This question again revisits the issue of ambulance bills where the patient did not ask for the ambulance to be called. For related posts see:
- Paying for ambulance services (October 4, 2014); and
- Subtle change in the way ambulance fees are recovered in NSW (June 1, 2015).
Today’s question considers the position in the Australian Capital Territory. My correspondent:
… had someone call and ambulance to my address despite myself and others suggesting not to call as it was not necessary and now I have been given the bill to pay. Am I required to pay as it was called for me despite not giving consent or is the caller responsible for the fee, if so how do I dispute this fee or transfer the fee to the original caller without court interaction.
The caller is not liable
First and foremost, the caller is not liable and never will be. No-one is going to set up a system where a person who calls triple zero is liable for the bill if the patient refuses to pay. People have to be able to call triple zero when they don’t know if an ambulance is required (eg they’ve just seen the car accident) or where they think an ambulance is required even if the patient does not. In the context of an institution such as the Australian National University consider a person who is injured or ill in the library but doesn’t want an ambulance called as they can’t afford it. The library staff can’t just leave the person there and what’s more they can’t just leave a person who they think actually needs an ambulance. The person may want to refuse treatment but that is harder to do when paramedics are on scene saying ‘you really need to go to hospital’. There is no chance that a person who rings for an ambulance is or will ever be liable for the bill.
The Emergencies Act 2004 (ACT) and the Emergencies (Fees) Determination 2018
The only person who can be liable, if anyone, is the person who receives the care. In the ACT the relevant legislation is the Emergencies Act 2004 (ACT). Section 201 says:
(1) The Minister may determine fees for this Act.
(2) A fee determined for a service provided to a person by an emergency service is payable by the person even if the person did not ask for, or consent to, the provision of the service.
The Emergencies (Fees) Determination 2018 sets out the fees for ambulance (and other emergency) services. Fees for items 294 (Emergency Medical Treatment), 295 (Non-Emergency Medical Treatment and Transport), 296 (Supply of ACTAS ambulance vehicles and/or personnel) and 298 (Aero-medical retrieval by the ACT Government’s aero-medical provider) are to be paid by the person receiving the service ([4(4)]).
There are exceptions. Ambulance fees in the ACT do not have to be paid (:
(a) by ACT school students who are injured or become ill at school or during approved school excursions within the ACT; or
(b) by residents of the ACT, New South Wales, Victoria, Tasmania or Northern Territory who, at the time the service was provided, held a current valid relevant concession card which includes an entitlement to free ambulance services under Commonwealth Government Department of Human Services provisions; or
(c) by persons who have been arrested and/or are in lawful custody; or
(d) by an entitled person, as defined in the Children and Young People Act 2008; or
(e) where the ambulance services were provided to a person in relation to performing a good Samaritan act; or
(f) for ambulance services provided following an incident involving a motor vehicle on a road or road related area in the ACT; or
(g) where ambulance services were provided to a person who was deceased, or was unable to be resuscitated, while in the care of ACTAS officers; or
(h) by a person who is a victim of domestic or family violence; or
(i) by a person who is a victim of sexual assault.
The Chief Officer – Ambulance Service may waive the fees where “exceptional personal or other circumstances apply to a person to whom ambulance services were provided” ([6(2)]). Exceptional personal or other circumstances are set out in Schedule 2. They are:
a. A charity, financial aid organisation, hospital or other social aid organisation provides evidence demonstrating that exceptional personal circumstances apply to the person and that requiring the person to pay would cause unreasonable financial hardship to the person;
b. The ambulance services were provided to a person aged under 18 years following an accident or other event that resulted in the person being the only survivor in their immediate family;
c. A person had applied for, but not yet received, a relevant concession card prior to receiving the ambulance services, and the application for the card was subsequently approved (noting that holders of relevant concession cards are not charged for ambulance services);
d. The ambulance service was provided to a person who is undergoing extensive and life saving medical treatment and who as a result is reliant on assistance from government or not-for-profit organisations in order to meet their basic costs of living and the requirement to pay for the ambulance services would cause unreasonable hardship;
e. Any other circumstances exist that in the opinion of the Chief Officer should see the fee waived.
As my correspondent was aged over 18 at the time, he or she is responsible for the paying the fees charged in accordance with the Emergencies Act 2004 (ACT) and the Emergencies (Fees) Determination 2018. Issues of consent or contractual principles are not relevant as the obligation to pay is a statutory obligation. It exists because the Emergencies Act says it does.
If my correspondent wants to avoid paying the bill he or she would have to satisfy the Ambulance Service that one of the exceptions listed in paragraph 5 apply. If they do not apply an application could be made to waive the fee on the basis that ‘exceptional personal or other circumstances apply’.
After reading this posting, I found the criteria for waving payment is quite fair and reflects tbe community standard.
However, is it an offence to decline to provide my personal details to the attending officers? If I did not provide those details, would a person from the ambulance service be breaching my privacy should they attempt to obtain the information from other parties without my consent, given that the information would not be necessary to provide me with clinical care and would only be for administrative purposes?
No it would not be an offence not to provide your details and not they would not be breaching your privacy by asking others. There is no right to privacy.
Would it therefore be possible for an anonymous caller to maliciously call for an ambulance to attend to someone and then make that person jump through the hoops to have the fee waived, or would the paramedics upon arrival determine that it was a hoax call and ensure that a fee was not raised?
If there was no-one to treat there is no one to send the bill to. The bill is payable by the person who receives the service, not any person at the address to which the ambulance is sent.
The fee under paragraph 294 of the Emergencies (Fees) Determination 2018 is for “Emergency ambulance service including medical treatment and ambulance transport within the ACT”. If there is no one to receive treatment and/or transport there is no-one receiving the service. Can you imagine a multi car accident and a bystander rings an ambulance that attends only to find no injuries. They can’t bill every person who was in the accident as no-one is receiving a service.
Paragraph 296 ‘Supply of ACTAS ambulance vehicles and/or personnel’ is about supplying ACTAS ambulance and crew to a sporting or public event, not just sending an ambulance somewhere.
So no there will be no fee for a hoax call, but the person making the call may be subject to criminal punishment – Emergencies Act 2004 (ACT) s 191. (I note that s 191 appears in Part 10.1 under the heading ‘Other offences relating to fires’ but it refers to a ‘false alarm of fire, or an emergency or other incident’ and that seems broad enough to include a false alarm that an ambulance is required).
Further to this post see http://www.abc.net.au/news/2018-07-19/good-samaritan-chased-by-debt-collector-after-calling-triple-0/10011774 where the ABC reports that a person who did call triple zero was contacted about the ambulance bill but note that the response from Ambulance Victoria was that the communication was an error and that:
St John Ambulance WA sent my mother a customer survey form after her last ambulance call.
She died as a result of her injuries.
A fire broke out at my house and a neighbour claimed he was suffering smoke inhalation and was treated by paramedics when called by police . I received the account in the treated persons name . Am I liable .
Kathleen, this is not the place for legal advice, but on what you say, no you’re not. The person liable for the bill is the person who receives the service. If it is in the patient’s name but your address send it back and tell them they have the wrong address.