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Home My WebLink AboutIR 25-0066INFORMAL REPORT TO CITY COUNCIL MEMBERS No. 25-0066 a 1673 To the Mayor and Members of the City Council June 3, 2025 Page 1 of 4 SUBJECT: EMERGENCY MEDICAL SERVICES WAIVER POLICIES On June 101", the City Council will consider adopting changes to the Financial Management Policy Statements (FMPS) regarding settlements, waivers and discounts established for Emergency Medical Services provided by the City starting on July 1, 2025. These services are currently being provided by the Metropolitan Area EMS Authority d/b/a MedStar Mobile Healthcare. Changes to the FMPS will delegate authority to grant discounts and the ability to write off or settle certain accounts receivable balances from the City Council to the Chief Financial Officer or their designee. Per the Texas Constitution (Art. III, Section 52), the City is not authorized to lend its credit or to grant public money or a thing of value "in aid of, or to any individual, association, or corporation whatsoever." However, the expenditure of public funds for a "public purpose" is not prohibited. The criteria to be met is: (1) the expenditure or grant of value is not gratuitous but instead brings a public benefit; (2) the predominate objective is to accomplish a legitimate public purpose, not to provide a benefit to a private party; and (3) the City retains control to ensure that the public purpose is in fact accomplished. Therefore, the City Council will be asked to find that this policy is not gratuitous, serves a legitimate public purpose and that adequate controls are in place to ensure the public purpose is accomplished. Staff from the City Attorney's Office, City Manager's Office, Financial Management Services, Fire and MedStar reviewed MedStar's current policies and recommend the City adopt the following policies that meet the above criteria: 3olicy Description Charity Care Provides full financial assistance for emergency or medically necessary care to individuals with incomes at or below 400% of the Federal Poverty Level (FPL), in accordance with community health standards. Eligibility is determined through income verification, ensuring assistance targets those most in need. This policy mitigates financial barriers, encouraging timely Public Purpose Ensures low-income and uninsured patients can access essential EMS without financial hardship, promoting health equity and preventing untreated medical conditions that could burden public health systems. This aligns with the City's commitment to equitable healthcare access and reduces downstream costs associated with unaddressed medical needs. ISSUED BY THE CITY MANAGER FORT WORTH, TEXAS INFORMAL REPORT TO CITY COUNCIL MEMBERS No. 25-0066 a 1673 To the Mayor and Members of the City Council June 3, 2025 Page 2 of 4 SUBJECT: EMERGENCY MEDICAL SERVICES WAIVER POLICIES Third Party Attorney Settlement Insurance Discount - Contractual Insurance Discount - other EMS utilization, which enhances community health outcomes. Authorizes a reduction of up to 20% off gross charges for settlements. This policy does not involve claims against the city but applies to third -party lawsuits (e.g., between a car accident victim and the responsible party) where EMS charges are included in settlement negotiations. For example, an attorney may negotiate a reduced EMS payment to align with the settlement amount, ensuring the city recovers funds efficiently while supporting case resolution for patients. Bill at the agreed upon contractual amount. Includes Medicare, Medicaid, and commercial insurance. Permits a discount of up to 20% off gross charges for insurance cases, contingent Encourages timely settlement of EMS charges in legal disputes, reducing administrative overhead and costs for the city. By offering a modest discount, the city facilitates faster collections and minimizes the need for prolonged billing disputes or litigation. Agreed upon contractual terms. Standard in healthcare billing and reflect pre - negotiated rates, ensuring fairness and consistency. Encourages prompt claim settlements and full payment from insurers, streamlining billing processes and reducing administrative costs. This ensures predictable revenue streams while maintaining compliance with contractual obligations. Encourages faster settlement with insurers and reduces administrative costs and ISSUED BY THE CITY MANAGER FORT WORTH, TEXAS INFORMAL REPORT TO CITY COUNCIL MEMBERS No. 25-0066 a 1673 To the Mayor and Members of the City Council June 3, 2025 Page 3 of 4 SUBJECT: EMERGENCY MEDICAL SERVICES WAIVER POLICIES DataiSight Reduction General Discount Monthly Payment Plan Prompt Pay Discount on documented agreement and notes entered in the billing system. This policy applies to non - contracted insurers or cases requiring negotiation, ensuring flexibility while maintaining documentation for transparency and auditability. Allows a discount of up to 20% off gross charges when reductions are negotiated by DataiSight Allows a discount of up to 20% for self -pay patients, provided the full balance is paid at once. This policy encourages financial responsibility while providing relief to patients who can settle their balances promptly Allows self -pay patients to split balances into 6, 12, or 18-month payments. Note: Cannot combine payment plan and discount. Allows 20% discount if paid in full (Note - the offer may only be included with the final bill before collections). delays in payment. This promotes operational efficiency and ensures timely revenue recovery. Supports negotiated discounts with payers to promote settlement and reduce administrative overhead, improving collection rates and operational efficiency. Facilitates collections by incentivizing full immediate payment, improving receivables and reducing collection costs. This enhances cash flow and minimizes the risk of uncollectible debt. Facilitates collections by making payments more manageable, improving cashflow and reducing bad debt. This supports access to EMS for those unable to pay upfront, aligning with public health equity goals. Improves cash flow and reduces bad debt through voluntary early payment incentives. Also minimizes the need for costly collection efforts, benefiting both the city i and patients. ISSUED BY THE CITY MANAGER FORT WORTH, TEXAS INFORMAL REPORT TO CITY COUNCIL MEMBERS No. 25-0066 a 1673 To the Mayor and Members of the City Council June 3, 2025 Page 4 of 4 SUBJECT: EMERGENCY MEDICAL SERVICES WAIVER POLICIES Homeless / Shelter Dead on Scene / Decease after transport Permits account write-offs for individuals verified as shelter residents who lack a billable address or whose mail has been returned, subject to internal review and approval. Accounts may be written off when no spouse or estate is identified, with billing d determined by the patient's insurance status. Note: This determination may occur several months after the date of transport. Supports vulnerable populations with no ability to pay; aligned with public health and social welfare objectives. Allows recovery where possible and protects indigent survivors when no estate is available. EMS waiver, settlement and discount policies will be reviewed, updated and presented for City Council approval on an annual basis, in conjunction with all Financial Management Policy Statements. If you have any questions, please contact Reginald Zeno, Chief Financial Officer, at 817-392-8500; Tony Rousseau, Deputy Finance Director at 817-392-8338 or Taylor Paris, Sr. Assistant City Attorney at 817-392-6285. Jesus "Jay" Chapa City Manager ISSUED BY THE CITY MANAGER FORT WORTH, TEXAS