No. Once gathered, patient information would be forwarded to a third party billing agency contracted by the City and specializing in EMS billing. The patient’s insurance company or Medicare would be billed for the run. Recent changes in rules set by the Department of Health and Human Services enables government entities to only invoice the patient’s insurance company or Medicare, and does not require them to bill those who cannot pay or are indigent. They may also waive the coinsurance fee for their residents rather than adopt a “hard billing” policy that would result in invoicing the patient for the balance and taking a proactive collection stance.