A Long History Of Excellence

Ambulance vs. Paratransit Services – Walking a Fine Line

It seems almost common sense that an ambulance can transport a patient, right?  Well in some circumstances it is not that simple.  In other words, while ambulances are granted a fair amount of deference to transport patients, if the particular transport falls within the jurisdiction of the Public Utilities Commission (“PUC”), the ambulance service may not be permitted to perform the transport without first obtaining certification from the PUC as a paratransit service.

By way of background, 66 Pa.C.S. § 102(9) states that a common carrier under the jurisdiction of the PUC does not include, “Any person or corporation who or which furnishes transportation for any injured, ill or dead person.”  Despite the apparent breadth of this language, subsequent opinions have limited its scope.

First, in Chappell v. Pa. Pub. Util. Com., 425 A.2d 873 (Pa. Commw. 1981), the court held that § 102(9) did not apply to all transports of injured and ill persons to non-medical as well as to medical destinations. The court made the distinction that the transport of non-ambulatory patients to and from various medical facilities for medical treatment fell under § 102(9), while transportation of ambulatory persons or transportation for non-medical purposes is within the jurisdiction of the PUC and must be certified accordingly.  Subsequent cases have followed suit further clarifying this distinction.

Ultimately, the PUC offered additional guidance issuing a policy statement at 52 Pa. Code § 41.11.  Incorporating Chappell and its progeny, the PUC advised that under the following circumstances § 102(9) applies and a service is not required to be certified by the PUC:

(1)  The transportation is performed by a carrier providing paratransit service utilizing specialized equipment, and,

(2)  The passengers are persons, including patients, who — because they are injured or ill — require transportation to or from health care providers…

Applying the policy statement, three ALJ opinions further expanded upon this delineation, ultimately resulting in further guidance being issued by the PUC.  On March 17, 2011, the PUC released a proposed revision to 52 Pa. Code § 41.11 based on the subsequent precedent.  While the proposed revisions to the policy statement were ultimately withdrawn, the revised policy statement still outlines the most recent guidance as to the line being drawn by the ALJs interpreting § 102(9).

Based on the foregoing, presently under the following circumstances § 102(9) likely applies and a service is likely not required to be certified by the PUC if:

(1) the patient is non-ambulatory;

(2) the vehicles used are an ambulance, or a vehicle that by its nature and equipment has ambulance-like characteristics;

(3) the vehicle is operated by at least one person, in addition to the driver, with some form of first responder or medical training in the transport of ill or injured persons; and

(4) the person is transported to or from a ”health care facility” or physicians’ offices at which reviewable ”clinically related health service” is rendered.

While the line is still less than clear, if all of the above requirements are met, under the current guidance, it appears likely that the transport does not fall within the jurisdiction of the PUC.  Ultimately, though, if an ambulance practice falls close to this line, it is best to have the practice reviewed by an attorney to evaluate whether submitting an application to provide paratransit services to the PUC is necessary.

For a confidential analysis of your healthcare and municipal and public sector issues, or questions about TRC’s practice in those areas, please contact Daniel J. Margonari, Esquire at (412) 316-8685 or [email protected]; Harry W. Rosensteel at (412) 316-8686 or [email protected]; or David R. Johnson, Esquire at (412-316-8662 or [email protected]

Important NoticeThis information is intended for general guidance only, and should not be used as a substitute for specific legal advice.  For specific legal advice applicable to your situation, you should consult an attorney of your choice.  Although believed to be accurate when written, no guarantee of completeness or accuracy to your particular circumstances should be implied.  Laws, regulations, and court decisions in this area change frequently, and you should consult the attorney of your choice for up-to-date information.