Allows for reimbursement of transportation costs for emergency care without prior authorization by the social services official

2 Co-sponsors

• Patty Ritchie
• Diane J. Savino

BILL NUMBER:S3312

Title of bill

An act to amend the social services law, in relation to reimbursement of transportation costs for emergency care

Purpose

To establish a Medicaid reimbursement methodology for ambulance transportation with rates that allow providers to recoup their costs

Summary of provisions

Section 1. Amends Subdivision 1 of section 365-h of the Social Services Law to exempt transportation to obtain emergency care from the requirement for prior authorization under Medicaid, to conform with the exemption in § 365a(2)(j) of the Social Services Law.

Amends Section 365-h of the Social Services Law to direct the Commis- sioner of Health to establish a Medicaid reimbursement methodology for ambulance transportation and care that ensures that providers are reim- bursed at the greater of the Medical Assistance Rate on the effective date of the bill or the Federal Medicare allowable charge. This reimbursement methodology shall be phased in over three years as follows: in the state fiscal year in which the bill becomes a law, 33 percent; in the following state fiscal year, 66 percent; and in the second state fiscal year following the fiscal year in which the bill becomes a law and all subsequent fiscal years, 100 percent

Section 2. Amends Subdivision 1 of section 368-a of the Social Services Law to ensure that the state bears 100 percent of the increase in medical assistance under this title. after first deducting any federal funds properly received or to be received on account thereof.

Section 3. Provides that this act shall take effect April 1, 2014.

Justification

The Medicaid reimbursement rate for ambulance trips is currently determined on a county-by-county basis. Almost every county in the state fails to adequately reimburse ambulance companies for the costs incurred in transporting patients.

This bill would create a methodology for ambulance reimbursement under Medicaid that more closely approximates the cost of providing the service. Ambulances arc required by law to pick everyone up, including Medicaid patients. It is unfair to require these ambulance companies to accept Medicaid patients and then not fairly reimburse them for the costs of providing services to these patients.

Legislative history

S.2715A/A.811A of 2011-12; S.5068/A 6674A of 2009- 10.

Fiscal implications

Dependent on the costs of transporting patients. The State would also assume the local share of any additional Medicaid spending,

Effective date

This act shall take effect April 1, 2014