Medical Reimbursement Sought by Firefighters

California’s firefighter associations have been busy at the Capitol this session lobbying on behalf of legislation that would give them a cut of the more than $1-billion business of attending to medical emergencies.

As they’ve explained to lawmakers, more than 80% of the state’s fire departments provide emergency medical care. And two-thirds of all calls to local fire departments involve medical situations--not fires. The bill (AB 452), sponsored by the California Professional Firefighters (https://www.cpf.org), is by Assemblyman Scott Wildman (D-Los Angeles). The measure would allow local fire stations to enter into contractual arrangements with private ambulance companies to bill those who receive emergency medical treatment from taxpayer-funded fire crews and paramedics.

The purpose of the bill is twofold: to let local fire stations, whose crews usually are the first to arrive at a medical emergency, recoup the costs of training staff and providing emergency treatment, and to prevent private ambulance firms from fraudulently charging for services they don’t perform.

Nothing prohibits fire stations from billing now, but the overwhelming majority lack the infrastructure to mail invoices and work with collection agencies on delinquent debts. Most simply absorb the expense, regarding it as just part of the job.

The bill has encountered some opposition from health insurers who fear passage would be the first step toward requiring them to reimburse consumers billed for emergency medical services by fire crews or paramedics.

Last year, Gov. Pete Wilson vetoed legislation widely opposed by health insurers that would have required health plans to reimburse fire departments and private ambulance firms for all on-scene emergency-care costs. Health plans typically cover ambulance trips to the hospital but rarely pay for initial emergency care administered before the ambulance arrives.

AB 452 also is being contested by the state Department of Health Services and the Department of Corporations because of concerns that health plans would end up paying for the costs billed by the firefighters.

The bill’s supporters, including the Anaheim Firefighters Political Action Committee and Glendale and Pasadena firefighters associations, say the bill simply provides a mechanism for fire departments to be reimbursed without mandating that HMOs pay for the services.

AB 452 cleared the Assembly in May and passed the Senate this week. Some minor changes to the bill must be agreed upon by the Legislature before it moves next to the governor’s desk.

Hot Bills

* Breast Cancer Treatment

Bottom line: Would let breast cancer patients seek independent review if doctors recommend, but health plans deny coverage of, a treatment known as autologous bone marrow transplant. Currently, patients denied the procedure will not be able to petition for review under a new state law slated to take effect next year because the breast cancer treatment, which costs from $80,000 to $100,000, does not qualify as experimental medicine.

Chances: The bill is opposed by health maintenance organizations and the state Department of Corporations. It has passed the Assembly, and it cleared its first test in the Senate this week.

Next step: Senate floor vote as early as Monday.

Details: AB 760 author Carole Migden (D-San Francisco) can be reached at (916) 445-8077 or by e-mail at carole.migden@assembly.ca.gov

* Public Utilities Bonds

Bottom line: This bill guarantees the highest rating possible for $7 billion to $9 billion worth of public bonds about to be issued on behalf of the state’s three major electric utilities. As part of the deal cut last year to speed industry deregulation, the bonds help pay off the utilities’ debts and fund a 10% rate cut for consumers.

Chances: Consumers Union and Ralph Nader began a last-ditch campaign to halt the bill within the last two weeks, calling it a bailout of the utilities with a token rate cut for consumers. They have created a ripple of anxiety among freshmen Assembly members unsure about supporting something that could evolve into a major consumer-advocacy battle. The bill is expected to win passage nonetheless.

Next step: Assembly floor vote.

Details: SB 477 author Sen. Steve Peace (D-El Cajon) can be reached at (916) 445-6767 or e-mailed at senator.peace@sen.ca.gov

--Capitol Alert News Service

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