HF 2285 (LSB 5688HV (1) 87)

HOUSE FILE 2285

BY  COMMITTEE ON LOCAL GOVERNMENT

(SUCCESSOR TO HF 2103)

A BILL FOR

An Act relating to supplemental reimbursement for publicly owned or operated ground emergency medical transportation providers through the Medicaid program, and including effective date provisions.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:

    Section 1.  DEPARTMENT OF HUMAN SERVICES —— SUBMISSION OF MEDICAID STATE PLAN AMENDMENT —— SUPPLEMENTAL REIMBURSEMENT FOR ELIGIBLE GROUND EMERGENCY MEDICAL TRANSPORTATION SERVICES.
   1.  By July 1, 2018, the department of human services shall submit a Medicaid state plan amendment to the centers for Medicare and Medicaid services of the United States department of health and human services to request authorization to establish and administer a methodology to provide supplemental reimbursement to eligible ground emergency medical transportation providers that provide ground emergency medical transportation services to Medicaid beneficiaries. Supplemental reimbursements shall be available only for the uncompensated care costs incurred by eligible ground emergency medical transportation providers for providing ground emergency medical transportation services to Medicaid beneficiaries. The department shall implement applicability of the supplemental reimbursement to eligible ground emergency medical transportation providers upon receipt of federal approval. 
   2.  For the purposes of this section:
   a.  “Advanced life support” means special services designed to provide definitive prehospital emergency medical care, including but not limited to cardiopulmonary resuscitation, cardiac monitoring, cardiac defibrillation, advanced airway management, intravenous therapy, administration of drugs and other medicinal preparations, and other specified techniques and procedures.
   b.  “Basic life support” means emergency first aid and cardiopulmonary resuscitation procedures to maintain life without invasive techniques.
   c.  “Eligible ground emergency medical transportation provider” means a provider who is eligible to receive supplemental payments, provides ground emergency medical transportation services to Medicaid beneficiaries continuously during the claiming period, is enrolled as a Medicaid provider during the period being claimed, and meets one of the following conditions:
   (1)  Is owned or operated by an eligible governmental entity, including but not limited to the state, a city, county, city and county, or fire district.
   (2)  Contracts with an eligible governmental entity, including but not limited to the state, a city, county, city and county, or fire district.
   d.  “Ground emergency medical transportation services” means both the act of transporting an individual from any point of origin to the nearest medical facility capable of meeting the emergency medical needs of the individual, as well as the advanced life support, limited-advanced life support, and basic life support services provided to an individual by ground emergency medical transportation providers before or during the act of transportation.
   e.  “Limited advanced life support” means special services to provide prehospital emergency medical care limited to techniques and procedures that exceed basic life support but are less than advanced life support services.
    Sec. 2.  REVISION OF STATE PLAN AMENDMENT REQUEST.  If the centers for Medicare and Medicaid services of the United States department of health and human services determines that the state plan amendment authorized and submitted pursuant to section 1 of this Act shall not apply to eligible ground emergency medical transportation providers who contract with an eligible governmental entity as specified in section 1, subsection 2, paragraph “c”, subparagraph (2), of this Act, the department shall revise the state plan amendment to exclude such providers and such revised state plan amendment shall be implemented in lieu of the initial state plan amendment submitted upon receipt of federal approval.
    Sec. 3.  EFFECTIVE UPON ENACTMENT.  This Act, being deemed of immediate importance, takes effect upon enactment.
EXPLANATION
The inclusion of this explanation does not constitute agreement with

the explanation’s substance by the members of the general assembly.
   This bill directs the department of human services (DHS), by July 1, 2018, to submit a state plan amendment to the centers for Medicare and Medicaid services of the United States department of health and human services (CMS) to request authorization to establish and administer a methodology to provide supplemental reimbursement to eligible ground emergency medical transportation providers. Supplemental reimbursements provided by the program shall be available only for the uncompensated care costs incurred by eligible ground emergency medical transportation providers. The bill provides, however, that if CMS determines that the state plan amendment authorized and submitted under the bill shall not include, as eligible ground emergency medical transportation providers, those who contract with an eligible governmental entity as specified in the bill, DHS shall revise the state plan amendment to exclude such providers and such revised state plan amendment shall be implemented in lieu of the initial state plan amendment submitted upon receipt of federal approval. Upon approval of the state plan amendment, DHS shall apply the supplemental reimbursement to eligible ground emergency medical transportation providers. 
   The bill takes effect upon enactment.