Section 5-416 - Emergency ambulance service fees(a) The Mayor, with the approval of the Council by resolution, and after the Council holds a public hearing, may establish from time to time a fee to be charged for transportation services provided by the emergency ambulance service of the Fire and Emergency Medical Services Department ("Department") in such amount as may be reasonable in consideration of the interests of the public and the persons required to pay the fee, and in consideration of the approximate cost of furnishing such services; provided, that no one shall be denied the services because of inability to pay and further provided that no one shall be questioned about ability to pay at the time the services are requested.(b)(1) A health care facility shall reimburse the Department for the cost of emergency ambulance services, as determined under subsection (a) of this section, incurred by a patient resident of the health care facility if the health care facility requests ambulance transport services from the Department and the patient's healthcare insurance denies payment for the ambulance transport after a determination that the transportation did not meet the medical necessity standard as provided in § 410.40(d) of Title 42 of the Code of Federal Regulations.(2) [Repealed by 2021 Amendment.] (c)(1) There is established as a special fund the Fire and Emergency Medical Services Department EMS Reform Fund ("Fund"), which shall be administered by the Fire and Emergency Medical Services Department in accordance with paragraph (3) of this subsection.(2) Non-Medicaid revenue generated by fees authorized in subsection (a) of this section and section 3(a)(2) of the Access to Emergency Medical Services Act of 1998, effective September 11, 1998 (D.C. Law 12-145; D.C. Official Code § 31-2802(a)(2) ) ("Medical Services Act"), in excess of the amount of Medicaid and non-Medicaid revenue generated by fees authorized in subsection (a) of this section and section 3(a)(2) of the Medical Services Act, in Fiscal Year 2016, shall be deposited in the Fund.(3) The Fund shall be used for the purpose of reform and improvement of the delivery of emergency medical services in the District of Columbia.(4)(A) The money deposited into the Fund shall not revert to the unrestricted fund balance of the General Fund of the District of Columbia at the end of a fiscal year, or at any other time.(B) Subject to authorization in an approved budget and financial plan, any funds appropriated into the Fund shall be continually available without regard to fiscal year limitation.(d) Fees charged for pre-hospital medical care and transport services shall be set as follows:(1) For the transportation of each patient in an advanced life support unit or basic life support unit, when advanced life support or basic life support, respectively, is administered to the patient being transported, no more than: (A) $750, beginning January 1, 2021;(B) $1,000, beginning January 1, 2022;(C) $1,250, beginning January 1, 2023;(D) $1,500, beginning January 1, 2024;(E) $1,750, beginning January 1, 2025; and(F) $2,000, beginning January 1, 2026; and(2) For each patient transported as described in paragraph (1) of this subsection, an additional fee for each mile, or fraction thereof, that the patient is transported by ambulance, no more than: (A) $11.25, beginning January 1, 2021;(B) $15, beginning January 1, 2022;(C) $18.75, beginning January 1, 2023;(D) $22.50, beginning January 1, 2024;(E) $26.25, beginning January 1, 2025; and(F) $30, beginning January 1, 2026.(e) For the purposes of this section, the term: (1) "Advanced life support unit" means an ambulance staffed by an emergency medical technician and an emergency medical technician intermediate or paramedic.(2) "Ambulance" means any privately or publicly owned vehicle specially designed, constructed, modified, or equipped for use as a means for transporting patients in a medical emergency, or any privately or publicly owned vehicle that is advertised, marked, or in any way held out as a vehicle for the transportation of patients in a medical emergency. The term "ambulance" includes vehicles capable of operation over ground, on water, and in air.(3) "Basic life support unit" means an ambulance staffed by 2 emergency medical technicians, or an emergency medical technician and an emergency medical technician intermediate or paramedic.(4) "Health care facility" shall have the same meaning as provided in section 2(5) of the Nurse Staffing Agency Act of 2003, effective March 10, 2004 (D.C. Law 15-74; D.C. Official Code § 44-1051.02(5) ).Amended by D.C. Law 24-45,§ III-A-3002, 68 DCR 010163, eff. 11/13/2021.Apr. 19, 1977, D.C. Law 1-124, § 502, 23 DCR 8749; Apr. 15, 2008, D.C. Law 17-147, § 4, 55 DCR 2558; May 26, 2011, D.C. Law 18-373, § 2, 58 DCR 613; Dec. 13, 2017, D.C. Law 22-33, § 3023, 64 DCR 7652.Section 3006 of D.C. Law 17-219 provided: "The Mayor shall explore all reasonable options for billing Medicaid and Medicare for costs of ambulance services. If the Mayor cannot raise $3.5 million from Medicaid and Medicare billing, the Mayor shall issue rules pursuant to section 502 of the Revenue Act for Fiscal Year 1978, effective April 19, 1977 (D.C. Law 1-124; D.C. Official Code § 5-416 ), effective October 1, 2008, to increase ambulance fees to an amount sufficient to raise up to $3.5 million in revenue in fiscal year 2009 and fiscal year 2010. The rules shall be submitted to the Council not later than September 15, 2008."
Applicability
Section 3024 of D.C. Law 22-33 provided that the amendments made to this section by section 3023 of D.C. Law 22-33 shall apply to all health benefit plans issued or renewed in the District 90 or more days after December 13, 2017.