TO:
Honorable Mayor and Members of the City Council
THROUGH:
Talyn Mirzakhanian, City Manager
FROM:
Libby Bretthauer, Finance Director
Emy-Rose Hanna, Financial Services Manager
Toni Page, Revenue Services Supervisor
Jesse Alexander, Fire Chief
Tyler Wade, Fire Division Chief
SUBJECT:Title
Consideration of a Resolution Amending the Citywide User Fee Schedule with Itemized Emergency Medical Services (EMS) Rates in Compliance with Assembly Bill 716 (No Budget Impact) (Finance Director Bretthauer).
ADOPT RESOLUTION NO. 25-0116
Body
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RECOMMENDATION:
Staff recommends that the City Council adopt Resolution No. 25-0116 amending the Citywide User Fee Schedule with itemized Los Angeles County rates for emergency health-related services, in compliance with Assembly Bill (AB) 716.
FISCAL IMPLICATIONS:
The proposed amendment does not increase EMS rates beyond those already authorized by Los Angeles County. Instead, it restructures the presentation of rates within the City’s Fee Schedule for compliance and transparency purposes. Revenue to the City is expected to remain consistent with current collections. However, if the required itemization is not implemented, the City may see a reduction in revenue due to reimbursement denials or reductions from Federal/State agencies.
BACKGROUND:
The City currently participates in Los Angeles County’s coordinated EMS system and charges for ambulance transport services in accordance with county established rates as set by Resolution 6262. These rates are updated on an annual basis by the County and have historically been incorporated into the City’s User Fee Schedule as a single line item for the base transport only.
In 2023, the California Governor signed Assembly Bill 716 (Boerner), which modified billing practices for ground ambulance services. AB 716 prohibits certain “bundling” of ambulance charges with other emergency medical services or facility fees and requires that patients be billed only for the ambulance transport and medically necessary services directly provided in connection with such transport.
To ensure compliance with State law and to provide greater transparency for residents and patients, staff recommends revising the User Fee Schedule to:
• Break out EMS related fees into distinct line items;
• Clearly identify established base ambulance transport rate; and
• Itemize allowable ancillary charges (for example: night transport rates, medical supplies and advanced life support interventions) consistent with the County and State regulations.
As added background, the attachment titled “Historical Emergency Medical Services (EMS) Billing Data” includes a breakdown of charge type, annual number of occurrences, billed rate and total amount billed for these emergency medical services in fiscal years 2023-24 and 2024-25.
DISCUSSION:
Updating the User Fee Schedule will improve clarity for patients, enhance compliance with AB 716, and align the City’s billing practices with LA County EMS standards. Breaking out fees provides transparency by showing how the total ambulance charge is calculated.
The proposed amendment will also:
• Ensure patients receive itemized bills, in compliance with AB 716;
• Protect the City from potential disputes or claims related to unlawful bundling;
• Align City billing practices with Los Angeles County EMS rate-setting methodology; and
• Increase administrative efficiency in reconciling EMS cost recovery.
Key benefits of this alignment include:
• Avoiding reimbursement denials or reductions from federal/State agencies;
• Streamlining billing operations with insurers and public programs;
• Maintaining legal compliance and audit readiness; and
• Protecting the fiscal integrity of City programs that interface with Medicaid/Medicare.
CONCLUSION:
The proposed amendment to the User Fee Schedule assures that the City of Manhattan Beach’s EMS billing practices are transparent, compliant under AB 716 and aligned with the City’s cost recovery fee principles. This will improve clarity and compliance in how ambulance related charges are presented.
PUBLIC OUTREACH:
After analysis, staff determined that public outreach was not required for this issue.
ENVIRONMENTAL REVIEW:
The City has reviewed the proposed activity for compliance with the California Environmental Quality Act (CEQA) and has determined that the activity is not a “Project” as defined under Section 15378 of the State CEQA Guidelines because it consists of an administrative activity of government that will not result in direct or indirect physical changes in the environment. Therefore, pursuant to Section 15060(c)(3) of the State CEQA Guidelines the activity is not subject to CEQA. Thus, no environmental review is necessary.
LEGAL REVIEW:
The City Attorney has reviewed this report and determined that no additional legal analysis is necessary.
ATTACHMENT/ATTACHMENTS:
1. Resolution No. 25-0116 and Exhibit A - Amended Emergency Medical Services (EMS) Section within Citywide User Fee Schedule
2. FY 2025-2026 LA County Ambulance Rates
3. Historical Emergency Medical Services (EMS) Billing Data