City should collect more revenue from LAFD 911 callers, audit says

The Los Angeles Fire Department should change the way it bills people who call 911 for medical help, according to an audit released Tuesday.

The 97-page report, issued by City Controller Ron Galperin, urges fire officials to develop new ways to recover millions of dollars spent each year to provide medical rescues.

Currently the city only charges 911 callers who are transported to a hospital, and the vast majority of those fees go uncollected. This is partly due to caps on how much the LAFD is allowed to charge government insurance programs that fund healthcare for the poor and the elderly, the report said.

The audit recommends that officials consider changes to billing practices that it says could raise more than $16 million each year, including introducing new fees for 911 callers who are treated but not taken to a hospital. It also encourages the LAFD to begin collecting money for care given to patients newly covered by health insurance plans under President Obama’s healthcare system overhaul.

“We are looking over the horizon at a much broader base of patients with access to health insurance,” Galperin said in a statement. “The extra money we can generate will allow us to enhance services and care.”

Marc Eckstein, an emergency room physician and the LAFD’s medical director, said he would welcome changes to decrease the financial incentive to drive 911 callers to hospitals when they can sometimes be better treated at the scene.

But improving the system will require numerous changes in regulations at the federal, state and city level, Eckstein said.

“It’s not as simple as it sounds,” he said.

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