Item 1: Future Ambulance Transport Funding

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ATTACHMENT A by this task force immediately be addressed at a regional level and given the highest possible priority for allocation of time and resources. Having studied this issue and the range of available options, having engaged the public at a se- ries of community forums and online, and having worked in concert with stakeholders including local fire and ambulance service professionals, hospitals, and firefighters’ unions, we recom- mend as follows: 1.That all three jurisdictions remain prepared to allocate a level of General Fund sup- port as necessary for the continued high-quality provision of this core service. 2.That the Eugene and Springfield City Councils authorize initial steps toward merger of their fire departments. 3.That exploration begin immediately of more sustainable public funding options. 4.That marketing of FireMed subscriptions be enhanced and expanded in an effort to generate additional revenues to lessen reliance on general fund tax support. 5.That the City of Eugene and Lane Rural Fire/Rescue analyze the possibility of recon- figuring the boundaries of the county’s Ambulance Service Areas so as to provide for an urban-rural split between Eugene and Lane Rural Fire/Rescue; and, if conditions appear favorable, that the Lane County Board of Commissioners be asked to enact such reconfiguration. 6.That work proceed as rapidly as possible regarding provision of a regional mobile health care system, featuring tiered levels of response (and cost) available to patients depending on the nature of the emergency with a report to elected officials by the end of calendar year 2010. 7.That public ambulance service provider agencies continue to lobby the Oregon legis- lature and U.S. Congress for larger-scale long-term solutions. BACKGROUND Throughout our region, the majority of patients transported are covered by Medicare. Before the implementation of the Ambulance Fee Schedule on April 1, 2002, ambulance suppliers received payment from Medicare on a “Reasonable Charge Basis.” Medicare would pay 80 percent of the allowable amount and the remaining balance was the responsibility of the patient. This allowed transport providers broad flexibility in setting rates and assured recovery of costs. The Balanced Budget Act (BBA) of 1997 added a new section 1834(1) to the Social Security Act which mandated the implementation of a national fee schedule. This section also required am- bulance providers and suppliers to accept the Medicare allowed charge as payment in full; there was no longer the ability to bill the patient or another insurance provider for the balance of the reasonable charge. The new fee schedule took effect in 2002 and was phased in over a five-year period, with full implementation on January 1, 2006. Year one (4/1/02-12/31/02) provided a blending of 20 per- cent fee schedule and 80 percent reasonable charge. The reasonable charge portion was then re- duced by 20 percent in each of the four subsequent years, so that as of 2006 only the fee schedule amount was payable. 2