Quoted from Shadow

There are a lot of people living on a fixed income that may disagree with you.

Quoted from DemocraticVoiceOfReason

If it is put up for a vote,  I predict that a majority of property owners in Rotterdam will vote YES for REMS
and a tax district.  
Most people in town know that the value of human life is worth more than 10cents per thousand and that
REMS is a great provider of service.

Quoted from senders

unfortunately that is where our thinking STOPS.....we already fund the elderly in this country......soooooo....dont tell me it will save $....
medicare and the likes still pay for ambulance.....stop lying to the poor poor victimized seniors.......pathetic politicians......

Quoted Text

Article: Medicare's ambulance fee schedule dispatched: Medicare's new ambulance fee schedule means more revenue for some providers but less for others.
Article from:Healthcare Financial Management Article date:August 1, 2002Author:Grimaldi, Paul L.CopyrightCOPYRIGHT 2009 Healthcare Financial Management Association. This material is published under license from the publisher through the Gale Group, Farmington Hills, Michigan.   All inquiries regarding rights or concerns about this content should be directed to customer service. (Hide copyright information)       Related articles  

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Medical Fees 2011
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Medicare's ambulance fee schedule, which took effect April 1, 2002, has meant higher payments for some providers and suppliers, but lower payments for others. (a) Healthcare financial managers must revise their policies, procedures, and chargemasters to satisfy new requirements. Expanded and revised diagnosis and procedure codes are required for billing purposes. Financial managers need to develop and implement methods to track the impact of the new fee schedule on their organizations bottom lines. Overall, Federal actuaries expect the new fee schedule to reduce Medicare spending for ambulance services by about 2 percent in 2002.

Former Methods

Previously, Medicare used two methods to pay for ambulance services. Providers (hospitals, skilled nursing facilities, and home health agencies) were paid on a reasonable-cost basis, which includes an inflation cap on the reimbursable cost per trip. Suppliers (entities independent of any provider) were paid on a reasonable-charge basis that linked payment to the lowest of a supplier's actual, customary, prevailing, or inflation-indexed charges.

The following four methods were used to bill for ambulance services:

* A single, all-inclusive charge for all services, supplies, and mileage;

* One charge for all services and supplies, and a separate charge for mileage;

* One charge for all services and mileage, and a separate charge for supplies; and

* Separate charges for services, supplies, and mileage.

In some localities, separate charges were allowed for supplies used with specialized services (eg, intubation and intravenous drug administration) commonly furnished during advanced life-support transportation, as well as for unusual waiting time. Suppliers within the same locality used different billing methods and were locked into the billing method they had chosen. ICD-9-CM diagnosis codes described the nature and symptoms that necessitated ambulance transportation; HCPCS procedure codes indicated the trip's origin and destination. After meeting the annual Part B deductible of $100, Medicare beneficiaries were responsible for 20 percent of billed charges. Suppliers (but not providers) did not have to accept assignment (ie, Medicare as full payment for covered services), but were permitted to bill the beneficiary the excess of their billed charges over the Medicare allowed-payment amount.

Fee Schedule

Under the new schedule, ambulance fees vary with the level of service and the length of the beneficiary's trip. Payment for mileage includes an add-on for beneficiaries picked up in a rural area. Providers and suppliers must meet revised certification requirements and use revised and expanded diagnosis and procedure codes to bill for ambulance services. Because the fee schedule affects the Medicare payment amount, it also affects a beneficiary's coinsurance liability.

Covered entities. Ambulance services may be furnished by providers or other entities, referred to as suppliers. Virtually all providers and suppliers that furnish ambulance services to Medicare beneficiaries have been covered by the new fee schedule since its launch date. The only exemptions are critical-access hospitals (CAHs) or CAH-owned and operated entities that are the only providers or suppliers of ambulance transportation within 35 miles of the CAH or the entity. Exempted hospitals and entities continue to be reimbursed on a reasonable-cost basis for ambulance services furnished to Medicare beneficiaries.

Covered services. Part B of Medicare pays for ground (ie, land and water) or air ambulance services when a beneficiary's condition justifies ambulance transportation and the specific level of service provided. Beneficiaries may be transported from their home, an accident scene, or other point of origin to the nearest hospital or skilled nursing facility furnishing the needed service. A beneficiary who resides at home and has end-stage renal disease may be transported to a renal-dialysis facility, regardless of whether it is hospital-based or freestanding. Rarely does Part B cover ambulance trips to a physician's office, urgent-care center, or freestanding radiological facility.

Part B coverage is preempted if the beneficiary, when transported, is an inpatient of a hospital or any other provider paid under Part A. In such instances, Part A pays the facility for the beneficiary's medically necessary ambulance services, for example, when a skilled nursing facility patient is taken for treatment to a hospital.

Both vehicles and vehicle staff must meet revised certification requirements to qualify for Medicare payments for ambulance services. A covered trip may be for a medical emergency or nonemergency. For the latter to be covered, the beneficiary …

Quoted Text

S5068: Allows for reimbursement of transportation costs for emergency care without prior authorization by the social services official

Same as: A6674A Versions: S5068 Print Page / ShareThis/ Read or Leave Comments

Sponsor: THOMPSON
Committee: SOCIAL SERVICES
Law Section: Social Services Law

S5068 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.
S5068 Actions
S5068 - COMMITTEE DISCHARGED AND COMMITTED TO HEALTH - May 13, 2009
S5068 - REFERRED TO SOCIAL SERVICES - Apr 27, 2009

S5068 Memo


BILL NUMBER: S5068

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

PURPOSE OR GENERAL IDEA OF THE BILL : To establish a Medicaid reimbursement methodology for ambulance transportation with rates that allow providers to recoup their costs.

SUMMARY OF SPECIFIC PROVISIONS :

Section 1.Amends Subdivision 1 of section 365h 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 5 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.

PRIOR LEGISLATIVE HISTORY : 2002: A11462
reported to Ways and Means

2003: A4746
reported to Ways and Means 2004: A4746-A: reported to

Rules 2005-06: A4017-B
reported to Ways and Means 2007-08: A3793-A -reported to Ways and Means

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

EFFECTIVE DATE : Immediately.
S5068 Text
S T A T E O F N E W Y O R K
5068
2009-2010 Regular Sessions I N SENATE April 27, 2009
Introduced by Sen. THOMPSON -- read twice and ordered printed, and when printed to be committed to the Committee on Social Services

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 added by chapter 81 of the laws of 1995, is amended and a new subdi vision 4 is added to read as follows:
1. The local social services official shall have responsibility for prior authorizing transportation of eligible persons and for limiting the provision of such transportation to those recipients and circum stances where such transportation is essential, medically necessary and appropriate to obtain medical care, services or supplies otherwise available under this title. HOWEVER, PRIOR AUTHORIZATION SHALL NOT BE REQUIRED FOR TRANSPORTATION TO OBTAIN EMERGENCY CARE, INCLUDING EMERGEN CY MEDICAL TRANSPORTATION BY AN AMBULANCE SERVICE CERTIFIED UNDER ARTI CLE THIRTY OF THE PUBLIC HEALTH LAW. 4. 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 STATE FISCAL YEAR FOLLOWING THE STATE FISCAL YEAR IN WHICH THE EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD06378-04-9
S. 5068 2 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 (z) to read as follows:
(Z) 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 TEN, AFTER FIRST DEDUCTING THEREFROM ANY FEDERAL FUNDS PROPERLY RECEIVED OR TO BE RECEIVED ON ACCOUNT THEREOF.

Quoted Text

S5068 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.

Quoted from 147

haven't you gotten the memo yet - it's up to 20 or 25c now

Quoted from Shadow

The total amount won't change all they're doing is stretching the cost to the taxpayer over 4 years instead on 1 year. DVOR what part of no new tax increases don't you get.