Meeting Summary
The city council meeting primarily addressed recent controversies surrounding EMSA's billing practices, including the necessity of billing third-party payers, the 60-day deadline for insurance information, and the filing of liens in accident cases. Staff provided clarification on these procedures, while council members raised concerns about communication, fairness to subscribers, and the scope of potential billing errors amidst a pending class-action lawsuit.
Financial Matters
EMSA Revenue and Billing Model
Explanation of how EMSA augments costs not covered by Medicare/Medicaid by billing third-party payers to meet budgetary needs and keep the utility fee low. It was noted that $5,729,000 was handled through the utility program in 2011, benefiting 11,164 individuals, with 3,700 having no insurance.
60-Day Insurance Information Requirement
Discussion on the policy requiring insurance information within 60 days, which was a staff-level change to ensure timely filing with insurance companies and avoid claim denials. This policy was not approved by the board.
Liens on Automobile Accident Proceeds
Clarification on EMSA's practice of filing liens on proceeds from automobile accidents, similar to hospitals and physicians, to recover costs from third-party insurance. It was emphasized that this does not affect credit ratings or property sales, and subscribers are not responsible for out-of-pocket expenses.
Coming Up
Watch For
- Further discussion on the EMSA lawsuit specifics after a response is filed.
- Potential executive session discussion regarding EMSA issues.
Agenda Summary
City Manager Reports - EMSA Billing Issues
A presentation and discussion led by Steve Williamson addressing public concerns and misconceptions regarding EMSA's billing practices, including third-party billing, the 60-day insurance information submission policy, and the use of liens in automobile accident cases. The discussion also covered the financial model supporting the $3.65 utility fee.