senate Bill S3312

2013-2014 Legislative Session

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

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Archive: Last Bill Status - In Committee


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

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Assembly Actions - Lowercase
Senate Actions - UPPERCASE
Jan 08, 2014 referred to health
Jan 31, 2013 referred to health

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S3312 - Bill Details

See Assembly Version of this Bill:
A5537
Current Committee:
Law Section:
Social Services Law
Laws Affected:
Amd §§365-h & 368-a, Soc Serv L
Versions Introduced in Previous Legislative Sessions:
2011-2012: S2715A
2009-2010: S5068

S3312 - Bill Texts

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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 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

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

                                  3312

                       2013-2014 Regular Sessions

                            I N  S E N A T E

                            January 31, 2013
                               ___________

Introduced  by  Sen.  SEWARD -- 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  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
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

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD08126-01-3

S. 3312                             2

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 FOUR-
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, 2014, 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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