Let fire departments charge for EMS services

New York's fire departments should have the right to charge the insurance providers of patients who use ambulances from their EMS services. Everyone else who offers this crucial and complex service can, and generally does, charge for it, from police departments to for-profit and nonprofit ambulance companies.

Year after year, State Sen. John Brooks (D-Seaford) has unsuccessfully led the charge to get the law changed, but this year could be different. Brooks, an active volunteer firefighter, says the increased pressure and expense of providing ambulance services, particularly during the COVID-19 pandemic, is burning the mostly volunteer fire departments on Long Island and upstate.

Brooks' bill — passed in the Senate, 61-2, earlier this month — would let all Long Island fire departments bill Medicare, Medicaid and private health insurance carriers for ambulance services, but it would ban billing any uninsured patients for the service. The new revenue would allow many departments to expand staffing, including adding round-the-clock professional paramedics, and buy and maintain needed equipment. It would mean the cost of providing ambulances won't eat into money meant for fire protection.

Opposition to the plan comes mostly from private for-profit ambulance services, who argue that fees for ambulance services, added to the property tax revenue of local departments, give the fire departments an unfair advantage. Since when does a private business have a right to narrow municipal services because they may be competitors?

The change actually could be a boon for for-profit services. New Yorkers who call 911 for an ambulance get whatever qualified crew is closest, meaning the patient has no idea whether the service they receive will be free or cost as much as $1,200. Because of that, savvy residents often call fire departments directly for a free ambulance. Allowing fire departments to charge could send such callers straight to 911, increasing business for the for-profit companies.

Letting the fire departments charge is a slam dunk, but the details have to be right, too. Departments suddenly flush from new revenue can’t go on unnecessary shopping sprees, and if the ambulances are really lucrative, property taxes in fire districts ought to go down as a result. Fire departments also might consider keeping fees lower than the national averages: What insurance companies pay for ambulances still costs taxpayers, when the insurance rates rise. And the billing may be tricky: What to do, for instance, about a resident who has health insurance, but with a deductible so high they’d still have to pay themselves? The bill doesn’t address this.

A change like this ought to be monitored by the state comptroller’s office from the outset, to assure sensible spending, fair billing and tax cuts where proper.

But locally funded, largely volunteer, community fire departments can’t go on being the only ambulance providers in the state unable to charge insurance companies for their lifesaving services.