NY State Senate Bill 2021-S1580

Senate Bill S1580

2021-2022 Legislative Session

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

download bill text pdf

Archive: Last Bill Status - In Senate Committee Health Committee

Introduced
- In Committee Assembly
- In Committee Senate
- On Floor Calendar Assembly
- On Floor Calendar Senate
- Passed Assembly
- Passed Senate
Delivered to Governor
Signed By Governor

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Actions

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	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Jan 05, 2022	referred to health
Apr 05, 2021	print number 1580a
Apr 05, 2021	amend and recommit to health
Jan 13, 2021	referred to health

Bill Amendments

Original

A (Active)

2021-S1580 - Details

Current Committee:: Senate Health
Law Section:: Social Services Law
Laws Affected:: Amd §§365-h & 368-a, Soc Serv L
Versions Introduced in Other Legislative Sessions:: 2009-2010: S5068
2011-2012: S2715
2013-2014: S3312
2015-2016: S1055
2017-2018: S2528
2019-2020: S7035
2023-2024: S3223
2025-2026: S3768

2021-S1580 - 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; authorizes the commissioner of health to establish a reimbursement methodology to ensure providers are reimbursed.

2021-S1580 - Sponsor Memo

                                
 
BILL NUMBER: S1580

SPONSOR: SANDERS
 
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.

2021-S1580 - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   1580
 
                        2021-2022 Regular Sessions
 
                             I N  S E N A T E
 
                             January 13, 2021
                                ___________
 
 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  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 7 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.
   7.  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.

                                                            LBD00645-02-1

 S. 1580                             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 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 TWEN-
 TY-THREE, AFTER FIRST DEDUCTING THEREFROM  ANY  FEDERAL  FUNDS  PROPERLY
 RECEIVED OR TO BE RECEIVED ON ACCOUNT THEREOF.
   §  3.  This  act  shall  take  effect April 1, 2023, 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.

2021-S1580A (ACTIVE) - Details

Current Committee:: Senate Health
Law Section:: Social Services Law
Laws Affected:: Amd §§365-h & 368-a, Soc Serv L
Versions Introduced in Other Legislative Sessions:: 2009-2010: S5068
2011-2012: S2715
2013-2014: S3312
2015-2016: S1055
2017-2018: S2528
2019-2020: S7035
2023-2024: S3223
2025-2026: S3768

2021-S1580A (ACTIVE) - Summary

2021-S1580A (ACTIVE) - Sponsor Memo

                                
 
BILL NUMBER: S1580A

SPONSOR: SANDERS
 
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
2019: A2789 - referred to Health / Senate Health
2020: A2789 - referred to Health / 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.

2021-S1580A (ACTIVE) - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  1580--A
 
                        2021-2022 Regular Sessions
 
                             I N  S E N A T E
 
                             January 13, 2021
                                ___________
 
 Introduced  by  Sen. SANDERS -- read twice and ordered printed, and when
   printed to be committed  to  the  Committee  on  Health  --  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 7 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.
   7. 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
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.

                                                            LBD00645-04-1

 S. 1580--A                          2
 
 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
 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 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 TWEN-
 TY-TWO, AFTER FIRST  DEDUCTING  THEREFROM  ANY  FEDERAL  FUNDS  PROPERLY
 RECEIVED OR TO BE RECEIVED ON ACCOUNT THEREOF.
   §  3.  This  act  shall  take  effect April 1, 2022, 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.

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