House File 2103 - Introduced HOUSE FILE 2103 BY HINSON and BRECKENRIDGE A BILL FOR An Act relating to supplemental reimbursement for publicly 1 owned or operated ground emergency medical transportation 2 providers through the Medicaid program, and including 3 effective date provisions. 4 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 5 TLSB 5688YH (6) 87 pf/rh

H.F. 2103 Section 1. DEPARTMENT OF HUMAN SERVICES —— SUBMISSION OF 1 MEDICAID STATE PLAN AMENDMENT —— SUPPLEMENTAL REIMBURSEMENT FOR 2 ELIGIBLE GROUND EMERGENCY MEDICAL TRANSPORTATION SERVICES. 3 1. By July 1, 2018, the department of human services 4 shall submit a Medicaid state plan amendment to the 5 centers for Medicare and Medicaid services of the United 6 States department of health and human services to request 7 authorization to establish and administer a methodology to 8 provide supplemental reimbursement to eligible ground emergency 9 medical transportation providers that provide ground emergency 10 medical transportation services to Medicaid beneficiaries. 11 Supplemental reimbursements shall be available only for the 12 uncompensated care costs incurred by eligible ground emergency 13 medical transportation providers for providing ground emergency 14 medical transportation services to Medicaid beneficiaries. 15 The department shall implement applicability of the 16 supplemental reimbursement to eligible ground emergency medical 17 transportation providers upon receipt of federal approval. 18 2. For the purposes of this section: 19 a. “Advanced life support” means special services designed 20 to provide definitive prehospital emergency medical care, 21 including but not limited to cardiopulmonary resuscitation, 22 cardiac monitoring, cardiac defibrillation, advanced airway 23 management, intravenous therapy, administration of drugs and 24 other medicinal preparations, and other specified techniques 25 and procedures. 26 b. “Basic life support” means emergency first aid and 27 cardiopulmonary resuscitation procedures to maintain life 28 without invasive techniques. 29 c. “Eligible ground emergency medical transportation 30 provider” means a provider who is eligible to receive 31 supplemental payments, provides ground emergency medical 32 transportation services to Medicaid beneficiaries continuously 33 during the claiming period, is enrolled as a Medicaid provider 34 during the period being claimed, and meets one of the following 35 -1- LSB 5688YH (6) 87 pf/rh 1/ 3

H.F. 2103 conditions: 1 (1) Is owned or operated by an eligible governmental entity, 2 including but not limited to the state, a city, county, city 3 and county, or fire district. 4 (2) Contracts with an eligible governmental entity, 5 including but not limited to the state, a city, county, city 6 and county, or fire district. 7 d. “Ground emergency medical transportation services” means 8 both the act of transporting an individual from any point of 9 origin to the nearest medical facility capable of meeting the 10 emergency medical needs of the individual, as well as the 11 advanced life support, limited-advanced life support, and basic 12 life support services provided to an individual by ground 13 emergency medical transportation providers before or during the 14 act of transportation. 15 e. “Limited advanced life support” means special services 16 to provide prehospital emergency medical care limited to 17 techniques and procedures that exceed basic life support but 18 are less than advanced life support services. 19 Sec. 2. REVISION OF STATE PLAN AMENDMENT REQUEST. If 20 the centers for Medicare and Medicaid services of the United 21 States department of health and human services determines that 22 the state plan amendment authorized and submitted pursuant 23 to section 1 of this Act shall not apply to eligible ground 24 emergency medical transportation providers who contract with 25 an eligible governmental entity as specified in section 1, 26 subsection 2, paragraph “c”, subparagraph (2), of this Act, the 27 department shall revise the state plan amendment to exclude 28 such providers and such revised state plan amendment shall 29 be implemented in lieu of the initial state plan amendment 30 submitted upon receipt of federal approval. 31 Sec. 3. EFFECTIVE UPON ENACTMENT. This Act, being deemed of 32 immediate importance, takes effect upon enactment. 33 EXPLANATION 34 The inclusion of this explanation does not constitute agreement with 35 -2- LSB 5688YH (6) 87 pf/rh 2/ 3

H.F. 2103 the explanation’s substance by the members of the general assembly. 1 This bill directs the department of human services (DHS), 2 by July 1, 2018, to submit a state plan amendment to the 3 centers for Medicare and Medicaid services of the United States 4 department of health and human services (CMS) to request 5 authorization to establish and administer a methodology to 6 provide supplemental reimbursement to eligible ground emergency 7 medical transportation providers. Supplemental reimbursements 8 provided by the program shall be available only for the 9 uncompensated care costs incurred by eligible ground emergency 10 medical transportation providers. The bill provides, however, 11 that if CMS determines that the state plan amendment authorized 12 and submitted under the bill shall not include, as eligible 13 ground emergency medical transportation providers, those who 14 contract with an eligible governmental entity as specified 15 in the bill, DHS shall revise the state plan amendment to 16 exclude such providers and such revised state plan amendment 17 shall be implemented in lieu of the initial state plan 18 amendment submitted upon receipt of federal approval. Upon 19 approval of the state plan amendment, DHS shall apply the 20 supplemental reimbursement to eligible ground emergency medical 21 transportation providers. 22 The bill takes effect upon enactment. 23 -3- LSB 5688YH (6) 87 pf/rh 3/ 3