Upper Mountain Fire Company asks Lewiston board to approve insurer billing for ambulance runs

John Malachuk, president of the Upper Mountain Fire Company and assistant chief for emergency medical services, told the Lewiston Town Board on May 30 that recent New York State legislation allows volunteer companies to seek reimbursement from insurance carriers for ambulance transports and related services. "I'm here tonight to seek your assistance in passing a resolution that will allow us to collect fees for reimbursement of the ambulance services that we provide out to town," Malachuk said.

Malachuk described the program as a "soft billing" approach: the company would submit claims to insurers and accept payment through a third-party billing agency. He said residents would not be required to pay more than their insurance deductible or copayment, and that the program would apply only to residents who live inside the Upper Mountain Fire Company’s certified service district. He told the board the plan is intended to offset rising costs for training, equipment and paramedic school and that collected funds must be returned to EMS operations rather than diverted to general town funds.

Board members and staff asked for clarifications about who would be covered and how rates are computed. Malachuk said the district boundary—described in the presentation by reference to local roads and landmarks—determines which households are eligible for the program. He explained that the billing includes a "loaded" mileage component to account for medical equipment and care (the presentation cited a $38-per-mile figure tied to Medicare/Medicaid reimbursement practices as an example), and that a third-party billing vendor and necessary HIPAA updates are being lined up.

Town officials said their attorney will review the draft resolution and related documents before the board considers a vote. Malachuk requested that the resolution be placed on the next meeting agenda with the goal of implementing the program by the end of July, subject to legal review and the town's formal action.

Next steps: the town attorney will review the draft agreement and fee schedule; the board indicated it expects to consider a resolution at the next meeting. The presentation did not include a final fee schedule approved by the town; that schedule and any vendor contract were presented as drafts requiring town legal review.