NY State Senate Bill 2015-S1055A

Senate Bill S1055A

2015-2016 Legislative Session

Allows for reimbursement of transportation costs for emergency care without prior authorization by the social services official

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Archive: Last Bill Status - In Senate Committee Health Committee

Introduced
- In Committee Assembly
- In Committee Senate
- On Floor Calendar Assembly
- On Floor Calendar Senate
- Passed Assembly
- Passed Senate
Delivered to Governor
Signed By Governor

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Actions

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	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Jan 11, 2016	print number 1055a
Jan 11, 2016	amend and recommit to health
Jan 06, 2016	referred to health
Jan 08, 2015	referred to health

Bill Amendments

Original

A (Active)

2015-S1055 - Details

See Assembly Version of this Bill:: A1512
Current Committee:: Senate Health
Law Section:: Social Services Law
Laws Affected:: Amd §§365-h & 368-a, Soc Serv L
Versions Introduced in Other Legislative Sessions:: 2009-2010: S5068
2011-2012: S2715
2013-2014: S3312, A5537
2017-2018: S2528, A3978
2019-2020: S7035, A2789
2021-2022: S1580, A231
2023-2024: S3223, A9237

2015-S1055 - Summary

Allows for reimbursement of transportation costs for emergency care without prior authorization by the social services official including emergency medical transportation by an ambulance service certified under article 30 of the public health law; and further authorizes the commissioner of health to establish a reimbursement methodology to ensure providers are reimbursed.

2015-S1055 - Sponsor Memo

                                BILL NUMBER:S1055

TITLE OF BILL:  An act to amend the social services law, in relation
to reimbursement of transportation costs for emergency care

PURPOSE:

To establish a Medicaid reimbursement methodology for ambulance
transportation with rates that allow providers to recoup their costs.

SUMMARY OF PROVISIONS:

Section 1. Amends Subdivision 1 of section 365-h of the Social
Services Law to exempt transportation to obtain emergency care from
the requirement for prior authorization under Medicaid, to conform
with the exemption in § 365a(2)(j) of the Social Services Law.

Amends Section 365-h of the Social Services Law to direct the
Commissioner of Health to establish a Medicaid reimbursement
methodology for ambulance transportation and care that ensures that
providers are reimbursed at the greater of the Medical Assistance Rate
on the effective date of the bill or the Federal Medicare allowable
charge. This reimbursement methodology shall be phased in over three
years as follows: in the state fiscal year in which the bill becomes a
law, 33 percent; in the following state fiscal year, 66 percent; and
in the second state fiscal year following the fiscal year in which the

bill becomes a law and all subsequent fiscal years, 100 percent.

Section 2. Amends Subdivision 1 of section 368-a of the Social
Services Law to ensure that the state bears 100 percent of the
increase in medical assistance under this title, after first deducting
any federal funds properly received or to be received on account
thereof.

Section 3. Provides that this act shall take effect immediately.

JUSTIFICATION:

The Medicaid reimbursement rate for ambulance trips is currently
determined on a county-by- county basis. Almost every county in the
state fails to adequately reimburse ambulance companies for the costs
incurred in transporting patients.

This bill would create a methodology for ambulance reimbursement under
Medicaid that more closely approximates the cost of providing the
service. Ambulances are required by law to pick everyone up, including
Medicaid patients. It is unfair to require these ambulance companies
to accept Medicaid patients and then not fairly reimburse them for the
costs of providing services to these patients.

LEGISLATIVE HISTORY:

S.3312 of 2013-14;
S.2715A of 2011-12;
S.5068 of 2009-10.

FISCAL IMPLICATIONS:


Dependent on the costs of transporting patients.  The State would also
assume the local share of any additional Medicaid spending.

EFFECTIVE DATE:

This act shall take effect April 1, 2016.

2015-S1055 - Bill Text download pdf

                            
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                  1055

                       2015-2016 Regular Sessions

                            I N  S E N A T E

                             January 8, 2015
                               ___________

Introduced  by  Sen.  SEWARD -- read twice and ordered printed, and when
  printed to be committed to the Committee on Health

AN ACT to amend the social services law, in relation to reimbursement of
  transportation costs for emergency care

  THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section  1. Subdivision 1 of section 365-h of the social services law,
as amended by section 20 of part B of chapter 109 of the laws  of  2010,
is amended and a new subdivision 6 is added to read as follows:
  1.  The  local social services official and, subject to the provisions
of subdivision four of this section, the commissioner  of  health  shall
have  responsibility  for  prior  authorizing transportation of eligible
persons and for limiting the provision of such transportation  to  those
recipients  and  circumstances  where  such transportation is essential,
medically necessary and appropriate to obtain medical care, services  or
supplies  otherwise available under this title.  HOWEVER, PRIOR AUTHORI-
ZATION SHALL NOT BE REQUIRED  FOR  TRANSPORTATION  TO  OBTAIN  EMERGENCY
CARE, INCLUDING EMERGENCY MEDICAL TRANSPORTATION BY AN AMBULANCE SERVICE
CERTIFIED UNDER ARTICLE THIRTY OF THE PUBLIC HEALTH LAW.
  6.  WITH  RESPECT  TO  TRANSPORTATION AND CARE PROVIDED TO AN ELIGIBLE
PERSON BY AN AMBULANCE SERVICE CERTIFIED UNDER  ARTICLE  THIRTY  OF  THE
PUBLIC  HEALTH  LAW,  THE COMMISSIONER OF THE DEPARTMENT OF HEALTH SHALL
ESTABLISH A REIMBURSEMENT METHODOLOGY THAT ENSURES  THAT  PROVIDERS  ARE
REIMBURSED  AT  THE  GREATER OF THE MEDICAL ASSISTANCE RATE IN EFFECT ON
THE EFFECTIVE DATE OF THIS SUBDIVISION, OR THE MEDICARE ALLOWABLE CHARGE
(PURSUANT TO TITLE XVIII OF THE FEDERAL SOCIAL SECURITY  ACT)  FOR  SUCH
TRANSPORTATION  AND  CARE.    THE  AMOUNT  OF  INCREASE IN REIMBURSEMENT
PRODUCED BY THIS METHODOLOGY OVER WHAT WOULD OTHERWISE  HAVE  BEEN  PAID
SHALL  BE  PHASED  IN AS FOLLOWS:  IN THE STATE FISCAL YEAR IN WHICH THE
PROVISIONS OF THIS SUBDIVISION BECOME A LAW,  THIRTY-THREE  PERCENT;  IN
THE  FOLLOWING  STATE  FISCAL YEAR, SIXTY-SIX PERCENT; AND IN THE SECOND

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD02699-01-5

S. 1055                             2

STATE  FISCAL  YEAR  FOLLOWING  THE  STATE  FISCAL  YEAR  IN  WHICH  THE
PROVISIONS  OF  THIS  SUBDIVISION BECOME A LAW AND ALL SUBSEQUENT FISCAL
YEARS, ONE HUNDRED PERCENT.
  S  2.  Subdivision  1  of  section 368-a of the social services law is
amended by adding a new paragraph (aa) to read as follows:
  (AA) NOTWITHSTANDING ANY INCONSISTENT PROVISION OF THIS CHAPTER OR ANY
OTHER PROVISION OF LAW TO THE  CONTRARY,  ONE  HUNDRED  PERCENT  OF  THE
AMOUNT  EXPENDED FOR MEDICAL ASSISTANCE UNDER THIS TITLE FOR TRANSPORTA-
TION AND CARE FURNISHED UNDER SUBDIVISION FOUR OF SECTION THREE  HUNDRED
SIXTY-FIVE-H  OF  THIS  TITLE  ON  OR  AFTER  APRIL  FIRST, TWO THOUSAND
SIXTEEN, AFTER FIRST DEDUCTING  THEREFROM  ANY  FEDERAL  FUNDS  PROPERLY
RECEIVED OR TO BE RECEIVED ON ACCOUNT THEREOF.
  S  3.  This  act  shall  take  effect April 1, 2016, provided that the
amendments to subdivision 1 of section 365-h of the social services  law
made  by  section one of this act shall not affect the repeal and rever-
sion of such section pursuant to subdivision (a) of section 40 of part B
of chapter 109 of the laws of 2010, as amended.

co-Sponsors

2015-S1055A (ACTIVE) - Details

See Assembly Version of this Bill:: A1512
Current Committee:: Senate Health
Law Section:: Social Services Law
Laws Affected:: Amd §§365-h & 368-a, Soc Serv L
Versions Introduced in Other Legislative Sessions:: 2009-2010: S5068
2011-2012: S2715
2013-2014: S3312, A5537
2017-2018: S2528, A3978
2019-2020: S7035, A2789
2021-2022: S1580, A231
2023-2024: S3223, A9237

2015-S1055A (ACTIVE) - Summary

2015-S1055A (ACTIVE) - Sponsor Memo

                                 BILL NUMBER:  S1055A

 TITLE OF BILL :  An act to amend the social services law, in relation
to reimbursement of transportation costs for emergency care

 PURPOSE :

To establish a Medicaid reimbursement methodology for ambulance
transportation with rates that allow providers to recoup their costs.

 SUMMARY OF PROVISIONS :

Section 1. Amends Subdivision 1 of section 365-h of the Social
Services Law to exempt transportation to obtain emergency care from
the requirement for prior authorization under Medicaid, to conform
with the exemption in § 365a(2)(j) of the Social Services Law.

Amends Section 365-h of the Social Services Law to direct the
Commissioner of Health to establish a Medicaid reimbursement
methodology for ambulance transportation and care that ensures that
providers are reimbursed at the greater of the Medical Assistance Rate
on the effective date of the bill or the Federal Medicare allowable
charge. This reimbursement methodology shall be phased in over three
years as follows: in the state fiscal year in which the bill becomes a
law, 33 percent; in the following state fiscal year, 66 percent; and
in the second state fiscal year following the fiscal year in which the

bill becomes a law and all subsequent fiscal years, 100 percent.

Section 2. Amends Subdivision 1 of section 368-a of the Social
Services Law to ensure that the state bears 100 percent of the
increase in medical assistance under this title, after first deducting
any federal funds properly received or to be received on account
thereof.

Section 3. Provides that this act shall take effect immediately.

 JUSTIFICATION :

The Medicaid reimbursement rate for ambulance trips is currently
determined on a county-by-county basis. Almost every county in the
state fails to adequately reimburse ambulance companies for the costs
incurred in transporting patients.

This bill would create a methodology for ambulance reimbursement under
Medicaid that more closely approximates the cost of providing the
service. Ambulances are required by law to pick everyone up, including
Medicaid patients. It is unfair to require these ambulance companies
to accept Medicaid patients and then not fairly reimburse them for the
costs of providing services to these patients.

 LEGISLATIVE HISTORY :

S.3312 of 2013-14;
S.2715A of 2011-12;
S.5068 of 2009-10.

 FISCAL IMPLICATIONS :

Dependent on the costs of transporting patients.  The State would also
assume the local share of any additional Medicaid spending.

 EFFECTIVE DATE :
This act shall take effect April 1, 2017.

2015-S1055A (ACTIVE) - Bill Text download pdf

                            
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                 1055--A

                       2015-2016 Regular Sessions

                            I N  S E N A T E

                             January 8, 2015
                               ___________

Introduced  by  Sen.  SEWARD -- read twice and ordered printed, and when
  printed to be committed to the Committee on Health --  recommitted  to
  the  Committee  on  Health in accordance with Senate Rule 6, sec. 8 --
  committee discharged, bill amended, ordered reprinted as  amended  and
  recommitted to said committee

AN ACT to amend the social services law, in relation to reimbursement of
  transportation costs for emergency care

  THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section 1. Subdivision 1 of section 365-h of the social services  law,
as  amended  by section 20 of part B of chapter 109 of the laws of 2010,
is amended and a new subdivision 6 is added to read as follows:
  1. The local social services official and, subject to  the  provisions
of  subdivision  four  of this section, the commissioner of health shall
have responsibility for prior  authorizing  transportation  of  eligible
persons  and  for limiting the provision of such transportation to those
recipients and circumstances where  such  transportation  is  essential,
medically  necessary and appropriate to obtain medical care, services or
supplies otherwise available under this title.  HOWEVER, PRIOR  AUTHORI-
ZATION  SHALL  NOT  BE  REQUIRED  FOR TRANSPORTATION TO OBTAIN EMERGENCY
CARE, INCLUDING EMERGENCY MEDICAL TRANSPORTATION BY AN AMBULANCE SERVICE
CERTIFIED UNDER ARTICLE THIRTY OF THE PUBLIC HEALTH LAW.
  6. WITH RESPECT TO TRANSPORTATION AND CARE  PROVIDED  TO  AN  ELIGIBLE
PERSON  BY  AN  AMBULANCE  SERVICE CERTIFIED UNDER ARTICLE THIRTY OF THE
PUBLIC HEALTH LAW, THE COMMISSIONER OF THE DEPARTMENT  OF  HEALTH  SHALL
ESTABLISH  A  REIMBURSEMENT  METHODOLOGY THAT ENSURES THAT PROVIDERS ARE
REIMBURSED AT THE GREATER OF THE MEDICAL ASSISTANCE RATE  IN  EFFECT  ON
THE EFFECTIVE DATE OF THIS SUBDIVISION, OR THE MEDICARE ALLOWABLE CHARGE
(PURSUANT  TO  TITLE  XVIII OF THE FEDERAL SOCIAL SECURITY ACT) FOR SUCH
TRANSPORTATION AND CARE.    THE  AMOUNT  OF  INCREASE  IN  REIMBURSEMENT
PRODUCED  BY  THIS  METHODOLOGY OVER WHAT WOULD OTHERWISE HAVE BEEN PAID

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD02699-02-6

S. 1055--A                          2

SHALL BE PHASED IN AS FOLLOWS:  IN THE STATE FISCAL YEAR  IN  WHICH  THE
PROVISIONS  OF THIS SUBDIVISION BECOME LAW, THIRTY-THREE PERCENT; IN THE
FOLLOWING STATE FISCAL YEAR, SIXTY-SIX PERCENT; AND IN THE SECOND  STATE
FISCAL  YEAR  FOLLOWING THE STATE FISCAL YEAR IN WHICH THE PROVISIONS OF
THIS SUBDIVISION BECOME LAW AND ALL SUBSEQUENT FISCAL YEARS, ONE HUNDRED
PERCENT.
  S 2. Subdivision 1 of section 368-a of  the  social  services  law  is
amended by adding a new paragraph (aa) to read as follows:
  (AA) NOTWITHSTANDING ANY INCONSISTENT PROVISION OF THIS CHAPTER OR ANY
OTHER  PROVISION  OF  LAW  TO  THE  CONTRARY, ONE HUNDRED PERCENT OF THE
AMOUNT EXPENDED FOR MEDICAL ASSISTANCE UNDER THIS TITLE FOR  TRANSPORTA-
TION  AND CARE FURNISHED UNDER SUBDIVISION FOUR OF SECTION THREE HUNDRED
SIXTY-FIVE-H OF THIS TITLE ON OR AFTER APRIL FIRST, TWO THOUSAND  SEVEN-
TEEN,  AFTER  FIRST  DEDUCTING  THEREFROM  ANY  FEDERAL  FUNDS  PROPERLY
RECEIVED OR TO BE RECEIVED ON ACCOUNT THEREOF.
  S 3. This act shall take effect  April  1,  2017,  provided  that  the
amendments  to  section 365-h of the social services law made by section
one of this act shall not  affect  the  repeal  and  reversion  of  such
section  pursuant  to subdivision (a) of section 40 of part B of chapter
109 of the laws of 2010, as amended.

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