Officials: Shelton's proposed paramedic service takeover should help seniors worried about 911 costs

Echo Hose Ambulance recently replaced a 2009 Ford Van ambulance with a 2019 Mercedes 4x4 Sprinter, costing $111,000, pictured above.

Echo Hose Ambulance recently replaced a 2009 Ford Van ambulance with a 2019 Mercedes 4x4 Sprinter, costing $111,000, pictured above.

Echo Hose Ambulance / Contributed photo

SHELTON — Echo Hose Ambulance’s agreement with Valley Emergency Medical Services will stem what city officials called a growing health emergency spurred by the cost of a paramedic.

“The city was concerned that our residents who were covered by Medicare were not calling 911 for medical emergencies or refusing the paramedic service due to the (separate paramedic) bill,” said Mayor Mark Lauretti. “The agreement will stop the second bill that a medicare recipient would receive and was not covered by insurance.”

Echo Hose Ambulance and VEMS late last week reached an agreement making Echo Hose the primary paramedic service for the city beginning in January 2022. The deal also allows for bundle billing, meaning individuals who require ambulance transport and a paramedic will no longer receive two bills.

Before the agreement was in place, city officials said, patients would receive a bill from Echo Hose for ambulance transport then another bill from VEMS — between $800 and $900 — for the paramedic service. Those who felt the budgetary impact the most were senior citizens on Medicare, officials said.

The result, according to Lauretti, was residents covered by Medicare choosing not to call 911 when in medical distress to avoid the paramedic bill from VEMS.

Emergency Management Director Michael Maglione said the city has no specific numbers on how many of the city’s Medicare patients — mainly senior citizens — had complained about the paramedic bill.

Anecdotally, Maglione said he knew of people who chose to drive to an UrgentCare instead of calling 911, others who would call the ambulance but refuse paramedic service and others still who told him they simply refused to call for fear of receiving a bill they could not pay.

“We were concerned that a health emergency was being created through people refusing the service,” Maglione said.

VEMS Board President Jared Heon said the issue of residents being concerned about not calling for an ambulance due to a paramedic bill was also not addressed with VEMS at any meeting by the City or Echo representative.

“VEMS would like to be clear that anyone using the service should do so with out reservation of financial strain,” Heon said. “We are dedicated to serving all citizens and work with our patients daily to forgive or implement a payment plan that is acceptable to both the patient and VEMS. Any request for forgiveness on a bill that has been received has always been granted when presented with a hardship.”

Lauretti said he would receive dozens of complaint calls each year about the paramedic billing, and resolving the matter was the “driving force” behind the move.

“Senior citizens have a lot of pride ... they want to pay their bills and be financially independent,” Lauretti said, adding that the second bill was too much of a burden for many to handle.

Heon said three of the Valley towns have bundle billing agreements in place where the town or city would make the difference up out of their regular fiscal budget.

“This was the case as well in Shelton until 2012 when the bundle billing agreement was terminated at the request of the city,” Heon said. “At this point, conventional billing practices resumed, which VEMS is bound to by (state) regulations and the CMS program.”

Heon said Echo Hose Ambulance contacted VEMS earlier this year to work on a solution to eliminate conventional billing. He added that VEMS, the city and Echo Hose Ambulance worked together to reach the bundle billing agreement that begins this month.

“Much to Mayor Lauretti’s credit, he has kept the needs of the rest of the Valley in mind and hosted numerous meetings with Valley officials to discuss this issue,” Heon said. “This effort has led to the cooperative agreement, essentially a bundle billing agreement, to rid the paramedic bill from Shelton residents on Medicare.

“Though this is for a period of 12 to 18 months,” Heon added, “it is the hope of the VEMS Board that a permanent solution can be found Valley wide and Shelton may reconsider once this is resolved to remain as part of the VEMS program.”

While a deal with VEMS has been reached, Echo Hose Ambulance still needs state Department of Public Health approval before it could assume the primary paramedic role.

Maglione and Echo Hose Assistant Chief Joe Laucella testified before a DPH hearing Thursday as the city moves to obtain the necessary license to provide primary paramedic services. The city would then shift that duty to Echo Hose, they said.

Maglione said Echo Hose offering the paramedic service would “eliminate the financial strain on residents.”

Residents have been faced with collection actions from VEMS trying to collect payment for paramedic services. Board of Aldermen President John Anglace Jr. said VEMS had nearly 40 liens on Shelton properties to collect past fees, which prompted the city in July to file a petition with the state DPH seeking approval to shift paramedic service from VEMS to Echo Hose.

Heon said VEMS does not aggressively collect on bills except in situations where a patient was paid by an insurance company directly and in turn chose not to pay their paramedic bill. He also said a previous vendor “who did not have permission to place liens had, in fact, done so.”

“The administration at VEMS is now working with our legal counsel to release all liens,” Heon added. “The company providing this service was replaced in 2018. The Board of Directors adamantly objects to any liens being placed on a patient’s property. This is currently being addressed and will be fixed immediately at no cost to our patients.”

The agreement creates a bundle billing deal so patients receive only one bill, which would be covered — all but the deductible — for those on Medicare. The deal states that the bundle billing will begin Feb. 26, 2021.

“The bottom line is a large expense for Medicare patients goes away,” Maglione said.

As part of the agreement, VEMS would receive $1,750 from Echo Hose each month until January as VEMS transitions its business operation covering the Valley without Shelton in the mix. The agreement gives VEMS the option to extend the bundle billing portion of the deal for an additional six months to June 30, 2022.