One area ambulance service will bill an obese patient more for its services than a person of normal weight, but it's done on a case-by-case basis, an official said Friday.
As the nation battles an obesity crisis, ambulance crews are trying to improve how they transport extremely heavy patients, who become significantly more difficult to move as they surpass 350 pounds.
Caring for such patients is expensive, requiring costly equipment and extra workers, so some ambulance companies have started charging higher fees for especially overweight people.
It's a move not approved by groups that call for acceptance of those who are obese.
Ambulance companies said it's time for insurance providers, Medicaid and Medicare or the patients themselves to begin paying the added costs, which are cutting into razor-thin profit margins. In the past, ambulance companies often absorbed the extra expense of serving the obese.
Rates almost doubled in Shawnee County, Kansas, where ambulance fees went from $629 to $1,172 for critical-care patients and people who are 500 pounds or heavier.
In Colorado Springs, Colo., and the Nebraska cities of Omaha and Lincoln, the fees are $1,421 for an extremely obese patient, compared with $758 for a typical patient.
Typical rates remain the same, but if a case requires more manpower - whether they are two floors up or extremely obese - it can tack on added costs, AMED Assistant Director Gary Watters said Friday, noting the policy has been in place for some time.
"Every case is different. If we need to send six additional people, we bill for those additional people," Watters said.
"But our flat rates are no different. It's still based on the level of care."
Other area ambulance services have not followed AMED's move.
"Depending on the case, it can add significant costs to some transports," Hollidaysburg American Legion Ambulance Service Director Rob Shirk said. "But I don't think it's changed how we charge."
Hollidaysburg and Ebensburg Area Ambulance said their transport billing procedures have stayed fairly simple.
"The rates we charge are flat. Transports either fall into one category or another," said Mary Ellen Peacock of Ebensburg Area Ambulance, noting they charge set rates for basic and advanced life support measures.
"If an incident requires special attention, we call out our second crew and that's it. It doesn't change anything," she said.
The Centers for Disease Control and Prevention has long said that nearly a third of Americans are obese. About 5 percent of the population is morbidly obese, meaning they are more than 100 pounds heavier than their ideal weight.
Some critics say the higher fees are a form of discrimination.
"Ambulance services are a critical public service and should accommodate the needs of all of those who require them at a fair cost," said Joseph Nadglowski, president of the advocacy group Obesity Action Coalition.
Peggy Howell, public director for the National Association to Advance Fat Acceptance, called such moves a great "disservice" any time anyone in a community is discriminated against.
Ambulance companies said the insurance industry is their best hope for closing the financial gap. As with any medical service, ambulance companies bill private insurers or government health care programs.
Medicare and Medicaid don't pay extra for transporting the extremely obese, but it's something the ambulance industry wants to change.
"It's really an emerging area," said Susan Pisano, a spokeswoman for the America's Health Insurance Plans, an insurance industry trade group. "It is one more way that obesity is contributing to health costs."
The Associated Press contributed to this story.
Mirror Staff Writer David Hurst is at 946-7457.