Legislation signed by Gov. Kathy Hochul last week expands what ambulance services can charge for, and recoup, from patients. The law, which was widely supported in both the New York State Assembly and Senate, allows for Medicaid reimbursement for treatment in place and for transportation to “alternative health care settings,” such as an Urgent Care clinic, and is effective Oct. 1. Previously, ambulance services could only be reimbursed for transporting patients to a hospital.
In 2022, the state passed a law allowing fire departments that run ambulance services to bill patients. The law sunsets in 2026, meaning that if the Legislature doesn’t act to extend it, billing after that time will no longer be allowed. No fire department on the East End has ever billed patients, and the new tweak to the law doesn’t seem to be influencing any to change that policy.
“The Bridgehampton Fire District does not bill for ambulance services and at this time we have no intention in doing so,” came a statement from its board of commissioners.
“I think some departments figured, ‘We’re not going to start doing this if it runs out in a couple of years,’ “ said Assemblyman Fred. W. Thiele Jr., who voted for the new law. “Some fire departments have taken advantage, but others haven’t.”
Here, the Amagansett, Montauk, Springs, and Bridgehampton Fire Departments run ambulance services in their fire districts. Ambulance service in East Hampton Village has been run by the Department of Emergency Medical Service since May 2023. The village ambulance also services the Northwest Fire Protection District, an area extending from Cedar Point in the north to Route 114 in the west and over to Three Mile Harbor in the east, and the East Hampton Water Supply Area, a smaller area mainly extending to the west and north of the village. For the prior 50 years, it was run by the East Hampton Village Ambulance Association, a nonprofit. The village has never charged for ambulance services, and doesn’t plan to start.
“We’re not getting into billing,” said Marcos Baladron, the East Hampton Village administrator. During the years’ long battle between the village and the now-defunct ambulance association, a consistent fear raised by opponents of Mayor Jerry Larsen’s administration and its move to take over ambulance services was that it planned to move to billing. “We’re technically already getting paid. The town pays us $3.8 million a year so their residents in the Northwest can receive ambulance services,” Mr. Baladron said. He pointed out that 70 percent of the calls to the village ambulance originate in the Northwest Fire District. “Those residents pay a tax. It would be double-billing.”
Mr. Baladron conceded that running an ambulance service is an expensive proposition and that every bit of money helps. The village just put a $40,000 down payment on a $414,000 ambulance that won’t be delivered for another three years. “We need that fourth ambulance.”
Brad Pinsky, a lawyer who has worked closely with East Hampton Village as it created the E.M.S. Department, said the law would only be applicable if a fire department already bills, which he says is a common practice across Long Island. “For commercial operators, 100 percent bill. It’s less common but not uncommon for fire departments to bill. It’s not like a department can just start sending bills because of the new law,” he said. Because commercial operators could only bill patients if they drove them to a hospital, in a way, they were encouraged to take them there, even if their patients didn’t need hospital services.
Chris Beckert, the chief of the Amagansett Fire Department, said his department does not bill for services and has no interest in doing so. Further, he said via text, it only transports patients to the emergency room. Neither the Montauk nor the Springs Fire Districts returned requests for comment.
“I don’t think it will have much of an impact on Long Island,” said Assemblyman Thiele. “I heard from E.M.S. services across the state and all of them supported this legislation. There was a package of five or six pieces of legislation designed to help E.M.S. and this was the only one to pass both houses. I think it’s more of an upstate issue.”
