Chautauqua County Director of Emergency Services Noel Guttman speaks at the legislature’s Audit and Control Committee meeting.

A change in the state law regarding billing for emergency medical services is creating havoc among local fire departments.

Noel Guttman, Chautauqua County Director of Emergency Medical Services, spoke about the changes during the legislature’s Audit and Control Committee meeting. He said the change allows fire departments to become their own billing agency if they choose. They can also partner with the county EMS to handle the billing. But if they don’t do anything, the county EMS will be legally required to bill the local fire departments for ALS calls. “This has been a very controversial bill,” he said.

Legislature Chairman Pierre Chagnon further explained this in an email that he sent out to all 19 county legislators. “The legislation states an ambulance service which does not issue a bill for its services and which requests an ALS intercept SHALL pay the ambulance service providing the ALS intercept. That is not optional, but mandatory,” he wrote, capitalizing the word “shall.”

In a follow up phone interview, Chagnon expressed concern that the state legislation is going to negatively impact the county. “That’s going to be a loss of revenue to the county fly car system,” he said.

Chagnon is also worried that local fire departments don’t have enough time to get a plan in place because the new law goes into effect July 8.

In Chagnon’s email, he notes there are 42 fire departments in the county. Jamestown, Dunkirk, Fredonia and Silver Creek EMS all have billing agreements with the county.

See EMS, Page A3

Dewittville, East Town Dunkirk, West Town Dunkirk, Sheridan, Irving, Sunset Bay and Hanover Center don’t have ambulances, although Sheridan is in the process of getting one.

That leaves 32 departments with ambulances. Falconer and Celoron both have agreements in place, with Celoron’s paperwork in the final stages. Fluvanna and Cassadaga have started the process to have the county take over the EMS billing. Forestville, Sherman and Ripley have made verbal commitments. Mayville, Bemus Point, Clymer, Portland, Findley Lake, Ellington, Frewsburg, Panama and Ellery Center have all asked for more information. Lakewood is interested in becoming its own billing agency but nothing formal has been decided.

There are others in the county that Chagnon didn’t mention, likely due to the fact that he has not heard one way or the other what those departments are planning on doing.

During the committee meeting, Guttman discussed the challenges facing fire departments that want to become their own billing agency. “In order for a fire department to become a billing entity, you have to get an NPI number, which is a national provider identification number,” he said. “That takes several weeks. Then they get their Medicare number which takes several months, then you get your Medicaid number which takes, again, several months.”

Guttman said the billing rate is up in the air as well. “The law specifically states that fire departments shall be billed by the provider of that ALS service. In the law, it states it can be a negotiated rate and if lack of a negotiated rate, it says it will be at the usual and customary rate. So I have been asked by the fire services, how we’re going to get to that negotiated rate. That’s a question I told them I cannot answer,” he said, adding that would be something the elected officials would need to decide.

For the short term, both Guttman and Chagnon are hoping the law’s implementation is delayed. Chagnon said he will try to speak with Assemblyman Andy Goodell before Wednesday night’s legislature meeting. He said he may request the county Legislature pass a motion requesting a delay in implementing the legislation. Motions do not hold legal authority, but are designed to show an opinion of the elected body.

County Executive PJ Wendel wants to see the new law delayed as well. “Last year we entered into a contract with the city of Jamestown. They began pursuing these numbers (NPI, Medicaid and Medicare) to bill in February. Billing did not commence until September and October. We saw how long this process is going to take so for the state, again, to put this in and expect it to be happening in 90 days was very irresponsible,” he said.

If the state does implement the law as scheduled, Chagnon said the county will not be sending out bills right away. Instead, they will discuss what options they have at their July committee meetings.

“We don’t necessarily have to send out those bills starting on July 9,” he said. “We can wait until the legislature has a chance to review the situation next month. Once we see what the governor does or doesn’t do, then we can discuss this further and come to a conclusion for what the fly car should be doing given the situation we find ourselves in after July 8.”