What's happening
This bill ensures ambulance providers are reimbursed at higher rates for emergency transportation and removes prior authorization requirements for emergency care.
Why it matters
Ambulance providers will receive higher payments for emergency transportation services. , as reimbursement rates must now match either the current Medicaid rate or the Medicare allowable charge—whichever is higher—gradually increasing to full implementation over two years.
Patients will no longer need prior authorization for emergency ambulance transport. , reducing delays and administrative barriers during crises and making it easier to access lifesaving care when time is critical.
Counties and the state will be required to cover all costs (after federal funds are applied) for these emergency ambulance services. , potentially shifting some financial responsibility to state or local budgets, but ensuring providers are paid promptly and fully.
By raising reimbursement rates and removing administrative hurdles, the bill aims to strengthen the financial stability of ambulance services. , which may help prevent service cutbacks, closures, or longer response times in both urban and rural communities.
Albany, before your first meeting.
Every bill that moved yesterday, summarized in a sentence and ranked by impact. The Albany Scorecard follows on Sundays.
Free. Unsubscribe in one click. Want alerts on specific bills? Create an account.
Who cares
Headline styles
Cover Emergency Ambulance Rides
Plain English, a few words. Used as the page title.
Sponsors
History
- Referred to health
- Referred to health
Companion bill
The same bill in the other chamber. A bill becomes law when one version passes both houses and the governor signs it, so either number can carry it.
Cover Emergency Transport Costs
In Assembly Committee · Ways And Means · Sponsor Richard Gottfried
Full text
2 pagesUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
2528
2017-2018 Regular Sessions
IN SENATE
January 13, 2017
Introduced by Sens. SEWARD, BRESLIN, RITCHIE -- read twice and ordered printed, and when printed to be committed to the Committee on Health
AN ACT to amend the social services law, in relation to reimbursement of transportation costs for emergency care
The People of the State of New York, represented in Senate and Assembly, do enact as follows:
Section 1. Subdivision 1 of section 365-h of the social services law, as amended by section 20 of part B of chapter 109 of the laws of 2010, is amended and a new subdivision 6 is added to read as follows:
1. The local social services official and, subject to the provisions of subdivision four of this section, the commissioner of health shall have responsibility for prior authorizing transportation of eligible persons and for limiting the provision of such transportation to those recipients and circumstances where such transportation is essential, medically necessary and appropriate to obtain medical care, services or supplies otherwise available under this title. However, prior authorization shall not be required for transportation to obtain emergency care, including emergency medical transportation by an ambulance service certified under article thirty of the public health law.
6. With respect to transportation and care provided to an eligible person by an ambulance service certified under article thirty of the public health law, the commissioner of the department of health shall establish a reimbursement methodology that ensures that providers are reimbursed at the greater of the medical assistance rate in effect on the effective date of this subdivision, or the medicare allowable charge (pursuant to title XVIII of the federal social security act) for such transportation and care. The amount of increase in reimbursement produced by this methodology over what would otherwise have been paid shall be phased in as follows: in the state fiscal year in which the provisions of this subdivision become law, thirty-three percent; in the following state fiscal year, sixty-six percent; and in the second state
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD02204-02-7
S. 2528 2
fiscal year following the state fiscal year in which the provisions of this subdivision become law and all subsequent fiscal years, one hundred percent.
§ 2. Subdivision 1 of section 368-a of the social services law is amended by adding a new paragraph (aa) to read as follows:
(aa) Notwithstanding any inconsistent provision of this chapter or any other provision of law to the contrary, one hundred percent of the amount expended for medical assistance under this title for transportation and care furnished under subdivision four of section three hundred sixty-five-h of this title on or after April first, two thousand nineteen, after first deducting therefrom any federal funds properly received or to be received on account thereof.
§ 3. This act shall take effect April 1, 2019, provided that the amendments to section 365-h of the social services law made by section one of this act shall not affect the repeal and reversion of such section pursuant to subdivision (a) of section 40 of part B of chapter 109 of the laws of 2010, as amended.
Reflowed for reading: line numbers and page breaks removed. Cite the official text.
Sponsor's memo
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 Commissioner of Health to establish a Medicaid reimbursement methodology for ambulance transportation and care that ensures that providers are reimbursed 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 the effective date.
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 are 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.1055 of 2015-16; S.3312 of 2013-14; S.27I5A of 2011-12; S.5068 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, 2019.
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.