KLC 2020 Legislative Update

2) EMERGENCY SERVICES
House Bill 8
GROUND AMBULANCE SERVICE PROVIDERS
Sponsor: Representative Rob Rothenburger (R-Shelbyville)
HB 8 amends sections of KRS Chapter 142 relating to health care provider taxes and creates new
sections of KRS Chapter 205 relating to public assistance programs to establish a Medicaid ambulance
service provider assessment to assist ground ambulance providers with a disproportionate number of
transports billed for payment by the state Medicaid program. “Ground ambulance provider” is defined to
mean a Class I, II, or III ground ambulance provider described in KRS 311A.030.
New sections of KRS Chapters 142 and 205 are created to require a ground ambulance provider to
pay an assessment to the Department of Revenue in an amount established by the Department for
Medicaid Services. The assessment shall not be implemented until after the Department for Medicaid
Services receives notice from the Centers for Medicare and Medicaid Services approving federal matching
funds. A ground ambulance provider shall not increase charges or add a surcharge to ground transport fees
based on, or as a result of, the assessment paid to the department. Upon approval by the Centers for
Medicare and Medicaid Services of the assessment for fee-for-service rates effective on or after July 1, 2020,
the Cabinet shall reimburse each ground ambulance provider that provided qualifying ground ambulance
service transports during the relevant assessment period an amount not to exceed the emergency medical
services ambulance rates adopted by the Cabinet for Health and Family Services.
The Department for Medicaid Services shall promulgate administrative regulations to establish the
standards and procedures necessary to implement the Medicaid ambulance service provider assessment,
including standards and procedures to: (1) calculate an assessment on emergency ground transport
collections; (2) administer assessment proceeds; (3) apply uniformly to all assessed ground ambulance
providers any annual changes to the assessment rate; and (4) evaluate current ground ambulance provider
reimbursement rates paid by managed care organizations and require rate increases consistent with
current fee-for-service reimbursement rates and maintenance of an adequate network of ambulance
service providers. The assessment shall not generate more than the maximum amount approved by the
Centers for Medicare and Medicaid Services.
Within 90 days after July 15, 2020, the commissioner of the Department for Medicaid Services shall
determine whether a state plan amendment or an amendment to any Kentucky federal Medicaid waiver is
required to implement the Act. If the commissioner determines that a state plan amendment or an
amendment to a Kentucky federal waiver is necessary, the commissioner is authorized to seek any
necessary state plan or waiver amendment, and the assessment shall not take effect until the state plan or
waiver amendment is approved.
The assessment shall not be implemented until the first day of the calendar quarter after the
Department for Medicaid Services receives notice of federal matching funds approval from the Centers for
Medicare and Medicaid Services and notifies the Department of Revenue. Payments to ground ambulance
providers shall begin within 90 days of the later of approval of federal matching funds, the state plan, or
waiver amendment. The first monthly assessment payment shall be due 60 days after the implementation
of the enhanced fee schedule.
Two hundred thousand dollars ($200,000) of the assessment amount shall annually be returned to
the Department for Medicaid Services to offset administrative expenses. The remaining portion of the
assessment shall be: (1) utilized to increase the rates paid by a managed care organization for emergency
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