HB 459 -- Federal Reimbursement Allowance for Ambulance Services

Sponsor:  Schaaf

This bill creates a federal reimbursement allowance for ground
ambulance services.  Each ambulance service, except state-owned
and -operated ambulances, will be required to pay an ambulance
service reimbursement allowance based on a formula established by
the Department of Social Services.  Each ambulance service is
required to keep the records necessary to determine the amount of
its reimbursement allowance and submit that information to the
department by October 1 of each year.

The department director is required to annually determine and
notify each ambulance service by October 1 of the amount of its
reimbursement allowance due.  If requested by the ambulance
service, the department is authorized to offset the federal
reimbursement allowance against any MO HealthNet Program payment
due to the ambulance service.

Each ambulance service reimbursement allowance determination is
final, unless the ambulance service files a protest with the
department director within 30 days of receipt of the written
notice.  If a timely protest is filed, the director must
reconsider the determination and grant a hearing within 45 days
if one is requested.  The director's final decision which must be
made within 45 days after the hearing may be appealed to the
Administrative Hearing Commission.

The Ambulance Service Reimbursement Allowance Fund is created to
provide payment to ambulance services and to disburse up to 5% of
the federal funds deposited into the fund each year up to $1.5
million to the credit of the newly created Ambulance Service
Quality of Care Fund, subject to appropriations.  All investment
earnings of the Ambulance Service Reimbursement Allowance Fund
must be credited to it.

The ambulance reimbursement allowance period will be from
October 1 to September 30.  The department is required to
annually notify each ambulance service on September 30 of the
balance due.  If an ambulance service fails to pay its
reimbursement allowance within 30 days of the notice, the
reimbursement allowance is considered delinquent and the
department may proceed with a lien against the ambulance
service's property; deny, suspend, or revoke its license; and
cancel or refuse to issue or extend its MO HealthNet provider
agreement.

The provisions of the bill will apply only as long as the
revenues generated are eligible for federal participation under
the MO HealthNet Program.  The bill requires the department to
provide copies of the proposed program rules to all interested
parties 72 hours before filing them with the Secretary of State.
The department director is required to maintain a list of
registered interested parties.

The provisions of the bill will expire September 30, 2015.

Missouri House of Representatives
95th General Assembly, 1st Regular Session
Last Updated November 17, 2009 at 9:24 am