What's happening
This bill ensures Medicaid covers emergency ambulance transportation without prior authorization and increases provider reimbursement rates to at least Medicare levels.
Why it matters
Guarantees immediate access to emergency ambulance services for Medicaid recipients. by removing the requirement for prior authorization, which can speed up care during critical situations and potentially save lives.
Raises reimbursement rates for ambulance providers to at least Medicare levels. , potentially improving the financial stability of ambulance services, increasing provider participation in Medicaid, and helping to address ambulance shortages, especially in rural or underserved areas.
Phases in the increased payments over three state fiscal years. , which may help state and local governments manage budget impacts while gradually improving provider compensation.
Specifies that state Medicaid will cover 100% of these increased costs (after federal funds are applied). , ensuring that local governments are not forced to absorb the additional financial burden, and possibly reducing local resistance to better ambulance funding.
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
No co-sponsors yet.
History
- 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.
Allows for reimbursement of transportation costs for emergency care without prior authorization by the social services official
In Assembly Committee · Health · Sponsor Richard Gottfried
Full text
2 pagesUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
7035
IN SENATE (Prefiled)
January 8, 2020
Introduced by Sen. SANDERS -- 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 fiscal year following the state fiscal year in which the provisions of
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD03445-01-9
S. 7035 2
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 twenty-one, after first deducting therefrom any federal funds properly received or to be received on account thereof.
§ 3. This act shall take effect April 1, 2021, 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 or general idea of bill
To establish a Medicaid reimbursement methodology for ambulance trans- portation 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 require- ment for prior authorization under Medicaid, to conform with the exemption in section 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 meth- odology 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 follow- ing 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 subse- quent 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. Effective date.
Justification
The Medicaid reimbursement rate for ambulance trips is currently deter- mined 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 ambu- lance 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.
Prior legislative history
2002: A11462 - reported to Ways and Means
2003: A4746 - reported to Ways and Means
2004: A4746-A - reported to Rules
2005-06: A4017-A - reported to Ways and Means
2007-08: A3793-A - reported to Ways and Means
2009-10: A6674- - referred to Health Committee
2011-12: A811 - referred to Health Committee
2013-14: A5537 - referred to Health Committee
2015-16: A1512A - referred to Health Committee
2017: A3978A - reported to Ways & Means / Senate Health
2018: A3978A - reported to Ways & Means / Senate Health
Fiscal implications for state and local governments
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.