AL
Alabama House Bill HB287

Alabama 2022 Regular Session

Alabama House Bill HB287 Compare Versions

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11 1 HB287
2-2 217190-2
2+2 217190-1
33 3 By Representative Clouse
44 4 RFD: Ways and Means General Fund
55 5 First Read: 08-FEB-22
66
7-Page 0 HB287
8-1
9-2 ENROLLED, An Act,
10-3 Relating to emergency medical transport providers;
11-4 to add Sections 40-26B-90 through 40-26B-99 to the Code of
12-5 Alabama 1975, to impose an assessment on emergency medical
13-6 transport providers; to provide additional Medicaid
14-7 enhancement payments for the maintenance and expansion of
15-8 emergency medical transport services; to provide the
16-9 methodology for calculating the assessment; to provide the
17-10 rate of the assessment; to provide the distribution of
18-11 assessment proceeds; and to provide the effective period for
19-12 the assessment.
20-13 BE IT ENACTED BY THE LEGISLATURE OF ALABAMA:
21-14 Section 1. Sections 40-26B-90, 40-26B-91, 40-26B-92,
22-15 40-26B-93, 40-26B-94, 40-26B-95, 40-26B-96, 40-26B-97,
23-16 40-26B-98, and 40-26B-99 are added to the Code of Alabama
24-17 1975.
25-18 §40-26B-90.
26-19 (a) The following words, terms, and phrases, when
27-20 used in this article shall have the meanings ascribed to them
28-21 in this section, except where the context clearly indicates a
29-22 different meaning:
30-23 (1) ASSESSMENT POOL. The total assessments collected
31-24 pursuant to this article as of a date determined by the
32-25 Commissioner of Alabama Medicaid, which date shall be no later
33-Page 1 HB287
34-1 than the 60th day of a fiscal quarter, that have not been
35-2 expended for the purposes of this article, net of the amounts
36-3 specified in subdivision (c)(1) of Section 40-26B-93, plus any
37-4 Medicaid federal financial participation.
38-5 (2) ASSESSMENT RATE. A monetary amount per emergency
39-6 medical transport applied to calculate emergency medical
40-7 transport assessments pursuant to this article.
41-8 (3) DEPARTMENT. The Department of Revenue of the
42-9 State of Alabama.
43-10 (4) EMERGENCY MEDICAL TRANSPORT. The act of
44-11 transporting an individual from any point of origin to the
45-12 nearest medical facility capable of meeting the emergency
46-13 medical needs of the patient by an ambulance licensed,
47-14 operated, and equipped in accordance with applicable state or
48-15 local statutes, ordinances, or regulations. "Emergency medical
49-16 transports" shall not include transportation of beneficiaries
50-17 by passenger cars, taxicabs, litter vans, wheelchair vans, or
51-18 other forms of public or private conveyances, nor shall it
52-19 include transportation by an air ambulance provider.
53-20 (5) EMERGENCY MEDICAL TRANSPORT ENHANCEMENT. An
54-21 additional Medicaid payment to emergency medical transport
55-22 providers authorized by Section 40-26B-95.
56-23 (6) EMERGENCY MEDICAL TRANSPORT PROVIDER. A provider
57-24 of emergency medical transports licensed by the Alabama
58-25 Department of Public Health's Office of Emergency Medical
59-Page 2 HB287
60-1 Services as a transport provider. The term "emergency medical
61-2 transport provider" includes both public and private
62-3 providers.
63-4 (7) FISCAL QUARTER. A state fiscal quarter within a
64-5 state fiscal year.
65-6 (8) FISCAL YEAR. An accounting period of 12 months
66-7 beginning on the first day of the first month of the state
67-8 fiscal year.
68-9 (9) GROSS RECEIPTS. Gross payments received as
69-10 patient care revenue for emergency medical transports,
70-11 determined on a cash basis of accounting.
71-12 (10) MEDICAID PROGRAM. The medical assistance
72-13 program as established in Title XIX of the Social Security Act
73-14 and as administered in the State of Alabama by the Alabama
74-15 Medicaid Agency pursuant to executive order and Title 560 of
75-16 the Alabama Administrative Code.
76-17 (11) TRANSPORT ENHANCEMENT RATE. An additional
77-18 Medicaid payment per emergency medical transport authorized
78-19 pursuant to this article.
79-20 §40-26B-91.
80-21 To provide further for the availability of indigent
81-22 health care, the operation of the Medicaid Program and the
82-23 maintenance and expansion of emergency medical transport
83-24 services:
84-Page 3 HB287
85-1 (1) Commencing no later than the fiscal quarter
86-2 starting April 1, 2023, and through and including the fiscal
87-3 quarter starting July 1, 2024, an assessment is imposed on
88-4 each emergency medical transport provider based on emergency
89-5 medical transports. The quarterly assessment for each
90-6 emergency medical transport provider shall be calculated based
91-7 on the product of the assessment rate and the total number of
92-8 emergency medical transports rendered by the emergency medical
93-9 transport provider from the previous fiscal quarter.
94-10 (2) In consultation with the Alabama Medicaid
95-11 Agency, the department shall calculate the assessment rate by
96-12 multiplying the projected total gross receipts for all
97-13 emergency medical transport providers for a fiscal year by 5.3
98-14 percent, which resulting product shall be divided by the
99-15 projected total annual emergency medical transports by all
100-16 emergency medical transport providers for the fiscal year,
101-17 subject to subsection (b) of Section 40-26B-98. In no case
102-18 shall the proportion of assessments collected under this
103-19 article divided by total gross receipts, expressed as a
104-20 percentage, exceed half a percent less than the maximum
105-21 percentage of the annual aggregate net patient revenue for
106-22 emergency medical transport providers that is prescribed
107-23 pursuant to federal law and regulations.
108-Page 4 HB287
109-1 (3) The assessment imposed by this article is in
110-2 addition to all other taxes and assessments of any kind now
111-3 imposed by law.
112-4 §40-26B-92.
113-5 The department shall notify, or make available to,
114-6 each emergency medical transport provider, in accordance with
115-7 notification procedures determined by the department, the
116-8 assessment rate, and the estimated assessment amount owed by
117-9 the provider for the applicable fiscal quarter.
118-10 §40-26B-93.
119-11 (a) The assessment imposed by this article shall be
120-12 due and payable to the department on a date determined by the
121-13 department, which date shall not be later than the 30th day of
122-14 the fiscal quarter for which the assessment is assessed,
123-15 except that Section 40-26B-97 shall apply to any fiscal
124-16 quarter for which federal approval has not been obtained as of
125-17 the first day of the fiscal quarter. When collected, the
126-18 assessment imposed by the article shall be deposited to the
127-19 Alabama Health Care Trust Fund.
128-20 (b) Any emergency medical transport provider that
129-21 fails to pay the assessment levied by this article within the
130-22 time required by the department shall pay, in addition to the
131-23 assessment, a penalty of 10 percent of the amount of the
132-24 assessment due, together with interest thereon at the rate
133-25 prescribed by Section 40-1-44, such penalty and interest to be
134-Page 5 HB287
135-1 assessed and collected as part of the assessment. Provided,
136-2 however, the department, if a good and sufficient reason is
137-3 shown, may waive or remit the penalty of 10 percent or a
138-4 portion thereof. If payment is not received by the 45th day of
139-5 the quarter in which the assessment was due, the department
140-6 shall notify the Alabama Medicaid Agency which shall determine
141-7 whether the emergency medical transport provider is a Medicaid
142-8 provider, and if so, shall withhold the payment, interest, and
143-9 penalty due from any reimbursement due said provider under the
144-10 Medicaid Program, including any emergency medical transport
145-11 enhancements authorized by Section 40-26B-95. The assessments
146-12 levied by this article shall constitute a debt due the State
147-13 of Alabama and may be collected by civil action in addition to
148-14 the methods provided in this article.
149-15 (c) Revenues generated by this assessment shall be
150-16 made available exclusively and are continuously appropriated
151-17 for the following purposes:
152-18 (1) To pay for the state's administrative costs of
153-19 this article and Medicaid funding for enhancements to health
154-20 care services with emphasis on non-emergency transportation in
155-21 an amount of one hundred seventy-five thousand dollars
156-22 ($175,000) per fiscal quarter, subject to subsection (d) of
157-23 Section 40-26B-98.
158-Page 6 HB287
159-1 (2) To pay emergency medical transport enhancements
160-2 to emergency transport providers pursuant to Section 40-26B-95.
161-3 §40-26B-94.
162-4 (a) Commencing no later than the fiscal quarter
163-5 starting April 1, 2023, and through and including the fiscal
164-6 quarter starting July 1, 2024, on or before the 15th day after
165-7 the close of each fiscal quarter, every emergency medical
166-8 transport provider shall file with the department a statement
167-9 under penalty of perjury on forms prescribed by the
168-10 department, showing the total number of emergency medical
169-11 transports, and the total amount of gross receipts for the
170-12 subject fiscal quarter, and such other reasonable and
171-13 necessary information as the department, after consultation
172-14 with the Alabama Medicaid Agency and adoption of appropriate
173-15 rules or regulations, may require for the proper enforcement
174-16 of the provisions of this article.
175-17 (b) It shall be the duty of each emergency medical
176-18 transport provider to keep and preserve such suitable books
177-19 and records as may be necessary to determine the amount of
178-20 assessments for which it is liable under the provisions of
179-21 this article. Said books and records shall be kept and
180-22 preserved for a period of not less than three years, and all
181-23 such books and records shall be open for examination during
182-24 business hours by the department or its duly authorized
183-25 agents.
184-Page 7 HB287
185-1 (c) All information secured pursuant to this article
186-2 by the department shall be confidential, as prescribed by
187-3 Section 40-2A-10, except that the department may provide such
188-4 information to the Alabama Medicaid Agency as necessary for
189-5 the proper administration of the Medicaid Program, or for the
190-6 department's proper administration of the assessment levied by
191-7 this article.
192-8 (d) The department shall from time to time, as it
193-9 deems desirable, adopt such reasonable rules and regulations
194-10 as necessary to provide for the orderly and efficient
195-11 administration of the assessment levied by this article.
196-12 §40-26B-95.
197-13 (a) Commencing no later than the fiscal quarter
198-14 starting April 1, 2023, and through and including the fiscal
199-15 quarter starting July 1, 2024, the Alabama Medicaid Agency
200-16 shall pay an emergency medical transport enhancement each
201-17 fiscal quarter to emergency medical transport providers as set
202-18 forth in this section on or before the last day of the
203-19 quarter, except that Section 40-26B-97 shall apply to any
204-20 fiscal quarter for which federal approval has not been
205-21 obtained as of the first day of the fiscal quarter. The
206-22 emergency medical transport enhancement shall be paid in
207-23 addition to any other amounts payable to emergency medical
208-24 transport providers with respect to those services and shall
209-Page 8 HB287
210-1 not affect any other payments to emergency medical transport
7+Page 0 1 217190-1:n:02/04/2022:KF/cmg LSA2022-050F
8+2
9+3
10+4
11+5
12+6
13+7
14+8 SYNOPSIS: This bill would impose an assessment on
15+9 emergency medical transport providers to provide
16+10 additional Medicaid enhancement payments for the
17+11 maintenance and expansion of emergency medical
18+12 transport services.
19+13 This bill would provide for the methodology
20+14 for calculating the assessment, the rate of the
21+15 assessment, distribution of proceeds, and the
22+16 effective period of the assessment.
23+17
24+18 A BILL
25+19 TO BE ENTITLED
26+20 AN ACT
27+21
28+22 Relating to emergency medical transport providers;
29+23 to add Sections 40-26B-90 through 40-26B-99 to the Code of
30+24 Alabama 1975, to impose an assessment on emergency medical
31+25 transport providers; to provide additional Medicaid
32+26 enhancement payments for the maintenance and expansion of
33+27 emergency medical transport services; to provide the
34+Page 1 1 methodology for calculating the assessment; to provide the
35+2 rate of the assessment; to provide the distribution of
36+3 assessment proceeds; and to provide the effective period for
37+4 the assessment.
38+5 BE IT ENACTED BY THE LEGISLATURE OF ALABAMA:
39+6 Section 1. Sections 40-26B-90, 40-26B-91, 40-26B-92,
40+7 40-26B-93, 40-26B-94, 40-26B-95, 40-26B-96, 40-26B-97,
41+8 40-26B-98, and 40-26B-99 are added to the Code of Alabama
42+9 1975.
43+10 §40-26B-90.
44+11 (a) The following words, terms, and phrases, when
45+12 used in this article shall have the meanings ascribed to them
46+13 in this section, except where the context clearly indicates a
47+14 different meaning:
48+15 (1) ASSESSMENT POOL. The total assessments collected
49+16 pursuant to this article as of a date determined by the
50+17 Commissioner of Alabama Medicaid, which date shall be no later
51+18 than the 60th day of a fiscal quarter, that have not been
52+19 expended for the purposes of this article, net of the amounts
53+20 specified in subdivision (c)(1) of Section 40-26B-93, plus any
54+21 Medicaid federal financial participation.
55+22 (2) ASSESSMENT RATE. A monetary amount per emergency
56+23 medical transport applied to calculate emergency medical
57+24 transport assessments pursuant to this article.
58+25 (3) DEPARTMENT. The Department of Revenue of the
59+26 State of Alabama.
60+Page 2 1 (4) EMERGENCY MEDICAL TRANSPORT. The act of
61+2 transporting an individual from any point of origin to the
62+3 nearest medical facility capable of meeting the emergency
63+4 medical needs of the patient by an ambulance licensed,
64+5 operated, and equipped in accordance with applicable state or
65+6 local statutes, ordinances, or regulations. "Emergency medical
66+7 transports" shall not include transportation of beneficiaries
67+8 by passenger cars, taxicabs, litter vans, wheelchair vans, or
68+9 other forms of public or private conveyances, nor shall it
69+10 include transportation by an air ambulance provider.
70+11 (5) EMERGENCY MEDICAL TRANSPORT ENHANCEMENT. An
71+12 additional Medicaid payment to emergency medical transport
72+13 providers authorized by Section 40-26B-95.
73+14 (6) EMERGENCY MEDICAL TRANSPORT PROVIDER. A provider
74+15 of emergency medical transports licensed by the Alabama
75+16 Department of Public Health's Office of Emergency Medical
76+17 Services as a transport provider. The term "emergency medical
77+18 transport provider" includes both public and private
78+19 providers.
79+20 (7) FISCAL QUARTER. A state fiscal quarter within a
80+21 state fiscal year.
81+22 (8) FISCAL YEAR. An accounting period of 12 months
82+23 beginning on the first day of the first month of the state
83+24 fiscal year.
84+25 (9) GROSS RECEIPTS. Gross payments received as
85+26 patient care revenue for emergency medical transports,
86+27 determined on a cash basis of accounting.
87+Page 3 1 (10) MEDICAID PROGRAM. The medical assistance
88+2 program as established in Title XIX of the Social Security Act
89+3 and as administered in the State of Alabama by the Alabama
90+4 Medicaid Agency pursuant to executive order and Title 560 of
91+5 the Alabama Administrative Code.
92+6 (11) TRANSPORT ENHANCEMENT RATE. An additional
93+7 Medicaid payment per emergency medical transport authorized
94+8 pursuant to this article.
95+9 §40-26B-91.
96+10 To provide further for the availability of indigent
97+11 health care, the operation of the Medicaid Program and the
98+12 maintenance and expansion of emergency medical transport
99+13 services:
100+14 (1) Commencing no later than the fiscal quarter
101+15 starting April 1, 2023, and through and including the fiscal
102+16 quarter starting July 1, 2024, an assessment is imposed on
103+17 each emergency medical transport provider based on emergency
104+18 medical transports. The quarterly assessment for each
105+19 emergency medical transport provider shall be calculated based
106+20 on the product of the assessment rate and the total number of
107+21 emergency medical transports rendered by the emergency medical
108+22 transport provider from the previous fiscal quarter.
109+23 (2) In consultation with the Alabama Medicaid
110+24 Agency, the department shall calculate the assessment rate by
111+25 multiplying the projected total gross receipts for all
112+26 emergency medical transport providers for a fiscal year by 5.3
113+27 percent, which resulting product shall be divided by the
114+Page 4 1 projected total annual emergency medical transports by all
115+2 emergency medical transport providers for the fiscal year,
116+3 subject to subsection (b) of Section 40-26B-98. In no case
117+4 shall the proportion of assessments collected under this
118+5 article divided by total gross receipts, expressed as a
119+6 percentage, exceed half a percent less than the maximum
120+7 percentage of the annual aggregate net patient revenue for
121+8 emergency medical transport providers that is prescribed
122+9 pursuant to federal law and regulations.
123+10 (3) The assessment imposed by this article is in
124+11 addition to all other taxes and assessments of any kind now
125+12 imposed by law.
126+13 §40-26B-92.
127+14 The department shall notify, or make available to,
128+15 each emergency medical transport provider, in accordance with
129+16 notification procedures determined by the department, the
130+17 assessment rate, and the estimated assessment amount owed by
131+18 the provider for the applicable fiscal quarter.
132+19 §40-26B-93.
133+20 (a) The assessment imposed by this article shall be
134+21 due and payable to the department on a date determined by the
135+22 department, which date shall not be later than the 30th day of
136+23 the fiscal quarter for which the assessment is assessed,
137+24 except that Section 40-26B-97 shall apply to any fiscal
138+25 quarter for which federal approval has not been obtained as of
139+26 the first day of the fiscal quarter. When collected, the
140+Page 5 1 assessment imposed by the article shall be deposited to the
141+2 Alabama Health Care Trust Fund.
142+3 (b) Any emergency medical transport provider that
143+4 fails to pay the assessment levied by this article within the
144+5 time required by the department shall pay, in addition to the
145+6 assessment, a penalty of 10 percent of the amount of the
146+7 assessment due, together with interest thereon at the rate
147+8 prescribed by Section 40-1-44, such penalty and interest to be
148+9 assessed and collected as part of the assessment. Provided,
149+10 however, the department, if a good and sufficient reason is
150+11 shown, may waive or remit the penalty of 10 percent or a
151+12 portion thereof. If payment is not received by the 45th day of
152+13 the quarter in which the assessment was due, the department
153+14 shall notify the Alabama Medicaid Agency which shall determine
154+15 whether the emergency medical transport provider is a Medicaid
155+16 provider, and if so, shall withhold the payment, interest, and
156+17 penalty due from any reimbursement due said provider under the
157+18 Medicaid Program, including any emergency medical transport
158+19 enhancements authorized by Section 40-26B-95. The assessments
159+20 levied by this article shall constitute a debt due the State
160+21 of Alabama and may be collected by civil action in addition to
161+22 the methods provided in this article.
162+23 (c) Revenues generated by this assessment shall be
163+24 made available exclusively and are continuously appropriated
164+25 for the following purposes:
165+26 (1) To pay for the state's administrative costs of
166+27 this article and Medicaid funding for enhancements to health
167+Page 6 1 care services with emphasis on non-emergency transportation in
168+2 an amount of one hundred seventy-five thousand dollars
169+3 ($175,000) per fiscal quarter, subject to subsection (d) of
170+4 Section 40-26B-98.
171+5 (2) To pay emergency medical transport enhancements
172+6 to emergency transport providers pursuant to Section
173+7 40-26B-95.
174+8 §40-26B-94.
175+9 (a) Commencing no later than the fiscal quarter
176+10 starting April 1, 2023, and through and including the fiscal
177+11 quarter starting July 1, 2024, on or before the 15th day after
178+12 the close of each fiscal quarter, every emergency medical
179+13 transport provider shall file with the department a statement
180+14 under penalty of perjury on forms prescribed by the
181+15 department, showing the total number of emergency medical
182+16 transports, and the total amount of gross receipts for the
183+17 subject fiscal quarter, and such other reasonable and
184+18 necessary information as the department, after consultation
185+19 with the Alabama Medicaid Agency and adoption of appropriate
186+20 rules or regulations, may require for the proper enforcement
187+21 of the provisions of this article.
188+22 (b) It shall be the duty of each emergency medical
189+23 transport provider to keep and preserve such suitable books
190+24 and records as may be necessary to determine the amount of
191+25 assessments for which it is liable under the provisions of
192+26 this article. Said books and records shall be kept and
193+27 preserved for a period of not less than three years, and all
194+Page 7 1 such books and records shall be open for examination during
195+2 business hours by the department or its duly authorized
196+3 agents.
197+4 (c) All information secured pursuant to this article
198+5 by the department shall be confidential, as prescribed by
199+6 Section 40-2A-10, except that the department may provide such
200+7 information to the Alabama Medicaid Agency as necessary for
201+8 the proper administration of the Medicaid Program, or for the
202+9 department's proper administration of the assessment levied by
203+10 this article.
204+11 (d) The department shall from time to time, as it
205+12 deems desirable, adopt such reasonable rules and regulations
206+13 as necessary to provide for the orderly and efficient
207+14 administration of the assessment levied by this article.
208+15 §40-26B-95.
209+16 (a) Commencing no later than the fiscal quarter
210+17 starting April 1, 2023, and through and including the fiscal
211+18 quarter starting July 1, 2024, the Alabama Medicaid Agency
212+19 shall pay an emergency medical transport enhancement each
213+20 fiscal quarter to emergency medical transport providers as set
214+21 forth in this section on or before the last day of the
215+22 quarter, except that Section 40-26B-97 shall apply to any
216+23 fiscal quarter for which federal approval has not been
217+24 obtained as of the first day of the fiscal quarter. The
218+25 emergency medical transport enhancement shall be paid in
219+26 addition to any other amounts payable to emergency medical
220+27 transport providers with respect to those services and shall
221+Page 8 1 not affect any other payments to emergency medical transport
211222 2 providers.
212223 3 (b) For each fiscal quarter, the emergency medical
213224 4 transport enhancement to each emergency medical transport
214225 5 provider shall be calculated as the total number of emergency
215226 6 medical transports reimbursed by the Alabama Medicaid Agency
216227 7 as the primary payor in accordance with Chapter 8 of the
217228 8 Medicaid Provider Manual to the emergency medical transport
218229 9 provider in the preceding fiscal quarter multiplied by the
219230 10 transport enhancement rate.
220231 11 (c) For each fiscal quarter, the Alabama Medicaid
221232 12 Agency shall establish the transport enhancement rate based on
222233 13 the assessment pool divided by the total number of emergency
223234 14 medical transports reimbursed by the Alabama Medicaid Agency
224235 15 as the primary payor to all emergency medical transport
225236 16 providers in the preceding fiscal quarter.
226237 17 §40-26B-96.
227238 18 (a) The proceeds of the assessment set forth in
228239 19 Section 40-26B-91 and the matching amount provided by the
229240 20 federal government shall be used to supplement existing
230241 21 Medicaid funding for emergency medical transports provided by
231242 22 emergency medical transport providers and not to supplant this
232243 23 funding.
233244 24 (b) The state shall continue its maintenance of
234245 25 effort for the level of state funding not derived from the
235-Page 9 HB287
236-1 assessment on emergency medical transport providers for each
237-2 fiscal quarter commencing on or after October 1, 2022, in an
238-3 amount not less than the amount that the state would have paid
239-4 for the same number of emergency medical transports under the
240-5 rate methodology that was in effect on January 1, 2022.
241-6 §40-26B-97.
242-7 If there is a delay in the implementation of this
243-8 Article for any reason, including a delay in any required
244-9 approval by the federal Centers for Medicare and Medicaid
245-10 Services, both of the following shall apply:
246-11 (1) An emergency medical transport provider may only
247-12 be required to pay the assessment pursuant to this article for
248-13 fiscal quarters for which the federal Centers for Medicare and
249-14 Medicaid Services has approved the enhanced payments pursuant
250-15 to Section 4-26B-95. The department may not collect
251-16 assessments pursuant to this article until the Alabama
252-17 Medicaid Agency has received federal approval of the enhanced
253-18 payments pursuant to Section 4-26B-95. Upon federal approval
254-19 of the enhanced payments pursuant to Section 4-26B-95, the
255-20 department shall establish a schedule for payment of
256-21 assessments in consultation with emergency medical transport
257-22 providers.
258-23 (2) The Alabama Medicaid Agency may retroactively
259-24 implement the emergency medical transport enhancements
260-Page 10 HB287
261-1 described in Section 40-26B-95 to the extent authorized by the
262-2 federal Centers for Medicare and Medicaid Services.
263-3 §40-26B-98.
264-4 (a)(1) The Alabama Medicaid Agency shall request any
265-5 approval from the federal Centers for Medicare and Medicaid
266-6 Services it deems necessary for the use of assessments
267-7 pursuant to this article and for the purpose of receiving
268-8 associated federal matching funds.
269-9 (2) This article shall be implemented only to the
270-10 extent that any necessary federal approvals are obtained and
271-11 federal financial participation is available.
272-12 (b) The Alabama Medicaid Agency may modify or make
273-13 adjustments to any methodology, assessment amount, or other
274-14 provision specified in this article to the extent necessary to
275-15 meet the requirements of federal law or regulations or to
276-16 obtain federal approval, but only if subsection (c) of Section
277-17 40-26B-93 and subsection (b) of Section 40-26B-96 remain in
278-18 full force and effect. To the extent that the Alabama
279-19 Medicaid Agency reduces the emergency medical transport
280-20 enhancement in order to meet the requirements of federal law
281-21 or regulations or to obtain federal approval, it must reduce
282-22 the assessment rate such that the amount of assessment
283-23 collected does not exceed the amounts needed for the uses
284-24 described in subsection (c) of Section 40-26B-93.
285-Page 11 HB287
286-1 (c) The Commissioner of Alabama Medicaid may exempt
287-2 categories of emergency medical transport providers from the
288-3 assessment if necessary to obtain federal approval.
289-4 (d) To the extent that the Alabama Medicaid Agency
290-5 reduces the total assessment collected pursuant to this
291-6 Article pursuant to subsections (b) or (c) of this section,
292-7 the amount described in subdivision (c)(2) of Section
293-8 40-26B-93 shall be reduced in proportion to the amount of the
294-9 reduced total assessments.
295-10 §40-26B-99.
296-11 (a) This article shall cease to be operative on the
297-12 first day of the fiscal quarter beginning on or after the date
298-13 one or more of the following conditions is satisfied:
299-14 (1) Federal financial participation under Title XIX
300-15 of the Social Security Act is not available to the Alabama
301-16 Medicaid Program for the purposes of this article at the
302-17 approved federal medical assistance percentage, established
303-18 under Section 1905 of the Social Security Act, for the
304-19 applicable fiscal quarter.
305-20 (2) The state ceases to meet its obligation for the
306-21 level of state funding not derived from the assessment
307-22 established by this article as described in subsection (b) of
308-23 Section 40-26B-96.
309-24 "(b) On the earlier of the occurrence of one or more
310-25 of the conditions listed in subsection (a) is satisfied on
311-Page 12 HB287
312-1 December 1, 2023, the department shall refund any remaining
313-2 assessment pool to each provider of ground emergency medical
314-3 transport services in proportion to the amount paid by the
315-4 respective provider during the most recently completed
316-5 quarterly payment period.
317-6 Section 2. This act shall become effective
318-7 immediately following its passage and approval by the
319-8 Governor, or its otherwise becoming law.
320-Page 13 HB287
321-1
322-2
323-3
324-4
325-Speaker of the House of Representatives
326-
327-5
328-6 President and Presiding Officer of the Senate
329-House of Representatives7
330-I hereby certify that the within Act originated in8
331-9 and was passed by the House 17-FEB-22.
332-10
333-11 Jeff Woodard
334-12 Clerk
335-13
336- 14
337- 15
338-Senate16 02-MAR-22 Passed
339- 17
340-Page 14
246+26 assessment on emergency medical transport providers for each
247+27 fiscal quarter commencing on or after October 1, 2022, in an
248+Page 9 1 amount not less than the amount that the state would have paid
249+2 for the same number of emergency medical transports under the
250+3 rate methodology that was in effect on January 1, 2022.
251+4 §40-26B-97.
252+5 If there is a delay in the implementation of this
253+6 Article for any reason, including a delay in any required
254+7 approval by the federal Centers for Medicare and Medicaid
255+8 Services, both of the following shall apply:
256+9 (1) An emergency medical transport provider may only
257+10 be required to pay the assessment pursuant to this article for
258+11 fiscal quarters for which the federal Centers for Medicare and
259+12 Medicaid Services has approved the enhanced payments pursuant
260+13 to Section 4-26B-95. The department may not collect
261+14 assessments pursuant to this article until the Alabama
262+15 Medicaid Agency has received federal approval of the enhanced
263+16 payments pursuant to Section 4-26B-95. Upon federal approval
264+17 of the enhanced payments pursuant to Section 4-26B-95, the
265+18 department shall establish a schedule for payment of
266+19 assessments in consultation with emergency medical transport
267+20 providers.
268+21 (2) The Alabama Medicaid Agency may retroactively
269+22 implement the emergency medical transport enhancements
270+23 described in Section 40-26B-95 to the extent authorized by the
271+24 federal Centers for Medicare and Medicaid Services.
272+25 §40-26B-98.
273+26 (a)(1) The Alabama Medicaid Agency shall request any
274+27 approval from the federal Centers for Medicare and Medicaid
275+Page 10 1 Services it deems necessary for the use of assessments
276+2 pursuant to this article and for the purpose of receiving
277+3 associated federal matching funds.
278+4 (2) This article shall be implemented only to the
279+5 extent that any necessary federal approvals are obtained and
280+6 federal financial participation is available.
281+7 (b) The Alabama Medicaid Agency may modify or make
282+8 adjustments to any methodology, assessment amount, or other
283+9 provision specified in this article to the extent necessary to
284+10 meet the requirements of federal law or regulations or to
285+11 obtain federal approval, but only if subsection (c) of Section
286+12 40-26B-93 and subsection (b) of Section 40-26B-96 remain in
287+13 full force and effect. To the extent that the Alabama
288+14 Medicaid Agency reduces the emergency medical transport
289+15 enhancement in order to meet the requirements of federal law
290+16 or regulations or to obtain federal approval, it must reduce
291+17 the assessment rate such that the amount of assessment
292+18 collected does not exceed the amounts needed for the uses
293+19 described in subsection (c) of Section 40-26B-93.
294+20 (c) The Commissioner of Alabama Medicaid may exempt
295+21 categories of emergency medical transport providers from the
296+22 assessment if necessary to obtain federal approval.
297+23 (d) To the extent that the Alabama Medicaid Agency
298+24 reduces the total assessment collected pursuant to this
299+25 Article pursuant to subsections (b) or (c) of this section,
300+26 the amount described in subdivision (c)(2) of Section
301+Page 11 1 40-26B-93 shall be reduced in proportion to the amount of the
302+2 reduced total assessments.
303+3 §40-26B-99.
304+4 (a) This article shall cease to be operative on the
305+5 first day of the fiscal quarter beginning on or after the date
306+6 one or more of the following conditions is satisfied:
307+7 (1) Federal financial participation under Title XIX
308+8 of the Social Security Act is not available to the Alabama
309+9 Medicaid Program for the purposes of this article at the
310+10 approved federal medical assistance percentage, established
311+11 under Section 1905 of the Social Security Act, for the
312+12 applicable fiscal quarter.
313+13 (2) The state ceases to meet its obligation for the
314+14 level of state funding not derived from the assessment
315+15 established by this article as described in subsection (b) of
316+16 Section 40-26B-96.
317+17 "(b) On the earlier of the occurrence of one or more
318+18 of the conditions listed in subsection (a) is satisfied on
319+19 December 1, 2023, the department shall refund any remaining
320+20 assessment pool to each provider of ground emergency medical
321+21 transport services in proportion to the amount paid by the
322+22 respective provider during the most recently completed
323+23 quarterly payment period.
324+24 Section 2. This act shall become effective
325+25 immediately following its passage and approval by the
326+26 Governor, or its otherwise becoming law.
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