Delaware city officials are moving toward billing residents and visitors for ambulance calls starting in 2027, a shift aimed at recouping money the city lost after Delaware County stopped reimbursing it for EMS runs. The plan would bring in more than $1 million a year, according to city estimates, and could determine whether the fire department can keep adding staff and equipment in the years ahead.
The proposal, first reported by The Columbus Dispatch, would have the city bill insurance companies for city residents who use EMS services, while applying a softer approach to patients who live outside Delaware. Under that model, the city would seek reimbursement from health insurers, Medicare or Medicaid as applicable, then send any remaining uninsured balance to out-of-city patients — but without aggressively pursuing collection on what's left unpaid.
City staff are currently selecting a vendor to run the billing program, according to David Moser, and officials expect that selection to come before city council in early November. The Dispatch reports that whichever company is chosen will help develop billing policies and procedures, manage bill collection and the distribution of funds back to the city, build a public communications and marketing plan, and ensure the program complies with state and federal law.
Why the County Money Dried Up
The push for EMS billing comes directly from Delaware County's decision to stop reimbursing the city for ambulance calls, per the Dispatch's reporting. Chris Neading told city council that every other EMS transport agency operating in Delaware County already bills for its services to offset costs, framing the city's current no-billing approach as the outlier rather than the norm.
Right now, Delaware's fire department leans on the city's general fund and impact fees collected from new residential construction to stay funded, the Dispatch notes. Those impact fees, however, are restricted to spending on new equipment, meaning they can't be redirected to cover staffing or day-to-day operating costs — a gap that EMS billing revenue is meant to help close.
Cindy Collins put the lost county funding in blunt terms, saying it's equivalent to the cost of 10 entry-level firefighter EMTs or two new medic units, according to the same report. She called billing the “easiest” way to avoid cutting any existing services, and warned that without it, the city could be forced to delay routine equipment requests or halt plans to add staff.
Guardrails City Officials Want in Place
Collins also said whatever vendor the city hires must come with strict controls against fraudulent or duplicative billing, a detail that speaks to how closely officials are scrutinizing the program before it launches. The city is aiming to have the EMS billing program running by January 1, 2027, though city council still has to approve it before it can move forward.
Delaware has set a public hearing for 7:15 p.m. on Nov. 9 to consider Resolution No. 26-75, which would authorize an agreement for EMS billing services, according to a notice posted by the City of Delaware. That hearing gives residents a formal chance to weigh in before any contract is finalized.
How Delaware County Already Handles It
Delaware County offers a working template just next door. In July 2026, the county made an approximately 5% adjustment to its EMS billing rates.
Delaware County EMS uses insurance billing, and patients are not expected to pay out of pocket.
Billing practices vary elsewhere in the region, too. Beavercreek Township, for example, says it bills all non-residents and routes transport charges to a third-party payer first; if Medicare, Medicaid or private insurance doesn't cover the cost, the township bills the individual directly, according to Beavercreek Township.
Separately, Delaware County commissioners have also approved a request for proposals to hire a contractor supporting the county EMS agency's participation in Ohio's Ambulance Supplemental Payment Program, according to Citizen Portal.
For now, Delaware's EMS billing plan remains in the proposal stage, pending the Nov. 9 public hearing and eventual city council approval. Whether the city settles on the same insurance-only approach the county already uses, or adjusts its model for out-of-city patients, will likely become clearer once a vendor is selected and the resolution comes up for a vote.
