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Mehlville Fire District won't change ambulance fees


By KAREN CALLANAN

For the Call

Until Mehlville Fire Protection District receives complaints about fees for mutual aid ambulance service, the district has no plans to change its policies.

Neighboring fire districts recently notified Mehlville of their plan to charge Mehlville residents for services when they respond to mutual aid calls inside the 57-square-mile south county fire district. The fees would be for patient transportation.

Recently, questions were raised about how Mehlville would address fees chargedto Mehlville residents by neighboring districts which respond to mutual aid calls here. Mehlville waives charges to its residents. Non-residents' insurance carriers are charged for Mehlville's service when Mehlville's ambulances respond to mutual aid calls.

In order to avoid charges to local taxpayers for services their taxes were already supposed to provide neighboring districts examined two potential solutions. First, it suggested that fire districts reimburse each other for the mutual aid charges. Second, some thought residents should be reimbursed for mutual aid charges.

Mehlville's attorney, John Hessel of Lewis, Rice and Fingersh Apr. 7 said both solutions were imperfect.

"I suspected when it was presented to me that this was sort of a simple issue that could be addressed relatively easily,'' Hessel said. "I want to first report back to you that this is not a simple issue.

"It directly involves the Anti-Kick-Back Statute, which I think you recall that we spent some time talking about when the district adopted its policy to waive or forgive those portions of the fee equal to the deductible amount of any of our residents," Hessel said.

He explained that because of the risks involved, the district had relied heavily on a detailed opinion from the Office of the Inspector General in adopting the ambulance billing policy. The opinion, he said, emphasized the severe penalties associated with violations of the Anti-Kick-Back Statute.

"When you get lawyers writing opinions that involve this amount of risk, they're going to come up with all sorts of qualifications and caveats, " Hessel said.

"According to the Office of the Inspector General, there is a very significant issue about waiving fees for people who are not your residents, and there is a very significant issue relating to a mutual aid agreement, and I would have to tell you that in my opinion, I would advise against doing that, unless you want me to spend considerably more time taking a look at it to determine if it is something that's even doable."

Hessel continued by addressing the issue of reimbursing taxpayers who receive outside services.

"They note that it's limited to governmental units, so we are exempt under that process. And it does mention that 'a municipality can pay a co-insurance owed, or otherwise make provisions for payment of such co-insurance under certain circumstances.'"

He said he had not researched the issue in great detail, but he thought it was "a more likely possibility than the mutual aid agreement."

Assistant Chief Phil Minnella said that from Jan. 1, 2002 to March 20, 2003 Mehlville received 108 mutual aid responses from other districts. In about two-thirds of those calls, patients were transported somewhere and perhaps charged by assisting districts.

On Apr. 7 Minnella told the board those incidents were "fairly low," and that most residents who called the district regarding the ambulance billing simply wanted to share insurance information.

Secretary Dan Ottoline, who originally expressed concern that residents were being charged when it was not their fault, then said, "As long as there's no complaints. That's the main thing, I guess. If we get our citizens complaining, then we got a problem. But if they're not complaining, let's not look for trouble."

Chairman Tom O'Driscoll then said, "So we leave it.''

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