S T A T E O F N E W Y O R K
________________________________________________________________________
5133
2023-2024 Regular Sessions
I N A S S E M B L Y
March 2, 2023
___________
Introduced by M. of A. McDONALD -- read once and referred to the Commit-
tee on Health
AN ACT to amend the public health law and the state finance law, in
relation to an ambulance service assessment fee
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
Section 1. The public health law is amended by adding a new section
3033 to read as follows:
§ 3033. AMBULANCE SERVICE ASSESSMENT. 1. THE DEPARTMENT SHALL CHARGE
EVERY AMBULANCE SERVICE A UNIFORM AMBULANCE ASSESSMENT FEE, PROVIDED
THAT THE FEE SHALL NOT APPLY TO ANY MUNICIPAL FIRE DEPARTMENT, POLICE
DEPARTMENT, OR OTHER GOVERNMENT ENTITY THAT PROVIDES EMERGENCY MEDICAL
SERVICES, ANY AMBULANCE SERVICE THAT EXCLUSIVELY PROVIDES EMERGENCY
MEDICAL CARE BY AIRCRAFT, OR ANY PROVIDER REQUIRED TO PAY AN ASSESSMENT
ON AMBULANCE SERVICE REVENUE UNDER ARTICLE TWENTY-EIGHT OF THIS CHAPTER.
2. THE UNIFORM ASSESSMENT FEE SHALL BE ASSESSED ON EACH AMBULANCE
SERVICE COVERED UNDER THIS SECTION AT A RATE OF AT LEAST FIVE AND THREE-
QUARTERS PERCENT OF A COVERED AMBULANCE SERVICE'S ANNUAL REVENUE,
PROVIDED HOWEVER THAT THE COMMISSIONER, IN CONSULTATION WITH THE DIREC-
TOR OF THE DIVISION OF THE BUDGET, MAY SET SUCH FEE AT A RATE NO GREATER
THAN THE MAXIMUM LIMIT ALLOWABLE UNDER 42 C.F.R. 433.68(F). THE DEPART-
MENT SHALL SET AND IMPLEMENT SUCH FEES USING THE BEST DATA AVAILABLE IN
CONSULTATION WITH STAKEHOLDERS, INCLUDING TRADE ASSOCIATIONS REPRESENT-
ING AMBULANCE PROVIDERS SUBJECT TO SUCH ASSESSMENT, AND SHALL UPDATE
SUCH FEES ON A PERIODIC BASIS BUT AT LEAST ANNUALLY.
3. ALL FEES COLLECTED UNDER THIS SECTION SHALL BE EXPENDED BY THE
COMMISSIONER IN A TIMELY MANNER AND SOLELY FOR PURPOSES OF INCREASING
MEDICAL ASSISTANCE PAYMENT RATES FOR AMBULANCE SERVICES SUBJECT TO SUCH
FEES TO MORE CLOSELY ALIGN WITH THE AVERAGE COMMERCIAL RATE OF PAYMENT,
AND ENSURING ADEQUACY OF THE AMBULANCE SERVICES IN A REGION AS DEFINED
BY THE COMMISSIONER, AND TO COVER THE REASONABLE ADMINISTRATIVE EXPENSES
OF THE DEPARTMENT IN ADMINISTERING THE FUND. SUCH MONIES SHALL NOT BE
USED TO REDUCE OR REPLACE OTHER PAYMENT COMMITMENTS BY THE STATE.
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD00572-01-3
A. 5133 2
4. FEES COLLECTED UNDER THIS SECTION SHALL BE HELD IN A FUND ADMINIS-
TERED BY THE DEPARTMENT AS SET FORTH IN SECTION NINETY-SEVEN-Q-1 OF THE
STATE FINANCE LAW.
5. THE DEPARTMENT MAY IMPOSE PENALTIES FOR ANY AMBULANCE SERVICE THAT
FAILS TO PAY THE FEE WITHIN THE TIME REQUIRED BY THE DEPARTMENT.
6. FEES UNDER THIS SECTION SHALL BE COLLECTED ONLY IF FEDERAL FINAN-
CIAL PARTICIPATION IS AVAILABLE FOR EXPENDITURES INCURRED UNDER THIS
SECTION. ANY FEES COLLECTED BUT NOT EXPENDED IN A FISCAL YEAR SHALL
REMAIN AVAILABLE FOR EXPENDITURE IN SUBSEQUENT FISCAL YEARS. THE
DEPARTMENT SHALL SUBMIT ALL NECESSARY DOCUMENTATION FOR FEDERAL APPROVAL
OF THIS PROGRAM, INCLUDING AMENDMENTS TO THE STATE PLAN UNDER TITLE XIX
OF THE FEDERAL SOCIAL SECURITY ACT, NECESSARY TO IMPLEMENT THIS SECTION
WITHIN ONE HUNDRED EIGHTY DAYS OF THE EFFECTIVE DATE OF THIS SECTION.
§ 2. The state finance law is amended by adding a new section 97-q-1
to read as follows:
§ 97-Q-1. STATEWIDE AMBULANCE FUND; ASSESSMENT OF ANNUAL FEES ON AMBU-
LANCE SERVICES. 1. THERE IS HEREBY ESTABLISHED IN THE CUSTODY OF THE
COMPTROLLER, A SPECIAL FUND TO BE KNOWN AS THE "STATEWIDE AMBULANCE
FUND".
2. THE FUND SHALL CONSIST OF:
(A) ALL FEES OR PENALTIES COLLECTED PURSUANT TO SECTION THREE THOUSAND
THIRTY-THREE OF THE PUBLIC HEALTH LAW;
(B) AN AMOUNT EQUAL TO ANY FEDERAL FINANCIAL PARTICIPATION REVENUES
CLAIMED AND RECEIVED BY THE STATE FOR ELIGIBLE EXPENDITURES TO BE MADE
FROM THE FUND;
(C) ANY APPROPRIATION OR OTHER REVENUE AUTHORIZED BY OR REQUIRED BY
LAW TO BE CREDITED TO THE FUND; AND
(D) INTEREST EARNED ON ANY MONEY IN THE FUND.
3. AMOUNTS CREDITED TO THE FUND SHALL BE EXPENDED SOLELY FOR MEDICAID
PAYMENTS TO AMBULANCE SERVICES SUBJECT TO FEES PURSUANT TO SECTION THREE
THOUSAND THIRTY-THREE OF THE PUBLIC HEALTH LAW, AND AN AMOUNT NOT TO
EXCEED THE ACTUAL AND REASONABLE ADMINISTRATIVE EXPENSES OF THE DEPART-
MENT OF HEALTH TO ADMINISTER THE FUND. AFTER PAYMENT OF THE ADMINISTRA-
TIVE EXPENSES OF THE DEPARTMENT OF HEALTH, THE REVENUES OF THE FUND
SHALL BE EXPENDED EXCLUSIVELY FOR MEDICAID PAYMENTS TO AMBULANCE
SERVICES SUBJECT TO SUCH FEES IN ACCORDANCE WITH SECTION THREE THOUSAND
THIRTY-THREE OF THE PUBLIC HEALTH LAW AND SHALL SUPPLEMENT NOT SUPPLANT
EXISTING STATE PAYMENTS FOR AMBULANCE SERVICES.
4. THE DEPARTMENT OF HEALTH SHALL ASSESS THE FEE DESCRIBED IN SECTION
THREE THOUSAND THIRTY-THREE OF THE PUBLIC HEALTH LAW ONLY UPON APPROVAL
FROM THE CENTERS FOR MEDICARE AND MEDICAID SERVICES AUTHORIZING
ENHANCED MEDICAID PAYMENTS.
5. (A) IF THE CENTERS FOR MEDICARE AND MEDICAID SERVICES RESCINDS
APPROVAL OF THE MEDICAID PAYMENTS MADE TO AMBULANCE SERVICES, THEN ALL
MONIES IN THE FUND SHALL BE RETURNED TO THE AMBULANCE SERVICES, PRO RATA
BY CONTRIBUTION AMOUNT.
(B) IF THE COMMISSIONER OF HEALTH DETERMINES THE FEE CANNOT BE
COLLECTED AS REQUIRED BY SECTION THREE THOUSAND THIRTY-THREE OF THE
PUBLIC HEALTH LAW, ALL MONIES IN THE FUND SHALL BE RETURNED TO THE
APPLICABLE AMBULANCE SERVICES PRO RATA BY CONTRIBUTION AMOUNT.
6. THE COMMISSIONER OF HEALTH MAY ORDER DISBURSEMENT FROM THE FUND IN
ACCORDANCE WITH A SCHEDULE OF PAYMENTS TO AMBULANCE SERVICE PROVIDERS
THAT HAVE CONTRIBUTED TO SUCH FUND, AS PROVIDED IN SECTION THREE THOU-
SAND THIRTY-THREE OF THE PUBLIC HEALTH LAW.
§ 3. This act shall take effect immediately.