S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   5122
 
                        2023-2024 Regular Sessions
 
                             I N  S E N A T E
 
                             February 23, 2023
                                ___________
 
 Introduced  by  Sens. RIVERA, SKOUFIS -- read twice and ordered printed,
   and when printed to be committed to the Committee on Health
 
 AN ACT to amend the public health law and  the  state  finance  law,  in
   relation to an ambulance service assessment fee
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1.  The public health law is amended by adding a  new  section
 3033 to read as follows:
   §  3033.  AMBULANCE SERVICE ASSESSMENT. 1. THE DEPARTMENT SHALL CHARGE
 EVERY AMBULANCE SERVICE A UNIFORM  AMBULANCE  ASSESSMENT  FEE,  PROVIDED
 THAT  THE  FEE  SHALL NOT APPLY TO ANY MUNICIPAL FIRE DEPARTMENT, POLICE
 DEPARTMENT, OR OTHER GOVERNMENT ENTITY THAT PROVIDES  EMERGENCY  MEDICAL
 SERVICES,  ANY  AMBULANCE  SERVICE  THAT  EXCLUSIVELY PROVIDES EMERGENCY
 MEDICAL CARE BY AIRCRAFT, OR ANY PROVIDER REQUIRED TO PAY AN  ASSESSMENT
 ON AMBULANCE SERVICE REVENUE UNDER ARTICLE TWENTY-EIGHT OF THIS CHAPTER.
   2.  THE  UNIFORM  ASSESSMENT  FEE  SHALL BE ASSESSED ON EACH AMBULANCE
 SERVICE COVERED UNDER THIS SECTION AT A RATE OF AT LEAST FIVE AND THREE-
 QUARTERS PERCENT  OF  A  COVERED  AMBULANCE  SERVICE'S  ANNUAL  REVENUE,
 PROVIDED  HOWEVER THAT THE COMMISSIONER, IN CONSULTATION WITH THE DIREC-
 TOR OF THE DIVISION OF THE BUDGET, MAY SET SUCH FEE AT A RATE NO GREATER
 THAN THE MAXIMUM LIMIT ALLOWABLE UNDER 42 C.F.R. 433.68(F).  THE DEPART-
 MENT SHALL SET AND IMPLEMENT SUCH FEES USING THE BEST DATA AVAILABLE  IN
 CONSULTATION  WITH STAKEHOLDERS, INCLUDING TRADE ASSOCIATIONS REPRESENT-
 ING AMBULANCE PROVIDERS SUBJECT TO SUCH  ASSESSMENT,  AND  SHALL  UPDATE
 SUCH FEES ON A PERIODIC BASIS BUT AT LEAST ANNUALLY.
   3.    ALL  FEES  COLLECTED UNDER THIS SECTION SHALL BE EXPENDED BY THE
 COMMISSIONER IN A TIMELY MANNER AND SOLELY FOR  PURPOSES  OF  INCREASING
 MEDICAL  ASSISTANCE PAYMENT RATES FOR AMBULANCE SERVICES SUBJECT TO SUCH
 FEES TO MORE CLOSELY ALIGN WITH THE AVERAGE COMMERCIAL RATE OF  PAYMENT,
 AND  ENSURING  ADEQUACY OF THE AMBULANCE SERVICES IN A REGION AS DEFINED
 BY THE COMMISSIONER, AND TO COVER THE REASONABLE ADMINISTRATIVE EXPENSES
 OF THE DEPARTMENT IN ADMINISTERING THE FUND. SUCH MONIES  SHALL  NOT  BE
 USED TO REDUCE OR REPLACE OTHER PAYMENT COMMITMENTS BY THE STATE.
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
              

                       [ ] is old law to be omitted.
                                                            LBD00572-01-3
 S. 5122                             2

   4.  FEES COLLECTED UNDER THIS SECTION SHALL BE HELD IN A FUND ADMINIS-
 TERED  BY THE DEPARTMENT AS SET FORTH IN SECTION NINETY-SEVEN-Q-1 OF THE
 STATE FINANCE LAW.
   5.  THE DEPARTMENT MAY IMPOSE PENALTIES FOR ANY AMBULANCE SERVICE THAT
 FAILS TO PAY THE FEE WITHIN THE TIME REQUIRED BY THE DEPARTMENT.
   6. FEES UNDER THIS SECTION SHALL BE COLLECTED ONLY IF  FEDERAL  FINAN-
 CIAL  PARTICIPATION  IS  AVAILABLE  FOR EXPENDITURES INCURRED UNDER THIS
 SECTION.  ANY FEES COLLECTED BUT NOT EXPENDED IN  A  FISCAL  YEAR  SHALL
 REMAIN  AVAILABLE  FOR  EXPENDITURE  IN  SUBSEQUENT  FISCAL YEARS.   THE
 DEPARTMENT SHALL SUBMIT ALL NECESSARY DOCUMENTATION FOR FEDERAL APPROVAL
 OF THIS PROGRAM, INCLUDING AMENDMENTS TO THE STATE PLAN UNDER TITLE  XIX
 OF  THE FEDERAL SOCIAL SECURITY ACT, NECESSARY TO IMPLEMENT THIS SECTION
 WITHIN ONE HUNDRED EIGHTY DAYS OF THE EFFECTIVE DATE OF THIS SECTION.
   § 2. The state finance law is amended by adding a new  section  97-q-1
 to read as follows:
   § 97-Q-1. STATEWIDE AMBULANCE FUND; ASSESSMENT OF ANNUAL FEES ON AMBU-
 LANCE  SERVICES.  1.  THERE  IS HEREBY ESTABLISHED IN THE CUSTODY OF THE
 COMPTROLLER, A SPECIAL FUND TO BE  KNOWN  AS  THE  "STATEWIDE  AMBULANCE
 FUND".
   2. THE FUND SHALL CONSIST OF:
   (A) ALL FEES OR PENALTIES COLLECTED PURSUANT TO SECTION THREE THOUSAND
 THIRTY-THREE OF THE PUBLIC HEALTH LAW;
   (B)    AN AMOUNT EQUAL TO ANY FEDERAL FINANCIAL PARTICIPATION REVENUES
 CLAIMED AND RECEIVED BY THE STATE FOR ELIGIBLE EXPENDITURES TO  BE  MADE
 FROM THE FUND;
   (C)  ANY  APPROPRIATION  OR OTHER REVENUE AUTHORIZED BY OR REQUIRED BY
 LAW TO BE CREDITED TO THE FUND; AND
   (D) INTEREST EARNED ON ANY MONEY IN THE FUND.
   3. AMOUNTS CREDITED TO THE FUND SHALL BE EXPENDED SOLELY FOR  MEDICAID
 PAYMENTS TO AMBULANCE SERVICES SUBJECT TO FEES PURSUANT TO SECTION THREE
 THOUSAND  THIRTY-THREE  OF  THE  PUBLIC HEALTH LAW, AND AN AMOUNT NOT TO
 EXCEED THE ACTUAL AND REASONABLE ADMINISTRATIVE EXPENSES OF THE  DEPART-
 MENT OF HEALTH TO ADMINISTER THE FUND.  AFTER PAYMENT OF THE ADMINISTRA-
 TIVE  EXPENSES  OF  THE  DEPARTMENT  OF HEALTH, THE REVENUES OF THE FUND
 SHALL  BE  EXPENDED  EXCLUSIVELY  FOR  MEDICAID  PAYMENTS  TO  AMBULANCE
 SERVICES  SUBJECT TO SUCH FEES IN ACCORDANCE WITH SECTION THREE THOUSAND
 THIRTY-THREE OF THE PUBLIC HEALTH LAW AND SHALL SUPPLEMENT NOT  SUPPLANT
 EXISTING STATE PAYMENTS FOR AMBULANCE  SERVICES.
   4.  THE DEPARTMENT OF HEALTH SHALL ASSESS THE FEE DESCRIBED IN SECTION
 THREE THOUSAND THIRTY-THREE OF THE PUBLIC HEALTH LAW ONLY UPON  APPROVAL
 FROM  THE  CENTERS  FOR  MEDICARE  AND  MEDICAID    SERVICES AUTHORIZING
 ENHANCED MEDICAID PAYMENTS.
   5. (A) IF THE CENTERS FOR  MEDICARE  AND  MEDICAID  SERVICES  RESCINDS
 APPROVAL  OF  THE MEDICAID PAYMENTS MADE TO AMBULANCE SERVICES, THEN ALL
 MONIES IN THE FUND SHALL BE RETURNED TO THE AMBULANCE SERVICES, PRO RATA
 BY CONTRIBUTION AMOUNT.
   (B) IF THE  COMMISSIONER  OF  HEALTH  DETERMINES  THE  FEE  CANNOT  BE
 COLLECTED  AS  REQUIRED  BY  SECTION  THREE THOUSAND THIRTY-THREE OF THE
 PUBLIC HEALTH LAW, ALL MONIES IN THE  FUND  SHALL  BE  RETURNED  TO  THE
 APPLICABLE AMBULANCE SERVICES PRO RATA BY CONTRIBUTION AMOUNT.
   6.  THE COMMISSIONER OF HEALTH MAY ORDER DISBURSEMENT FROM THE FUND IN
 ACCORDANCE WITH  A SCHEDULE OF PAYMENTS TO AMBULANCE  SERVICE  PROVIDERS
 THAT  HAVE CONTRIBUTED TO  SUCH FUND, AS PROVIDED IN SECTION THREE THOU-
 SAND THIRTY-THREE OF THE PUBLIC HEALTH LAW.
   § 3.  This act shall take effect immediately.