MedCorp pans $500 cap for ambulance transports

7/8/2004

Lucas County commissioners have capped the prices private ambulance companies charge for routine transports at $500 in response to patient complaints about wide variations in bills.

MedCorp, the county's largest private ambulance company, is against the restriction, saying it will hurt patient care because MedCorp will have to limit its service to comply.

But Ali Talb is all for a cap.

About a month ago, he and his wife, Maiza, were in an auto accident at Secor and Laskey roads. The Toledo couple reported sore backs and necks, and were taken by different ambulance companies to Toledo Hospital.

Mr. Talb said when they got their bills, he nearly fell off his chair. His bill was $488, which he figured was reasonable, but his wife was charged $1,011.

"This is outrageous," he said.

"It's way out of line."

Dennis Cole thinks so too. Mr. Cole, Lucas County EMS director, said because the county acts as the dispatcher, it has an obligation to make sure patients' bills don't vary widely. When there's a "large disparity between companies, it feels wrong," he said.

For serious injuries, patients often are transported by one of the county's 10 life squads, which provide paramedics trained in advanced life support at no cost to patients. Those runs are usually classified as "advanced" life support transports.

But three private ambulance companies under contract with the county often are designated to perform many transports because county officials say most transports require only cheaper care often provided by emergency medical technicians. These runs are classified as "basic" life support runs. Last year, the county dispatched 16,686 such runs by private ambulances.

The private companies are MedCorp, Rumpf Ambulance, and Life Star, which is owned by Mercy Health Partners. ProMedica Health System soon will begin to send some of its ambulances to accident scenes. They bill insurance, government programs, and/or the patient to recover their costs.

County commissioners last week unanimously approved the $500 cap for routine transports as well as a maximum of $9 per mile charge for those transports.

Mr. Cole wrotes to the companies Tuesday and gave them until the end of the month to respond. As of yesterday, all but MedCorp had agreed to the cap.

Richard Bage, president of MedCorp, said he's "shocked and surprised" by the cap. He said limiting what companies can charge would hurt them financially, and hurt patient care because companies would have to reduce care to save money.

He said MedCorp officials plan to meet with the county in hopes of changing the cap.

Mr. Cole said a last-resort option open to the county would be to stop using any company that won't comply with the cap.

If MedCorp dropped out, it could have a large impact. It's by far the largest private ambulance company, with about 25 ambulances and nine stations.

Life Star has 16 ambulances in the county and nine stations with another one to open soon. Rumpf has six ambulances and four stations.

Mr. Bage said MedCorp classifies up to 80 percent of its county-arranged runs advanced runs because patients' conditions frequently get worse during transport, or his crews determine upon arrival that despite what county dispatchers feel, a patient needs advanced care.

Jeff Kish, owner of Rumpf, disputed that, saying less than 2 percent of his county-arranged runs are severe enough to be considered advanced.

Mr. Cole and his colleagues last year began investigating the rates charged by the companies. In a February letter to commissioners, he said in many cases MedCorp had "questionable ethical issues" when it came to billing, though nothing illegal.

Mr. Cole said it appeared MedCorp would often upgrade the classification of its county-arranged transports to advanced instead of basic, thus inflating the cost for patients.

The county's cap would not allow any company to upgrade a run to advanced, Mr. Cole said.

Mr. Bage has denied MedCorp has done anything wrong. He said all his ambulances have paramedics on board and provide a higher level of care.

Contact Luke Shockman at:

lshockman@theblade.com

or 419-724-6084.