Fees retroactive to January

Montgomery County has begun retroactively charging for ambulance rides.

Officials started billing insurance companies for the new county ambulance fee, which was approved as of Jan. 1. But because the county didn't receive approval from the federal government to begin charging Medicare and Medicaid until March, billing dating to Jan. 1 began about three weeks ago, said Assistant Fire Chief Scott Graham.

Officials at the Fire and Rescue Service are still determining how much money will be collected this fiscal year and how that will be hurt by the delay.

The program, in which insurers will be charged for residents to use county ambulances, charges between $400 and $800 per ride. Bills go to insurance companies, with the county saying it will pay whatever the insurers don't.

The county expects to raise $18 million a year, about 60 percent of which will come from Medicare and Medicaid, the federal health insurance programs for the elderly and poor.

The program has been controversial. In 2010, a similar measure on the November ballot failed after 54 percent of county voters rejected it. County Executive Ike Leggett urged the county to reconsider, and the County Council passed a bill writing the fee into law in May 2012.

Graham said insurance agencies have varying stipulations on how far back they can be billed, and the department is collecting information to see which companies will allow the charge as far back as Jan. 1.

The delay was brought to light as the County Council's Public Safety Committee was reviewing the department's fiscal 2014 budget recommendations. Councilman Phil Andrews, D-Gaithersburg/Rockville, said he didn't anticipate a big change in revenue because of the delay.

County spokesman Patrick Lacefield said the delay will affect only the fiscal 2013 revenue the county expected to receive.

"I don't know if [the delay] will mean a significant impact," he said. "The expectation is that the [fiscal] 2014 budget will be fine."

He added that since the new fiscal year starts July 1, the county anticipated only a few million dollars in revenue for fiscal 2013.