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1. When will the billing for the EMS Transport Reimbursement Program begin?

The billing is not expected to begin until early 2015.

2. Why does Loudoun County seek reimbursement for EMS services?

Seeking reimbursement for EMS transport and medical services associated with emergency care makes financial sense for the combined career and volunteer EMS system. The majority of Loudoun County citizens and visitors have already paid for these benefits through their health insurance premiums or federal taxes.

For those who have private medical insurance, this benefit is a part of their health insurance premium through their employer or workers’ association. For those who are Medicare eligible, they have paid for this benefit through payroll deduction into the Medicare fund.

By seeking reimbursement for EMS transport services, the county’s EMS service providers will be able to recover existing funds for EMS operations, thereby infusing additional revenue into the operational needs of the fire and rescue system, without raising taxes.

3. Will those who can least afford an ambulance bill bear the brunt of an EMS Reimbursement Program?

No. Many retirees have existing healthcare plans or Medicare that pay for ambulance transport. Those citizens who are unemployed, uninsured, or poor are eligible for Medicaid, which provides reimbursement for ambulance transport.

4. Will health care premiums be increased to cover ambulances fee?

No. insurance carriers and Medicare have already built ambulance fees into their premiums. They have already factored the ambulance reimbursement cost into their actuary tables for their plan enrollees.

The cost for ambulance reimbursement transport for many insurance companies is an extremely small percentage of their overall expenditures. The vast majority of expenditures that an insurance company experiences each year are for hospitalization and hospital procedures and operations.

Loudoun residents are paying insurance rates that assume there is a charge for EMS service, but the county is not actually receiving any funds.

5. Will citizens be reluctant to call for an ambulance if they know they will receive a bill?

EMS services are traditionally used by individuals who are having an acute or emergency situation and there is no evidence that an entity's seeking reimbursement for EMS services plays a role in a person's decision to call 911. No one who calls 911 will ever be denied treatment or transport to a hospital because they lack healthcare insurance.

6. What is the revenue sharing model for the new EMS reimbursement program?

• EMS Stations Ownership: 20 percent


• EMS Equipment Ownership: 20 percent


• EMS Staffing: 25 percent


• County-Provided Infrastructure (Dispatch) and Training: 25 percent


• Engine and/or Fire Truck First Responder: 10 percent

7. Do other jurisdictions in Virginia participate in EMS transport reimbursement?

Yes, according to the Virginia Office of Emergency Medical Services, of the 544 Emergency Medical Services (EMS) agencies in Virginia, 341, or 63 percent, participate in EMS transport reimbursement.

8. If 9-1-1 is called by me or on my behalf, and I refuse ambulance transport, will I be subject to reimbursement requirements?

No, the proposed program is only for ambulance transportation. Persons are encouraged to contact 9-1-1 at the earliest thought that they or another person may be in need of emergency medical services. However, certain situations result in treatment only, or the person may simply not desire to be transported by ambulance. In those non-transport cases, there would be no responsibility for reimbursement.

9. What will Loudoun County do with the revenue from the EMS transport reimbursement program?

The intent of the Board of Supervisors is that the program revenue will be used to enhance and support the EMS delivery system in Loudoun County. Funding would be earmarked for the purchase of ambulances and equipment for volunteer and career staffed stations, for purchasing EMS training materials and delivering EMS training classes and for supporting communications technologies needed for effective EMS service delivery.

10. As a supervisor of a facility or of a group of people, am I or my organization responsible for any reimbursement if I call 9-1-1 for someone in my charge?

No. Only the person for whom 9-1-1 is called would have this responsibility. 9-1-1 should be contacted at the earliest point when someone may need emergency medical services. Teachers, coaches, facility managers and the like should not hesitate to call 9-1-1 when they think emergency medical services are needed.

11. How did Loudoun County establish the fees for EMS transport reimbursement? Are the fees similar to surrounding jurisdictions?

The Board of Supervisors authorized the hiring of a consultant firm to conduct research on developing and implementing the EMS Transport Reimbursement program for Loudoun County. The consultants used their experience on this subject from market research in other localities throughout the United States, to include the Washington, DC metropolitan area, and based their recommendations accordingly. The Board of Supervisors evaluated the recommendations and settled on fees which are generally consistent with surrounding jurisdictions.

12. Why is there an ordinance for the EMS transport reimbursement program?

The formal authorization to implement this program and to collect and distribute revenue comes from the Board of Supervisors. Loudoun County regulates many programs through its Codified Ordinances to ensure public awareness and consistent application of these regulations.

13. I called 9-1-1 and was transported by ambulance to the hospital. I was then transported to another hospital by a private ambulance service. Will I be charged twice?

You may be. However, private ambulance services are different from EMS. Loudoun County would only request reimbursement for the EMS ambulance transport. The private ambulance or other service may charge a separate fee for the transport from one hospital to another. Regulation of private ambulance services and fees are outside of the regulatory control of the Board of Supervisors.