HCS SS SB 307 -- HEALTH CARE PROVIDER ASSESSMENTS

SPONSOR:  Dempsey (Schaaf)

COMMITTEE ACTION:  Voted "do pass" by the Committee on Healthcare
Transformation by a vote of 11 to 1.

This substitute establishes health care provider assessments for
ground ambulance services and certain mental health providers.

FEDERAL REIMBURSEMENT ALLOWANCE FOR AMBULANCE SERVICES

The 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 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 department director
must reconsider the determination and grant a hearing within 45
days if one is requested.  The department 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.

MENTAL HEALTH PROVIDER CERTIFICATION FEE

Beginning July 1, 2009, certain mental health providers will be
subject to a certification fee including publicly and privately
operated programs that have been certified to meet the Department
of Mental Health's certification standards for providing
residential habilitation, individualized supported living, or day
habilitation services to developmentally disabled individuals.
The fee will be based on a formula established by the department
and will not be in effect until the department receives federal
approval.  The fee will be determined on an annual basis and
prorated monthly by the department director and paid to the
Director of the Department of Revenue.  As an alternative to
paying the fee, the Department of Social Services can offset from
the amount of any payment to a provider the amount of the fee
payment owed for any month.  Every provider that is subject to
the fee must annually submit an acknowledgment of certification
for the purpose of paying the certification fee.

The Home and Community-based Developmental Disabilities Waiver
Reimbursement Allowance Fund is created into which fee payments
will be deposited.  All investment earnings of the fund must be
credited to it.

The Director of the Department of Social Services is authorized
to withhold the estimated fee amount and remit it to the Director
of the Department of Revenue.  If a provider objects to the
estimated fee or any other decision under the provisions of the
substitute, a hearing may be requested.  A provider will be
offered 30 days to provide evidence of the correct amount due.
The Director of the Department of Mental Health is required to
issue a final decision within 45 days of the completed hearing.

The provisions regarding the ambulance reimbursement tax and the
certification fee for mental health providers will expire
September 30, 2011.

The substitute contains an emergency clause for the provisions
regarding the certification fee for mental health providers.

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.

PROPONENTS:  Supporters say that the bill will increase the
reimbursement rates of the MO HealthNet Program for ground
ambulances and provide additional federal funds.

Testifying for the bill were Senator Dempsey; and Metropolitan
Ambulance Services Trust.

OPPONENTS:  There was no opposition voiced to the committee.

OTHERS:  Others testifying on the bill explained how the
certification fee for mental health providers will work.

Testifying on the bill was Department of Mental Health.

Missouri House of Representatives
95th General Assembly, 1st Regular Session
Last Updated November 17, 2009 at 9:26 am