HCS HB 459 -- FEDERAL REIMBURSEMENT ALLOWANCE FOR AMBULANCE
SERVICES (Schaaf)

COMMITTEE OF ORIGIN:  Committee on Healthcare Transformation

This substitute 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 of Revenue by October 1 of each
year.

The Director of the Department of Social Services 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.  All investment earnings
of the 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 substitute will apply only as long as the
revenues generated are eligible for federal participation under
the MO HealthNet Program.  The substitute 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.

Currently, ambulance reimbursement under the MO HealthNet Program
is made through a base fee, which includes the first five miles
of transport, and mileage for the remainder of the transport.
The substitute requires reimbursement to be made based on mileage
calculations from the point of pick up to the destination.

The provisions regarding the ambulance reimbursement tax will
expire September 30, 2011.

FISCAL NOTE:  Estimated Cost on General Revenue Fund of $24,725
in FY 2010, $30,547 in FY 2011, and $31,463 in FY 2012.  No
impact on Other State Funds in FY 2010, FY 2011, and FY 2012.

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