[HISTORY: Adopted by the Township Board of the Township of Denton as indicated in article histories. Amendments noted where applicable.]
This article is adopted on Change Request (CR) 6880 which updates billing instructions and claim processing requirements to fully implement the policy for Medicare beneficiaries in state and local custody that was outlined in CR 6544. Change Request 6880 rescinds and fully replaces CR 6544 and revises the Medicare Claims Processing Manual, Chapter 1, Section 10.4, and the Medicare Benefit Policy Manual, Chapter 17, Section 50.3.3(3).
Any person held in custody, confined, or incarcerated, including but not limited to, individuals who are under arrest, incarcerated, imprisoned, escaped from confinement, under supervised release, on medical furlough, required to reside in mental health facilities, required to reside in halfway houses, required to live under home detention, or confined completely or partially in any way under a penal statue or rule, shall be solely responsible for the payment of any medical services rendered to, and received by, that person during the course of his or her confinement, including, without limitations, transportation to and from a medical treatment facility, and any treatment deemed necessary by his or her treating physician, whether or not requested by the prisoner, and shall be required to reimburse the Township, in full, for any fees or charges incurred for such services, if not paid directly to the medical facility or practitioner by the prisoners' insurance carrier. (Note: The Centers for Medicare and Medicaid Services maintain a file of incarcerated beneficiaries, obtained from the Social Security Administration, that is used to edit the claims.)
The fee to be assessed to and paid by any person utilizing the emergency services of Denton Township for the purposes of treating and/or transporting that person to a facility for emergency medical treatment shall be as designated by the current fee schedule being used by Denton Township.
Nothing in this article hereby adopted shall be construed to affect any suit or proceeding pending in any court, or any rights acquired, or liability incurred, or any cause of action acquired or existing, under any act or ordinance herby repealed, nor shall any just or legal right or remedy of any character be lost, impaired or affected by this article.
Should any word, sentence, phrase or any portion of this article be held in a manner invalid by any court of competent jurisdiction or by any state agency having authority to do so for any reason whatsoever, such holdings shall be construed and limited to such word, sentence, phrase to any portion of this article held to be invalid and shall not be construed as affecting the validity of any remaining words, sentences, phrases or portions of this article. Any portion of this article held to be so invalid shall not be construed as affecting the validity of any of the remaining words, sentences, phrases or portions of this article.
All prior existing ordinances adopted by the Township of Denton inconsistent or in conflict with the provisions of this article are, to the extent of such conflict or inconsistency, hereby expressly repealed.
As only the transporting agency is eligible to receive insurance reimbursement, Denton Township ALS Intercept services are not applicable to this article and shall be excluded. ALS Intercept fees shall be billed directly to the BLS transporting agency as per current ALS Intercept agreements.