Oregon Hospital Sues Fire Department Over Bills for EMS Transports

The St. Charles Health System has filed suit against the La Pine Fire District contending that an ordinance assigning financial responsibility for inter-facility EMS transports to the hospital is unconstitutional. St. Charles operates a hospital in Bend, as well as several medical facilities in Deschutes County.

According to the complaint, fire department personnel were frustrated with being called several times a week to a St. Charles medical facility in order to transport patients to the hospital in Bend. In response, the district’s board enacted an ordinance allowing itself to charge the facility who requests EMS for interfacility transports.

As explained in the complaint:

  • In August 2019, La Pine Fire, now acting in its legislative capacity, passed Ordinance No. 2019-03.
  • The stated authority for the Ordinance is ORS 478.410(4). The Ordinance gives the Fire Chief of La Pine Fire unilateral authority to impose two type of “fees” on various facilities in La Pine: (1) a non-emergency facility fee and (2) an ambulance transport fee.
  • The Fire Chief may impose a “non-emergency facility fee” for certain “non-emergency requests for assistance from residential care, assisted living, nursing facilities, medical offices, medical clinics, immediate care, urgent care, and hospitals.”
  • The Fire Chief has “sole discretion” to impose the fee, after considering whether “the response was: 1) a result of a non-emergent situation, 2) caused by or related to a lack of adequate staffing or lack of adequate facility resources necessary to meet the patients or residents non-emergent needs, or 3) requested by a facility who has repeatedly requested non-emergency assistance.”
  • Since January 1, 2020, to the present date, La Pine Fire has submitted at least 50 invoices to St. Charles Clinics.
  • Each invoices represents a specific patient who presented at the St. Charles Clinic with a specific medical condition.
  • In many cases, a medical provider determined that the patient needed emergency care that the clinic could not provide.
  • In many cases, a representative of St. Charles called 911.
  • In others, the patient or a family member may have called 911.
  • On information and belief, in each case, an EMS provider assessed the patient, and made a determination of whether the patient needed emergency transport.
  • If the patient did not require emergency transport, the EMS provider made a decision about whether to transport the patient pursuant to its right of first refusal to provide non-emergent transport.
  • On information and belief, La Pine Fire provided the patient information required by Oregon law.
  • On information and belief, La Pine Fire did not tell each patient that it intended to shift the cost of transport to St. Charles Clinic because the patient purportedly was not suffering a medical emergency.
  • La Pine Fire did not tell St. Charles Clinic that they intended to shift the cost of transport to St. Charles Clinic because the patient purportedly was not suffering a medical emergency.
  • In each case, the patient made a decision about whether to accept the transport services being offered by the La Pine Fire.
  • Other than providing a medical diagnosis in good faith, St. Charles Clinic had no involvement in the transaction between La Pine Fire and the patient.
  • St. Charles could not prohibit or require La Pine to transport the patient.
  • On information and belief, La Pine Fire did not charge the patient, Medicare, Medicaid, or private insurance for these transports.
  • La Pine Fire sent the invoices to a collection agency, Credit Associates, which sent a demand letter requiring payment of disputed invoices.
  • La Pine Fire and Credit Associates then sent a draft complaint to St. Charles Clinic, which included a claim for payment exceeding $300,000 for transports that predate the Ordinance.
  • Both Credit Associates and La Pine falsely claimed that St. Charles’s medical providers made knowingly false statements about the medical conditions its patients.
  • La Pine Fire’s and Credit Associates’ demand for over $300,000, along with an over 35% collection fee, for invoices that pre-date the Ordinance, and for which La Pine Fire already has been compensated, has no basis in the law and is illegal.

The complaint seeks a declaratory judgment ruling that the ordinance and the fees sought by the fire district violate Oregon law, and are unconstitutional; that certain of the fees sought exceed what is authorized by the ordinance; and that charges that pre-date the enactment of ordinance are invalid.

Here is a copy of the complaint:

About Curt Varone

Curt Varone has over 45 years of fire service experience and 35 as a practicing attorney licensed in both Rhode Island and Maine. His background includes 29 years as a career firefighter in Providence (retiring as a Deputy Assistant Chief), as well as volunteer and paid on call experience. He is the author of two books: Legal Considerations for Fire and Emergency Services, (2006, 2nd ed. 2011, 3rd ed. 2014, 4th ed. 2022) and Fire Officer's Legal Handbook (2007), and is a contributing editor for Firehouse Magazine writing the Fire Law column.

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