CITY COUNCIL AGENDA ITEM
ACTION REQUESTED:
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Waive the first reading and pass the ordinance amending Section 1-8B-4 of the Naperville Municipal Code regarding ambulance and emergency response services billing
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DEPARTMENT: Fire Department
SUBMITTED BY: Mark Puknaitis, Chief
BOARD/COMMISSION REVIEW:
N/A
BACKGROUND:
Section 1-8B-4 of the Naperville Municipal Code states that the Naperville Fire Department (FD) is responsible for providing ambulance (EMS) and other emergency response services (non-EMS) within the city. The FD also responds to calls for service in designated areas outside the city under established contractual agreements. The Naperville Municipal Code also establishes the billable rates charged to residents and non-residents when City emergency response resources are deployed.
To ensure accuracy and transparency, each year the FD is required to submit a cost report to the Illinois Department of Healthcare and Family Services and/or the federal Centers for Medicare and Medicaid Services documenting the actual costs associated with ambulance transport services. Additionally, beginning in October 2026, EMS transport rates must be annually submitted to the Illinois Department of Public Health.
Recent Illinois legislation has expanded the definition of balance billing for all patients and authorizes EMS providers to bill for Mobile Integrated Health Care (MIH) services, including patient follow-up visits, as well as for the use of department resources related to continuous lift-assist responses at facilities.
DISCUSSION:
Previously, non-residents were billed for the balance of the unpaid bill. Under Public Act 102-0901, balance billing applies to all patients. The proposed text amendment will ensure that all patients, regardless of residency, will be billed appropriately and consistently, in accordance with state law.
Additionally, Illinois Public Acts 104-0057 and 103-0599 authorize reimbursable billing for excessive lift-assist calls for service to congregate living facilities, including billing directed to those facilities for such responses. The legislation also authorizes reimbursement for Mobile Integrated Health (MIH) services, including certain non-transport responses and follow-up visits for eligible patients. Refusals of care will no longer be billed; rather only calls for service where medically necessary intervention was performed, regardless of transport status, will be billed.
These changes will remove out-of-pocket costs from all patients who request services and would ensure the City is following state law.
FISCAL IMPACT:
Revenue according to the response service provided.