[HISTORY: Adopted by the Township Committee of the Township of Middle 4-5-2004 by Ord. No. 1148-04. Amendments noted where applicable.]
The Township of Middle provides full-time professional emergency medical services (EMS) to citizens and visitors to the Township of Middle on a twenty-four-hours-per-day basis throughout the year to the extent that services are available. EMS services are provided by employees of the Township of Middle, Department of Public Safety. Dispatching and other support services for the EMS are provided by employees of the Township of Middle, Department of Public Safety, Division of Police.
In addition to the full-time professional emergency medical services as provided in § 131-1, the Township of Middle may provide secondary nonemergency transport based on the criteria established by the Department of Public Safety.
All persons needing EMS who are located within the Township of Middle shall be serviced to the extent that services are available without discrimination on any basis and without respect to residency, ability to pay, or any other factor. No person located within the Township of Middle at the time emergency services are needed shall be denied available service, when such services are available. There shall be no delay in providing available service due to EMS cost-recovery procedures.
The costs of providing available service due to EMS shall be paid by a combination of insurance payments for service to persons who have insurance coverage; direct payments from persons served for amounts not covered by insurance; revenues from service agreements with persons, agencies, and jurisdictions that rely on EMS and local property taxation for residents who certify they do not have insurance coverage or other resources to pay for service.
Personnel of the Division of Public Safety shall maintain accurate records of all EMS requests for service, service calls, and services provided on a form approved by the Director of Public Safety. Said records shall include pertinent information about the general nature of the call and shall identify the complete name, mailing address, location and telephone numbers of all persons requesting and receiving EMS services.
[Amended 5-4-2009 by Ord. No. 1321-09; 5-17-2010 by Ord. No. 1357-10; 4-4-2011 by Ord. No. 1377-11; 10-1-2012 by Ord. No. 1426-12]
The Township of Middle shall contract with a third-party billing agent who shall issue a bill in the amount of $850 in each instance where EMS services are provided. Said bill shall be issued to the insurance company providing coverage for the person served, if any, or directly to the person served if insurance coverage is not available.
[Amended 6-15-2015 by Ord. No. 1504-15]
In addition to the amount billed pursuant to Subsection A above, the third-party billing agent shall also bill for load miles. Load miles are those miles traveled by an EMS vehicle from the location where the patient was initially transported to the end destination. Load miles shall be billed at $10 per load mile.
Any resident patient whose insurance denies payment due to injury and/or illness diagnosis will be billed the current Medicare allowed emergency ground transport rate, including mileage and any supplies used. Nonresidents will be billed the full charges, including mileage and supplies.
Resident and nonresident patients who decline transport or request a lift-assist will be charged $100 per occurrence.
Persons receiving bills for EMS services shall make payment in full to the Chief Financial Officer of the Township of Middle, or her designee, within 30 days, or provide proof that they have submitted a claim to their insurance carrier for payment within 30 days of receipt of the bill. These provisions shall be subject to the following:
Persons receiving EMS service who have health insurance to cover ambulance and emergency medical services are expected to cooperate with the Chief Financial Officer, or her designee, and other personnel as designated by the Township of Middle to secure full payment for services rendered.
In the event the health insurance company of a taxpayer or full-time resident of the Township of Middle does not pay the bill in full, the Township will accept such partial payment to the extent of the insured's policy limits, including deductible and co-insurance requirements, as payment in full.
In the event a taxpayer or year-around resident of the Township of Middle does not have health insurance, payment in full shall be required; except that, upon submission of proof in accordance with the rules and regulations established concerning the inability to pay the full charge, a minimum payment in the amount not less than the current and customary Medicare payment for emergency medical services shall be accepted.
Due to time requirements for the preparation and processing of insurance claims, interest shall not be charged on EMS billings.
The Chief Financial Officer, or her designee, shall be responsible for receipt of all payments and the communication to the third-party billing agent for payments received. The third-party billing agent shall be responsible for accounting of payments and providing the Township with a current billing and receivable ledger. The third-party billing agent is responsible for the initial billing and two followup billings. Costs associated with the third-party billing agent shall be based solely on a percent of cash collections. After three attempts to collect said claim, the third-party billing agent shall notify the Township and relinquish rights to that billing. The Township of Middle or third-party billing agent shall turn said delinquent accounts to a collection agency that will be compensated on a percent of cash collections of the delinquent accounts. The Township of Middle reserves the right to determine that a bill is uncollectable and written off.
[Amended 10-1-2012 by Ord. No. 1426-12]
For the purpose of emergency medical services charges, the following definitions shall apply:
- DECLINED TRANSPORT/REFUSAL OF CARE
- When an ambulance is requested and patient contact is made
with an individual and that individual declines or refuses transport
to a medical facility, including but not limited to treat and release,
lift assist, etc.[Added 10-1-2012 by Ord. No. 1426-12]
- A. Any individual who is the spouse or unmarried child (natural, adopted or stepchild) under the age of 19 years of a "taxpayer" or "year-round resident," as defined in this section;
- B. Any unmarried child under the age of 19 years for whom the taxpayer or year around resident has been appointed legal guardian;
- C. Any individual who resides in the permanent domicile of the taxpayer or year-around resident and is claimed as a dependent for federal income tax purposes; or
- D. Any individual who resides in the permanent domicile of the taxpayer or year-around resident and who is deemed to be a dependent under the health insurance policy of the taxpayer or year-around resident.
- Any individual that does not reside within the municipal
boundaries or meet the verification of residency of a year-round resident
shall be deemed a nonresident.[Added 10-1-2012 by Ord. No. 1426-12]
- Any individual listed on the deed of ownership of any property located within the municipal boundaries of the Township of Middle and their "dependents," as defined in this section. In the case of a corporation or partnership, only those individuals retaining a twenty-five-percent or greater ownership shall be considered a taxpayer. For the purpose of determining a twenty-five-percent or greater ownership, adult married husband and wife may combine their ownership.
- YEAR-AROUND RESIDENT
- Any individual residing within the municipal boundaries of the Township of Middle for a period of at least six months during the year prior to EMS service. Verification of residency shall be based on voter registration, or a state of New Jersey driver's license, or proof of filing a State of New Jersey income tax return from a Township of Middle address. A "dependent," as defined in this section, shall be considered a "taxpayer."
The Township of Middle is authorized to adopt, by resolution, rules and regulations to implement the emergency medical services provisions of this chapter, including but not limited to the criteria by which eligibility to pay is determined. On matters not addressed by provisions of this chapter or specific regulations and implementation decisions by resolution of the Township of Middle, the Director of the Department of Revenue and Finance (as to the billing and collection aspect) are authorized to establish and follow administrative rules and regulations for the effective administration of this chapter.