There have been a few announcements recently from Howard County Government about new legislation that they are proposing. Those announcement had me go look on the Howard County Council website at the “Prefiled Legislation” page to see the details…and when I did…I came across something that I had not seen announced…that is CB-9 2019. Here is the summary information of that bill:
AN ACT authorizing the County to establish charges to recover costs generated by providing emergency medical services; defining certain terms; requiring a certain reimbursement; providing for certain waivers; providing that out-of-pocket payments for emergency medical services shall not be required from certain individuals; requiring the County Council to adopt by Resolution a Rate schedule; authorizing the County Executive to adopt certain regulations; and generally relating to the Emergency Medical Services Insurance Reimbursement Program
Here are the full bill details: https://scotteblog.com/wp-content/uploads/2019/02/CB9-2019.pdf
So when I initially read it the “establish charges to recover costs” it caught my attention big time. All I could initially think was dang it…another revenue generating fee that is going to hit my pocket book (note – it is not). Then I read the full bill…read the current law…reached out to the County Government….reached out to members on the County Council…so that I had my facts correct. Here are some items I have learned about this bill:
Key pieces of the bill for Howard County residents and people that live outside of Howard County as it relates to this bill are in sections C, D and E. They state:
(C) IMPOSITION OF CHARGE. THE COUNTY MAY:
(1) IMPOSE A CHARGE FOR EMERGENCY MEDICAL SERVICES PROVIDED IN THE COUNTY BY THE FIRE AND RESCUE SERVICE; AND
(2) ENTER A MUTUAL AID AGREEMENT WITH OTHER JURISDICTIONS REGARDING THE COLLECTION OF CHARGES.
(D) LIABILITY FOR CHARGE. AN INDIVIDUAL WHO RECEIVES EMERGENCY MEDICAL
(1) EXCEPT AS PROVIDED IN SUBSECTION (E) OR (F), IS RESPONSIBLE FOR PAYMENT OF THE CHARGE;
(2) SHALL PROVIDE INFORMATION REQUESTED BY THE COUNTY INCLUDING, WITHOUT LIMITATION, INFORMATION RELATED TO THE INDIVIDUAL’S INSURANCE COVERAGE; AND
(3) SHALL ASSIGN INSURANCE BENEFITS TO THE COUNTY FOR THE PAYMENT OF THE CHARGE COVERED AND REIMBURSED BY THE INDIVIDUAL’S INSURANCE COMPANY.
(E) UNINSURED PORTION OF THE CHARGE.
A COUNTY RESIDENT SHALL NOT BE REQUIRED TO PAY ANY OUT-OF-POCKET EXPENSE RELATING TO ANY EMERGENCY MEDICAL SERVICES PROVIDED BECAUSE THE RESIDENT IS DEEMED TO HAVE PAID ANY CO PAYMENT, DEDUCTIBLE, OR UNINSURED PORTION OF THE COST OF EMERGENCY MEDICAL SERVICES THROUGH TAXES PAID TO THE COUNTY.
So as I read this bill (and after discussions with various people)…this is what I understand all of this to mean:
- The county will begin charging for medical services provided by Fire and Rescue
- The county will be billing your insurance company for these services if provided
- The county will write off any unpaid portion of the fees that the insurance does not pay for COUNTY RESIDENTS
- Non-county residents will be on the hook to pay fees not paid by insurance companies
- If you have no insurance at all…and are a county resident…you are not on the hook for any charges for services rendered
- If you have no insurance at all…and are not county resident..you are on the hook for all charges for services rendered
- Howard County Council will create a “rate schedule” of charges for services and update it annually
- Non-county residents are eligible for a “Hardship Waiver” if their “HOUSEHOLD INCOME IS AT OR BELOW 300 PERCENT OF THE FEDERAL POVERTY GUIDELINES“
- All money collected will be “DEPOSITED INTO THE FIRE AND RESCUE FUND, WITH APPROPRIATIONS BEING MADE THROUGH THE ANNUAL BUDGET AND APPROPRIATION ORDINANCE”
That is my summary of the reading of this bill.
I am all for billing the insurance companies to obtain money…that sounds like a wonderful idea…and will raise revenue for Fire and Rescue and hopefully eliminate the need to raise our taxes to support their mission.
I mentioned above that I reached out to the Howard County Government and Howard County Council Members for additional information. Let me tell you how that went:
Howard County Government: I reached out to Scott Peterson (Director of Communications for Howard County Government) asking who should I speak with in county government about this bill. He responded and stated he would forward me to someone at Howard County Department of Fire and Rescue Services. A little while later in the day someone from Fire and Rescue emailed me asking what questions I had. I sent my questions and they sent me the following this morning:
Apologies for the delay. Please see the answers below.
1) Are there are laws on the books today that would allow the county charge for emergency medical services? I know this would be a new section of Title 17 (http://howardcounty-md.elaws.us/code/coor_apxid10147_title17_subtitle1) but was curious if any other laws existed as it relates to this topic.
This is the first. This enabling legislation is the initial step in the process.
2) I am attempting to understand who this would affect in regards of charges. If I read section D and E correctly…other that charging of insurance…there would be no additional charges for county residents….is that correct? Would non-county residents be charged “UNINSURED PORTION OF THE CHARGE” as outlined in section E.
Correct. There would be no additional charges for county residents other than what their insurance company pays.
Non-residents would be billed for the remainder (after insurance payments), however, there is a provision for a waiver based on ability to pay, and no one would ever have their credit rating impacted.
Please let us know if we can provide any additional information.
Digital Media Specialist
I replied asking if there was someone I could talk to on the phone this morning because I had a few additional questions…and Brad Tanner (Dir of Community Outreach & Media Affairs) followed up via email and I gave him a quick call with some follow up questions. Here is what her sent back:
Follow up questions from Scott
“It is understood that not everyone has insurance.
With that, if a HoCo resident does not have insurance, Section E reads they will NOT be charged. Is this correct?
Also, if someone is NOT a HoCo resident they WILL be charged the full amount. Is this correct?”
CORRECT. THEIR INSURANCE WILL BE BILLED, AND THEY WILL BE BILLED THE REMAINDER. THAT REMAINDER COULD BE ADJUSTED BASED ON FINANCIAL HARDSHIP VIA THE WAIVER PROCESS. EFFORTS TO COLLECT WILL
ALWAYS BE COMPASSIONATE, AND NO ONE WILL EVER SUFFER FINANCIAL HARDSHIP AS A RESULT OF RECEIVING EMERGENCY MEDICAL SERVICES.
Dir of Community Outreach & Media Affairs
Of note – Scott Peterson later in the day yesterday reached out to make sure I had been contacted by Fire and Rescue…AWESOME CUSTOMER SERVICE from a director within county government.
Howard County Council: I emailed all five members of the Howard County Council (on 2/25/19 at 6:39am) and CC’d their staff members (because I understand that county council members can get busy and thought by cc’ing staffers I would have a shot of hearing back). Here is a summary of what I did (or did not) get back from each:
District 1 (Liz Walsh): NOTHING
District 2 (Opel Jones): NO REPLY VIA E-MAIL YET. Now I will say that Opel Jones and I chatted via Facebook messenger yesterday and today and he noted that his staffer was out yesterday with the flu..so I will give him a bit of a pass. He told me that he would try and give it a look later today and get back to me. If he sends an update…I will update the article.
District 3 (Christiana Rigby): I got an initial email yesterday with this follow up email coming to me this morning –
We are just now getting some information in from our auditor about this bill. From what we understand, all surrounding Counties have something like this set up. Howard County will use a 3rd party biller, who will be billing insurance companies. Apparently individuals will not be billed, unless they are non-residents. We will be getting more information and thorough analyses in a couple of weeks after the bill is formally introduced. At the moment, Councilwoman Rigby does not have enough information to understand the scope or effects of the legislation fully or be able to take a position yet.
Special Assistant, District 3
District 4 (Deb Jung): NOTHING
District 5 (David Yungmann): Was the superstar of all council members. Yesterday he replied and said he would have a staffer look into the subject. That staffer responded and asked me what questions I had on this topic. I sent my questions and the staffer said they would look into it. Later in the day the staffer and council member Yungmamm called me on my cell to talk more in depth about my questions. While they did not have all answers for me because this is new legislation…they reached out, listened and engaged with me on this topic. I really appreciated that they took a little time out of their day to reach out and discuss this issue with a resident of Howard County (me). For me…this is what public service should look like and I hope this is the type of feedback WE ALL get from elected members that represent us (locally or at any level) when we reach out.
Have additional thoughts on this topic? Let me know in the comments.