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Fire Department wants Manchester to seek new ambulance service bids

New Hampshire Union Leader

March 19. 2013 11:09PM

MANCHESTER - The Fire Department wants the city to issue a new request for proposals for an emergency ambulance service provider that could replace American Medical Response, the company that has been dogged by complaints over its billing practices.

Fire Chief James Burkush made the recommendation at an Administration Committee meeting Tuesday, following months of consultations with a special committee that included elected officials and finance and legal department heads.

The committee was tasked with analyzing and coming up with a proposal for bringing the ambulance service "in house," rather than having an outside company handle 9-1-1 transports.

Burkush said putting out a new RFP was a necessary "transition" step, due to the complexity and cost associated with having the department run its own ambulance service. The contract would run 5.5 years, but could be terminated after 2.5 years. It would call on the vendor to assist the department in taking on a share, if not all, of the ambulance services In the meantime, Burkush said the new contract would force any company to be more responsive.

"Basically the best control would be a totally city-run operation, as we do plowing the streets and picking up trash," he said. "I think the present contract was lacking in controls the board and citizens wanted."

The new contract would require, for example, that the company have a local billing office and wait 90 days before sending bills to collection agencies.j

AMR, insurer reach deal

AMR was awarded the contract to be the city's 9-1-1 ambulance provider three years ago, but it has been beset by complaints over large bills, a complicated claims process and aggressive debt collection practices.

Part of the problem was attributed to the lack of a provider agreement between Anthem Blue Cross and Blue Shield, the city's largest insurer, and AMR.

On the same day as the committee meeting, Mayor Ted Gatsas announced that an agreement had been reached between the parties.

"That was the biggest problem we had," Gatsas told the committee.

In a news release from the Mayor's Office, Christopher Stawasz, AMR's state general manager, said, "I would like to express our sincere thanks to Manchester Mayor Theodore Gatsas, whose efforts helped facilitate this process."

$7 million, 35 employees

Gatsas noted that an in-house ambulance service would swell the fire department's budget and that collecting unpaid bills would be a challenge in the city.

"Your collection rate in Manchester is going to be much different than in surrounding communities," Gatsas told Burkush. "We can talk about a transition here, but it sounds like (going in-house) is what the plan is."

Burkush estimated that for the department to run its own ambulance service, it would require another 35 employees and cost $7 million, which he conceded could be challenging under the tax cap.

The new proposed contract does not specify the reimbursement rate for the ambulance company or the amount it would pay to use its 9-1-1 system, a standard part of such agreements. These would be the subject of direct negotiations, according to department officials.

Burkush said while there had been improvements in AMR's service, some problems continued.

Alderman at-large Dan O'Neil was more pointed in his criticism.

"This has caused a lot of heartache for a lot of people. We'll never know just how much was over-billed, unless the attorney general gets involved. To me it's a serious issue. AMR dropped the ball. It wasn't the city's fault. AMR lost the city's trust."

The committee voted to table the proposal in order to consider the newly announced agreement between AMR and Anthem.

Fire Department officials want the new contract to take effect when AMR's current contract expires, Dec. 31.

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