
A. Manual defibrillation/cardioversion;
B. Endotracheal intubation;
C. Central venous line;
D. Cardiac pacing;
E. Chest decompression;
F. Surgical airway; or
G. Intraosseous line.
(4) “Transport.” To carry or convey a person by a publicly owned and/or operated motor vehicle being used in response to a call for emergency medical assistance from one location to another.
(5) “Fees for Service.” The fee associated with the emergency transportation of each individual requiring either basic life support or advanced life support shall be the usual, customary and reasonable (UCR) charge established by insurance companies within the region.
(b) Payment of Fee.
(1) No person shall be charged for basic life support or advanced life support treatment unless he or she is transported by the City's Emergency Medical Service.
(2) Every person being transported by the Emergency Medical Service or some other person on behalf of that person being transported shall complete and execute an assignment of benefits form at the time of such Emergency Medical Service transport.
(3) If either the person being transported or some other person on behalf of that person being transported, when, for any reason, the person being transported is unable to execute an assignment of benefits form which entitles the City to recover its Emergency Medical Service transportation fee directly from the appropriate public or private insurer or any Federal, State or County public welfare agency which may be responsible for paying the costs of treated person's emergency transportation, the person being transported shall not be held liable for all or any part of the fee forth above.
A. If the person being transported or some other person on behalf of that person being transported provides incomplete, false or misleading information which prevents the City from recovering upon its assignment of benefits, the person being transported shall not be relieved of liability for the fee set forth above until a complete, truthful and accurate assignment of benefits form has been prepared, signed and presented to the Finance Department.
B. If in spite of the completion of an assignment of benefits form, the person being transported receives all or any part of the City's Emergency Medical Service transportation fee, the person being transported shall not be relieved of liability for such fee until he or she has remitted to the City all moneys he or she received for payment of such fee for such Emergency Medical Service.
(4) If the person being transported has no insurance and no other payment source for the Emergency Medical Service fee exits, or if the appropriate public or private insurer or Federal, State or County welfare agency pays less than the full Emergency Medical Service fee, the balance still due and owing for transportation of that person shall be waived by the City as payment in full unless this provision violates any State or Federal law as it pertains to the collection of fees.
(c) Establishment of Rates. It is hereby authorized and approved that the third party administrator selected by the City shall establish the fee submitted to the insurance carrier, determinate upon the level of the service provided to the individual(s) being transported.
(Ord. 2007-46. Passed 11-5-07; Ord. 2012-55. Passed 1-7-13; Ord. 2015-26. Passed 8-17-15; Ord. 2015- 44. Passed 11-2-15.)