senate Bill S2715A

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

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Sponsor

Bill Status


  • Introduced
  • In Committee
  • On Floor Calendar
    • Passed Senate
    • Passed Assembly
  • Delivered to Governor
  • Signed/Vetoed by Governor
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actions

  • 31 / Jan / 2011
    • REFERRED TO SOCIAL SERVICES
  • 04 / Jan / 2012
    • REFERRED TO SOCIAL SERVICES
  • 27 / Jan / 2012
    • AMEND AND RECOMMIT TO SOCIAL SERVICES
  • 27 / Jan / 2012
    • PRINT NUMBER 2715A
  • 07 / Feb / 2012
    • REPORTED AND COMMITTED TO HEALTH

Summary

Allows for reimbursement of transportation costs for emergency care without prior authorization by the social services official including emergency medical transportation by an ambulance service certified under article 30 of the public health law; and further authorizes the commissioner of health to establish a reimbursement methodology to ensure providers are reimbursed.

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Bill Details

Versions:
S2715
S2715A
Legislative Cycle:
2011-2012
Current Committee:
Senate Health
Law Section:
Social Services Law
Laws Affected:
Amd §§365-h & 368-a, Soc Serv L
Versions Introduced in Previous Legislative Cycles:
2009-2010: S5068
2007-2008: S2633A

Votes

3
0
3
Aye
0
Nay
3
aye with reservations
0
absent
0
excused
0
abstained
show Social Services committee vote details

Sponsor Memo

BILL NUMBER:S2715A

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)(i) 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 that this act shall take effect immediately.

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.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, 2013, with provisions.

view bill text
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                 2715--A

                       2011-2012 Regular Sessions

                            I N  S E N A T E

                            January 31, 2011
                               ___________

Introduced  by  Sen.  SEWARD -- read twice and ordered printed, and when
  printed to be committed to the Committee on Social Services --  recom-
  mitted  to  the Committee on Social Services in accordance with Senate
  Rule  6,  sec.  8  --  committee  discharged,  bill  amended,  ordered
  reprinted as amended and recommitted to said committee

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 ASSEM-
BLY, 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 5 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  AUTHORI-
ZATION  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.
  5. 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

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD02510-02-2

S. 2715--A                          2

SHALL BE PHASED IN AS FOLLOWS:  IN THE STATE FISCAL YEAR  IN  WHICH  THE
PROVISIONS  OF  THIS  SUBDIVISION BECOME A 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 THIS SUBDIVISION BECOME A LAW AND  ALL  SUBSEQUENT  FISCAL
YEARS, ONE HUNDRED PERCENT.
  S  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 TRANSPORTA-
TION AND CARE FURNISHED UNDER SUBDIVISION FOUR OF SECTION THREE  HUNDRED
SIXTY-FIVE-H  OF  THIS TITLE ON OR AFTER APRIL FIRST, TWO THOUSAND THIR-
TEEN,  AFTER  FIRST  DEDUCTING  THEREFROM  ANY  FEDERAL  FUNDS  PROPERLY
RECEIVED OR TO BE RECEIVED ON ACCOUNT THEREOF.
  S  3.  This  act  shall  take  effect April 1, 2013, provided that the
amendments to subdivision 1 of section 365-h of the social services  law
made  by  section one of this act shall not affect the repeal and rever-
sion of such section pursuant to subdivision (a) of section 40 of part B
of chapter 109 of the laws of 2010, as amended.

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