By Stephanie Samuel

Sentinel Staff Writer

The Prince George's Count Fire/Emergency Medical Services Department is increasing ambulance fees by more than $200 to pull in more insurance money and add more padding to the county coffers. Department and health advocates differ on whether or not county residents will bear the brunt of the charges.

Starting this month, the Prince George's County Fire/EMS Department is charging those who receive care in an EMS vehicle a hefty amount. In the past, County Fire/EMS Chief Spokesman Mark Brady said $200 to $250 was collected for EMS transport. However after studying other systems, the department is raising the fee.

A person receiving little more than transport to the hospital will be billed $500. However a person with serious injuries requiring onboard medical attention will be billed either $650 or $750, depending on the number of services administered in the ambulance. Brady said treatment for chest pain while in the ambulance would constitute Advanced Life Support 1, costing $650. A case of severe trauma where three or more life-sustaining services must be administered would be considered ALS-2 and cost patients $750.

In addition, the county will add a fee of $5 per loaded transport mile from pick up to the hospital. County Fire/EMS officials say that the fees are meant to make the most of health insurance benefits.

"It's monies that are made available by insurance companies," said Brady. Many insurance companies have a clause written into its plans to pay for medical transport, Brady says. Once they receive the money, Brady says, it will go to the county's general fund.

The money may prove to be a much-needed boost to the county government. Despite advancements in the county bond rating, it has been struggling to cope with a fallen housing market. Foreclosures led to a $121. 6 million budgetary shortfall earlier this year. Since then county has tried to close the gap by freezing hiring in the county government and increase property assessment and recordation fees. The increases alone are set to bring $11.9 million in county revenues. The hike in EMS ambulance fees will likely add on another $2 million to $6 million a year, Brady says.

Brady said that the Fire/EMS Department collaborated with several other county agencies to decide on the increase but did not consider the county's debt in its decision.

"I don't think one has to do with the other," he said. Brady said the department expects to benefit come budget time.

Matthew Weinstein, Baltimore director of Progressive Maryland and spokesman for the state campaign Health Care for America Now said of the fee, "It's another example of how people from are paying more and more for health care." Fire officials noted that the fees are covered in full by health insurance, Medicare and Medicaid. However, statistics gathered by Progressive Maryland in 2007 showed that 10 percent of all Marylanders are uninsured. Likewise, the Prince George's County Health Department 2003 statistics showed that over 9 percent of county residents are uninsured.

University of Maryland professor Darrell Gaskin, who studies health care disparities in African Americans, said, "[Whether or not the fee] has a negative impart on the uninsured depends on how aggressively they [the department's collection agency] go after the uninsured."

Brady says, "The fee is not in place to charge individuals" and that residents with proof they cannot afford the fee will be given a break. Additionally, if an insurance carrier chooses to pay only part of the fee, he says the department will still consider the bill "paid in full."

However, without proof, there are two other choices: pay the fee off immediately or pay it in portions. Brady says it does not know what kind of proof must be shown.

Weinstein also contends that even if insurance companies provide coverage for the fee, the increase may eventually lead to an increase in insurance premiums.

Still, Gaskin says, in the end, the fee makes fiscal sense.

"To not charge a fee leaves a lot of money on the table."

Contact Stephanie Samuel at

ssamuel@thesentinel.com