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General Assembly Raised Bill No. 179
February Session, 2024
LCO No. 1016
Referred to Committee on PUBLIC HEALTH
Introduced by:
(PH)
AN ACT CONCERNING RATES FOR AMBULANCE AND PARAMEDIC
SERVICES.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:
Section 1. Subdivision (9) of section 19a-177 of the 2024 supplement 1
to the general statutes is repealed and the following is substituted in lieu 2
thereof (Effective July 1, 2024): 3
(9) (A) Establish rates for the conveyance and treatment of patients 4
by licensed ambulance services and invalid coaches and establish 5
emergency service rates for certified ambulance services and paramedic 6
intercept services, provided (i) the present rates established for such 7
services and vehicles shall remain in effect until such time as the 8
commissioner establishes a new rate schedule as provided in this 9
subdivision, and (ii) any rate increase not in excess of the Medical Care 10
Services Consumer Price Index, as published by the Bureau of Labor 11
Statistics of the United States Department of Labor, for the prior year, 12
filed in accordance with subparagraph (B)(iii) of this subdivision shall 13
be deemed approved by the commissioner. For purposes of this 14
subdivision, licensed ambulance services and paramedic intercept 15 Raised Bill No. 179
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services shall not include emergency air transport services or mobile 16
integrated health care programs. 17
(B) Adopt regulations, in accordance with the provisions of chapter 18
54, establishing methods for setting rates and conditions for charging 19
such rates. Such regulations shall include, but need not be limited to, 20
provisions requiring that: [on and after July 1, 2000:] (i) Requests for rate 21
increases [may] shall be filed no more frequently than once a year, 22
except, [that,] in any case where an agency's rate schedule [of maximum 23
allowable rates] falls below that of the Medicare allowable rates for that 24
agency, the commissioner shall immediately amend such schedule so 25
that the rates are at or above the Medicare allowable rates; (ii) only 26
licensed ambulance services, certified ambulance services and 27
paramedic intercept services that apply for a rate increase in excess of 28
the Medical Care Services Consumer Price Index, as published by the 29
Bureau of Labor Statistics of the United States Department of Labor, for 30
the prior year, and do not accept the [maximum allowable rates] rate 31
schedule contained in any voluntary state-wide rate schedule 32
established by the commissioner for the rate application year shall be 33
required to file detailed financial information with the commissioner, 34
provided any hearing that the commissioner may hold concerning such 35
application shall be conducted as a contested case in accordance with 36
chapter 54; (iii) licensed ambulance services, certified ambulance 37
services and paramedic intercept services that do not apply for a rate 38
increase in any year in excess of the Medical Care Services Consumer 39
Price Index, as published by the Bureau of Labor Statistics of the United 40
States Department of Labor, for the prior year, or that accept the 41
[maximum allowable rates] rate schedule contained in any voluntary 42
state-wide rate schedule established by the commissioner for the rate 43
application year shall, not later than the last business day in August of 44
such year, file with the commissioner a statement of emergency and 45
nonemergency call volume, and, in the case of a licensed ambulance 46
service, certified ambulance service or paramedic intercept service that 47
is not applying for a rate increase, a written declaration by such licensed 48
ambulance service, certified ambulance service or paramedic intercept 49 Raised Bill No. 179
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service that no change in its currently approved [maximum allowable 50
rates] rate schedule will occur for the rate application year; and (iv) 51
detailed financial and operational information filed by licensed 52
ambulance services, certified ambulance services and paramedic 53
intercept services to support a request for a rate increase in excess of the 54
Medical Care Services Consumer Price Index, as published by the 55
Bureau of Labor Statistics of the United States Department of Labor, for 56
the prior year, shall cover the time period pertaining to the most recently 57
completed fiscal year and the rate application year of the licensed 58
ambulance service, certified ambulance service or paramedic intercept 59
service. Not later than November first, annually, the commissioner shall 60
issue the licensed ambulance service, certified ambulance service and 61
paramedic intercept service rate schedule for each such agency that 62
applies for a rate increase pursuant to clause (ii) of this subparagraph. 63
Not later than October first, annually, the commissioner shall issue the 64
rate schedule for each such agency that accepts the ambulance rate 65
schedule pursuant to clause (iii) of this subparagraph. 66
(C) Establish rates for licensed ambulance services, certified 67
ambulance services or paramedic intercept services for the following 68
services and conditions: (i) "Advanced life support assessment" and 69
"specialty care transports", which terms have the meanings provided in 70
42 CFR 414.605; and (ii) mileage, which may include mileage for an 71
ambulance transport when the point of origin and final destination for 72
a transport is within the boundaries of the same municipality. The rates 73
established by the commissioner for each such service or condition shall 74
be equal to (I) the ambulance service's base rate plus its established 75
advanced life support/paramedic surcharge when advanced life 76
support assessment services are performed; (II) two hundred twenty-77
five per cent of the ambulance service's established base rate for 78
specialty care transports; and (III) "loaded mileage", as the term is 79
defined in 42 CFR 414.605, multiplied by the ambulance service's 80
established rate for mileage. Such rates shall remain in effect until such 81
time as the commissioner establishes a new rate schedule as provided 82
in this subdivision. 83 Raised Bill No. 179
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(D) Establish rates for the treatment and release of patients by a 84
licensed or certified emergency medical services organization or a 85
provider who does not transport such patients to an emergency 86
department and who is operating within the scope of such 87
organization's or provider's practice and following protocols approved 88
by the sponsor hospital. The rates established pursuant to this 89
subparagraph shall not apply to the treatment provided to patients 90
through mobile integrated health care programs; 91
Sec. 2. (NEW) (Effective January 1, 2025) Each individual health 92
insurance policy providing coverage of the type specified in 93
subdivisions (1), (2), (4), (11) and (12) of section 38a-469 of the general 94
statutes that is delivered, issued for delivery or renewed, amended or 95
continued in this state on or after January 1, 2025, shall provide coverage 96
for (1) the conveyance and treatment of a patient by a licensed 97
ambulance service or invalid coach, (2) emergency services provided by 98
a certified ambulance services, and (3) paramedic intercept services 99
pursuant to the rate schedule issued by the Commissioner of Public 100
Health to each such agency of such services pursuant to subdivision (9) 101
of section 19a-177 of the general statutes, as amended by this act. 102
Sec. 3. (NEW) (Effective January 1, 2025) Each group health insurance 103
policy providing coverage of the type specified in subdivisions (1), (2), 104
(4), (11) and (12) of section 38a-469 of the general statutes that is 105
delivered, issued for delivery or renewed, amended or continued in this 106
state on or after January 1, 2025, shall provide coverage for (1) the 107
conveyance and treatment of a patient by a licensed ambulance service 108
or invalid coach, (2) emergency services provided by a certified 109
ambulance services, and (3) paramedic intercept services pursuant to 110
the rate schedule issued by the Commissioner of Public Health to each 111
such agency of such services pursuant to subdivision (9) of section 19a-112
177 of the general statutes, as amended by this act. 113
This act shall take effect as follows and shall amend the following
sections:
Section 1 July 1, 2024 19a-177(9) Raised Bill No. 179
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Sec. 2 January 1, 2025 New section
Sec. 3 January 1, 2025 New section
Statement of Purpose:
To change the maximum allowable rate for the conveyance and
treatment of patients by licensed ambulance services and invalid
coaches and emergency services rates for certified ambulance services
and paramedic intercept services to a rate schedule accepted by
providers and require insurance coverage for such services pursuant to
such rate schedule.
[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline, except
that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not
underlined.]