EMS Services in Angelina May be at Risk Due to Insurance Issues

According to a press release, the City of Lufkin may soon be forced to review how emergency medical services are delivered in Angelina County due to “deadbeat” insurance companies.

“An insurance company’s job is to pay for the medical claims of their people, and they aren’t doing it,” Assistant City Manager Jason Arnold said.

To date, health insurance companies owe the City of Lufkin $1.3 million. Of that total:

• $891k is 181 days past due.
• $190k is 365 days past due.

“The absence of payments and excessively low, late payment after a lengthy appeals process is jeopardizing the future of EMS in Angelina County,” City Manager Bruce Green said.

On average, municipalities expect to see roughly 34 percent of what they bill for emergency medical services. The City had been ahead of that curve at roughly 38 percent. Unfortunately, that number has continued to fall and sits at around 33 percent even with a full-time collections staff.

“The insurance companies have a number of different explanations that amount to nothing but bureaucratic excuses,” Green said. “For example, Blue Cross Blue Shield requires prior authorization for emergency transport. How are you supposed to do that when responding to a 911 call?”

Under the city’s current structure, Lufkin Fire Department (LFD) responds to emergency medical calls for all of Angelina County. LFD employees are not only highly trained firefighters but also certified paramedics, meaning they can deliver the highest level of emergency care. That care, however, comes at a cost.

“We are now approaching the inability of covering that cost,” Green said. “The longer this continues, the greater the threat to emergency medical care in Angelina County.”

If insurance companies continue refusing or delaying financial responsibility, the matter will likely land in the hands of city council.

“Ultimately city council would decide how we address this issue going forward,” Green said. “We like the fact that when you call 911, a Lufkin firefighter/paramedic arrives at your door. We believe they provide the best emergency care available anywhere. These deadbeat insurance companies are making it difficult to continue that quality of care to all of Angelina County.”

According to the press release, top offenders (as of March 17):

• Medicare of Texas: $287,117
• Texas Healthspring Medicare HMO: $161,823
• United Healthcare Community: $116,519
• United Healthcare Medicare Advantage: $110,554
• UTMB Correctional Managed Care: $71,992 (state inmate healthcare plan)
• BCBS of Texas: $85,264
• United Healthcare Dual Complete: $68,478