Duncan says some volunteer EMS agencies in Northern Virginia do not bill, in part out of fear that doing so will reduce donations. As of now, neither Loudoun nor Prince William county—both volunteer agencies—charges for EMS transports.
Maryland counties’ billing policies vary. Montgomery County EMS chief Michael McAdams favors billing, noting that aging fire/EMS stations are in need of repair and that many ambulances need replacing; transport fees would net about $12 million the first year.
County fire and EMS volunteers generally oppose charging. A proposal to begin charging was tabled recently by the Montgomery County Council. Prince George’s bills for EMS transports, as do Charles and Frederick.
Like the District, most jurisdictions in Maryland and Virginia employ “soft billing.” Bills are sent electronically to a health insurer, but if they’re not paid, no one is dunned. Says Maryland Region V administrator Marie Warner-Crosson: “We don’t want anyone to be denied medical care because of money.”