Okay, this is your last chance! In only a few days, the EMS Section's annual fire service EMS conference is set to blast off in Las Vegas. The cost of registering for the conference can be justified many times over by sessions that can improve revenue streams for budgets. No less than six sessions deal with the financial component of managing a fire EMS system.

"Billing 101," presented by Leslea Adams, President of Mediclaims, shows you how to set up a billing system that maximizes cost recovery while showing you important ways to ensure efficient billing and collection. Leslea also offers another class called "Billing: Advanced Issues." In this session, Leslea tackles complicated issues such as the on- going negotiated rulemaking with Health Care Finance Administration (HCFA), as well as Medicare and Medicaid changes.

Other topics at Fire-Rescue Med will more than pay the cost of registration and travel. In "Finding the Pot of Gold: Alternative Funding Sources," Erik Gaull takes you through alternative methods of EMS funding and explores new, lesser-known federal and state funding sources. If your budget is stretched, this is a "must-attend." Looking for another way of funding your EMS program? How about "Subscription EMS systems: Pay Me Now, Don't Pay Me Later!" Section members Deputy Chief John Garitz of Springfield, (OR) and EMS Chief Richard Lazarus of Shreveport, (LA) show you how they set and manage two of the most successful fire-based EMS subscriptions in the country. Their talk will include the risks, benefits, and how a subscription program may fit into your future.

Yes, there is more! Another money-impacting session is "Ambulance Reimbursement for the Next Century: Show Me the Money." This important topic is presented by section member Pete Lawrence of the Oceanside Fire Department (CA). A member of the IAFC's HCFA Task Force, Pete will talk about the IAFC's Medicare reform position paper, status of the negotiations, and an insight into how EMS reimbursement could be affected by the proposed changes.

Fire-Rescue Med will be held at the Orleans Hotel from April 26 - 28, 1999 in Las Vegas. With hotel rooms reserved for attendees at $49 per night, usually cheap air fares to Vegas, great prices on food, plenty of entertainment, and a low registration fee, the decision whether to attend or not is a "no-brainer." Call the IAFC at 703-273-0911 to register. On-site registration will also be available.

Watch out for that curve ball! Chris Daugherty, Chief of Managed Care Investigations for the Office of the Insurance Commissioner in the state of Washington has written a strongly word letter to Mary Weiler, Senior Health Plan Counsel for Kaiser Permanente with respect to their pathway management and transportation agreement with American Medical Response (AMR).

The letter centers on the recent five year, $600 million pathway management and transportation contract between AMR and Kaiser to move patients away from 911 systems. In the letter Ms. Daugherty writes, "It has come to the attention of the Office of Insurance Commissioner........................that AMR will provide and manage all medical transportation and related billings for Group Health Cooperative of Puget Sound, its health care service provider, Group Health Northwest and Kaiser Foundation Health Plan of the Northwest beginning September 1, 1999. It also appears that AMR contemplates coordinating unscheduled emergency services by requiring that persons in emergency situations choose between calling 911 or calling a consulting or advise nurse."

Ms. Daugherty further writes in her letter that "the protocols proposed by AMR appear to be overly restrictive and in violation of RCW 48.43.093 (Washington state's prudent layperson definition of an emergency for reimbursement).

Dropping the hammer, Daugherty also writes, "Please be advised that any attempt to implement this contract with the current provisions related to when to call 911 as opposed to when the call the consulting or advise nurse will be considered to be a violation of RCW 48.43.093 and will result in an enforcement action being taken against Kaiser Permanente."

Kudos to Washington state for recognizing the dangers of this new agreement between Kaiser and AMR, not to "manage the care" of their members, but to "manage the profits" of two large corporations by steering people away from 911.