BILL NUMBER: AB 1932AMENDED BILL TEXT AMENDED IN ASSEMBLY MAY 28, 2010 AMENDED IN ASSEMBLY MAY 3, 2010 AMENDED IN ASSEMBLY APRIL 15, 2010 AMENDED IN ASSEMBLY APRIL 5, 2010 INTRODUCED BY Assembly Member Hernandez FEBRUARY 17, 2010 An act to add Article 5.7 (commencing with Section 14186) to Chapter 7 of Part 3 of Division 9 of the Welfare and Institutions Code, relating to Medi-Cal. LEGISLATIVE COUNSEL'S DIGEST AB 1932, as amended, Hernandez. Medi-Cal: ambulance transportation services: reimbursement: service levels. Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services, under which health care services, including medical transportation services, are provided to qualified low-income persons. The Medi-Cal program is partially governed and funded under federal Medicaid provisions. Existing law and regulations prescribe various requirements governing payment policies and reimbursement rates for these services. This bill would authorize the department to utilize certain service levels for purposes of determining reimbursement rates for emergency and nonemergency basic life and advance life support transportation and specialty care transportation, as defined. If the department utilizes the aforementioned service levels, this bill would require the department to adopt the definitions and Healthcare Common Procedure Coding System codes for those service levels that have been established by the federal Centers for Medicare and Medicaid Services . Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: no. THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS: SECTION 1. Article 5.7 (commencing with Section 14186) is added to Chapter 7 of Part 3 of Division 9 of the Welfare and Institutions Code, to read: Article 5.7. Service Levels for Ambulance Transportation Reimbursement Rates 14186. (a) For purposes of determining reimbursement rates for emergency and nonemergency basic life and advanced life support transportation and specialty care transportation, the department may utilize the following service levels: (1) Advanced Life Support, Nonemergency Transport. (2) Advanced Life Support, Emergency Transport, Level 1. (3) Basic Life Support, Nonemergency Transport. (4) Basic Life Support, Emergency Transport. (5) Advanced Life Support, Level 2. (6) Specialty Care Transport. (b) If the department utilizes the ground ambulance service levels listed in subdivision (a), the department shall adopt the definitions for those ground ambulance service levels that have been established by the federal Centers for Medicare and Medicaid Services (CMS) in Section 30.1.1 of Chapter 10 of the Medicare Benefit Policy Manual and the Healthcare Common Procedure Coding System (HCPCS) codes established by CMS in Section 30 of Chapter 15 of the Medicare Claims Processing Manual for ground ambulance services delivered to Medicare beneficiaries.(b) For purposes of this section, the following definitions shall apply:(1) "Advanced Life Support, Level 2" means either one of the following:(A) Transportation by ground ambulance vehicle, medically necessary supplies and services, and the administration of at least three medications by intravenous push/bolus or by continuous infusion, excluding crystalloid, hypotonic, isotonic, and hypertonic solutions such as dextrose, normal saline, and Ringer's solution.(B) Transportation, medically necessary supplies and services, and the provision of at least one of the following advanced life support procedures:(i) Manual defibrillation/cardioversion.(ii) Endotracheal intubation.(iii) Central venous line.(iv) Cardiac pacing.(v) Chest decompression.(vi) Surgical airway.(vii) Intraosseous line.(2) "Specialty Care Transport" means interfacility transportation of a critically injured or ill beneficiary by a ground ambulance vehicle, including medically necessary supplies and services, at a level of service beyond the scope of an emergency medical technician-paramedic, as defined in Section 1797.84 of the Health and Safety Code. Specialty Care Transport is necessary when a beneficiary's condition requires ongoing care that must be furnished by one or more health professionals in an appropriate specialty area, including, but not limited to, nursing, emergency medicine, respiratory care, cardiovascular care, or a paramedic with additional training.