[HISTORY: Adopted by the Township Committee of the Township of Union as indicated in article histories. Amendments noted where applicable.]
Article I Third-Party Payment Plan
[Adopted 7-27-2004 by Ord. No. 4828]
The New Jersey State Department of Health has issued licensure for the Union Township Fire Department's Emergency Medical Services (the "program") administered by the Township of Union.
The program has been in operation providing experience and statistics regarding the service and the patients served.
The Department is applying for a provider number for the Federal and State Medicare/Medicaid Programs, enabling the municipality to institute third-party payment plan (the "payment plan").
Most residents have health insurance plan or Medicare/Medicaid, which provides payments to relieve their payment obligations.
The Township shall not balance bill the deductibles and co-pays for the Union Township residents, including those covered by Medicaid/Medicare, nor bill those Union residents for payment obligations without insurance coverage. Mutual aid partners residents will be treated in accordance with established policy of reciprocal agreement.
It is in the best interest of the taxpayers of the municipality to establish the third-party payment plan in accordance with the Health Care Finance Administration guidelines ("HCFA") so that taxpayers will not be responsible for any out-of-pocket expenses.
The Chief of the Department of Fire (the "Chief") and the Business Administrator or his/her designee of the municipality (the "B/A") in consultation with the municipality's EMS Program Consultant will be responsible for the plan's billing.
The fee service is initially set as $500 base rate, plus $7.50 per mile trip; nontransports where aid is provided: $250.
The CFO and the B/A shall annually review the plan's cost accounting records. The B/A shall obtain an industry average.
The Township of Union is authorized to enter into contracts with various hospitals that provide (ALS) services to the patients that are transported by Union Township Fire Department Emergency Medical Services allowing the hospitals to bundle bill Medicare for services rendered. The hospital will reimburse the municipality for its transportation costs within 30 days of receiving payment.
The Township may contract with the volunteer first aid squads to provide third-party billing as established in this article should that be necessary.
The B/A shall annually, no later than March 1, adjust the fee for services as set forth in § 260-3 herein pursuant to the recommendation of the Chief of the EMS Program Consultants.
A certified copy of this article shall be filed with the applicable federal and/or state agencies.