1.1 A bill for an act
1.2 relating to human services; providing a fuel adjustment for nonemergency medical
1.3 transportation and ambulance service reimbursement; amending Minnesota Statutes
1.4 2022, section 256B.0625, subdivisions 17, 17a, 18h.
1.5BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.6 Section 1. Minnesota Statutes 2022, section 256B.0625, subdivision 17, is amended to
1.7read:
1.8 Subd. 17.Transportation costs.(a) "Nonemergency medical transportation service"
1.9means motor vehicle transportation provided by a public or private person that serves
1.10Minnesota health care program beneficiaries who do not require emergency ambulance
1.11service, as defined in section 144E.001, subdivision 3, to obtain covered medical services.
1.12 (b) Medical assistance covers medical transportation costs incurred solely for obtaining
1.13emergency medical care or transportation costs incurred by eligible persons in obtaining
1.14emergency or nonemergency medical care when paid directly to an ambulance company,
1.15nonemergency medical transportation company, or other recognized providers of
1.16transportation services. Medical transportation must be provided by:
1.17 (1) nonemergency medical transportation providers who meet the requirements of this
1.18subdivision;
1.19 (2) ambulances, as defined in section 144E.001, subdivision 2;
1.20 (3) taxicabs that meet the requirements of this subdivision;
1.21 (4) public transit, as defined in section 174.22, subdivision 7; or
1Section 1.
REVISOR AGW/AK 23-0016301/03/23
State of Minnesota
This Document can be made available
in alternative formats upon request
HOUSE OF REPRESENTATIVES
H. F. No. 196
NINETY-THIRD SESSION
Authored by Huot01/09/2023
The bill was read for the first time and referred to the Committee on Health Finance and Policy 2.1 (5) not-for-hire vehicles, including volunteer drivers, as defined in section 65B.472,
2.2subdivision 1, paragraph (h).
2.3 (c) Medical assistance covers nonemergency medical transportation provided by
2.4nonemergency medical transportation providers enrolled in the Minnesota health care
2.5programs. All nonemergency medical transportation providers must comply with the
2.6operating standards for special transportation service as defined in sections 174.29 to 174.30
2.7and Minnesota Rules, chapter 8840, and all drivers must be individually enrolled with the
2.8commissioner and reported on the claim as the individual who provided the service. All
2.9nonemergency medical transportation providers shall bill for nonemergency medical
2.10transportation services in accordance with Minnesota health care programs criteria. Publicly
2.11operated transit systems, volunteers, and not-for-hire vehicles are exempt from the
2.12requirements outlined in this paragraph.
2.13 (d) An organization may be terminated, denied, or suspended from enrollment if:
2.14 (1) the provider has not initiated background studies on the individuals specified in
2.15section 174.30, subdivision 10, paragraph (a), clauses (1) to (3); or
2.16 (2) the provider has initiated background studies on the individuals specified in section
2.17174.30, subdivision 10, paragraph (a), clauses (1) to (3), and:
2.18 (i) the commissioner has sent the provider a notice that the individual has been
2.19disqualified under section 245C.14; and
2.20 (ii) the individual has not received a disqualification set-aside specific to the special
2.21transportation services provider under sections 245C.22 and 245C.23.
2.22 (e) The administrative agency of nonemergency medical transportation must:
2.23 (1) adhere to the policies defined by the commissioner;
2.24 (2) pay nonemergency medical transportation providers for services provided to
2.25Minnesota health care programs beneficiaries to obtain covered medical services;
2.26 (3) provide data monthly to the commissioner on appeals, complaints, no-shows, canceled
2.27trips, and number of trips by mode; and
2.28 (4) by July 1, 2016, in accordance with subdivision 18e, utilize a web-based single
2.29administrative structure assessment tool that meets the technical requirements established
2.30by the commissioner, reconciles trip information with claims being submitted by providers,
2.31and ensures prompt payment for nonemergency medical transportation services.
2Section 1.
REVISOR AGW/AK 23-0016301/03/23 3.1 (f) Until the commissioner implements the single administrative structure and delivery
3.2system under subdivision 18e, clients shall obtain their level-of-service certificate from the
3.3commissioner or an entity approved by the commissioner that does not dispatch rides for
3.4clients using modes of transportation under paragraph (i), clauses (4), (5), (6), and (7).
3.5 (g) The commissioner may use an order by the recipient's attending physician, advanced
3.6practice registered nurse, physician assistant, or a medical or mental health professional to
3.7certify that the recipient requires nonemergency medical transportation services.
3.8Nonemergency medical transportation providers shall perform driver-assisted services for
3.9eligible individuals, when appropriate. Driver-assisted service includes passenger pickup
3.10at and return to the individual's residence or place of business, assistance with admittance
3.11of the individual to the medical facility, and assistance in passenger securement or in securing
3.12of wheelchairs, child seats, or stretchers in the vehicle.
3.13 Nonemergency medical transportation providers must take clients to the health care
3.14provider using the most direct route, and must not exceed 30 miles for a trip to a primary
3.15care provider or 60 miles for a trip to a specialty care provider, unless the client receives
3.16authorization from the local agency.
3.17 Nonemergency medical transportation providers may not bill for separate base rates for
3.18the continuation of a trip beyond the original destination. Nonemergency medical
3.19transportation providers must maintain trip logs, which include pickup and drop-off times,
3.20signed by the medical provider or client, whichever is deemed most appropriate, attesting
3.21to mileage traveled to obtain covered medical services. Clients requesting client mileage
3.22reimbursement must sign the trip log attesting mileage traveled to obtain covered medical
3.23services.
3.24 (h) The administrative agency shall use the level of service process established by the
3.25commissioner to determine the client's most appropriate mode of transportation. If public
3.26transit or a certified transportation provider is not available to provide the appropriate service
3.27mode for the client, the client may receive a onetime service upgrade.
3.28 (i) The covered modes of transportation are:
3.29 (1) client reimbursement, which includes client mileage reimbursement provided to
3.30clients who have their own transportation, or to family or an acquaintance who provides
3.31transportation to the client;
3.32 (2) volunteer transport, which includes transportation by volunteers using their own
3.33vehicle;
3Section 1.
REVISOR AGW/AK 23-0016301/03/23 4.1 (3) unassisted transport, which includes transportation provided to a client by a taxicab
4.2or public transit. If a taxicab or public transit is not available, the client can receive
4.3transportation from another nonemergency medical transportation provider;
4.4 (4) assisted transport, which includes transport provided to clients who require assistance
4.5by a nonemergency medical transportation provider;
4.6 (5) lift-equipped/ramp transport, which includes transport provided to a client who is
4.7dependent on a device and requires a nonemergency medical transportation provider with
4.8a vehicle containing a lift or ramp;
4.9 (6) protected transport, which includes transport provided to a client who has received
4.10a prescreening that has deemed other forms of transportation inappropriate and who requires
4.11a provider: (i) with a protected vehicle that is not an ambulance or police car and has safety
4.12locks, a video recorder, and a transparent thermoplastic partition between the passenger and
4.13the vehicle driver; and (ii) who is certified as a protected transport provider; and
4.14 (7) stretcher transport, which includes transport for a client in a prone or supine position
4.15and requires a nonemergency medical transportation provider with a vehicle that can transport
4.16a client in a prone or supine position.
4.17 (j) The local agency shall be the single administrative agency and shall administer and
4.18reimburse for modes defined in paragraph (i) according to paragraphs (m) and (n) when the
4.19commissioner has developed, made available, and funded the web-based single administrative
4.20structure, assessment tool, and level of need assessment under subdivision 18e. The local
4.21agency's financial obligation is limited to funds provided by the state or federal government.
4.22 (k) The commissioner shall:
4.23 (1) verify that the mode and use of nonemergency medical transportation is appropriate;
4.24 (2) verify that the client is going to an approved medical appointment; and
4.25 (3) investigate all complaints and appeals.
4.26 (l) The administrative agency shall pay for the services provided in this subdivision and
4.27seek reimbursement from the commissioner, if appropriate. As vendors of medical care,
4.28local agencies are subject to the provisions in section 256B.041, the sanctions and monetary
4.29recovery actions in section 256B.064, and Minnesota Rules, parts 9505.2160 to 9505.2245.
4.30 (m) Payments for nonemergency medical transportation must be paid based on the client's
4.31assessed mode under paragraph (h), not the type of vehicle used to provide the service. The
4.32medical assistance reimbursement rates for nonemergency medical transportation services
4Section 1.
REVISOR AGW/AK 23-0016301/03/23 5.1that are payable by or on behalf of the commissioner for nonemergency medical
5.2transportation services are:
5.3 (1) $0.22 per mile for client reimbursement;
5.4 (2) up to 100 percent of the Internal Revenue Service business deduction rate for volunteer
5.5transport;
5.6 (3) equivalent to the standard fare for unassisted transport when provided by public
5.7transit, and $11 for the base rate and $1.30 per mile when provided by a nonemergency
5.8medical transportation provider;
5.9 (4) $13 for the base rate and $1.30 per mile for assisted transport;
5.10 (5) $18 for the base rate and $1.55 per mile for lift-equipped/ramp transport;
5.11 (6) $75 for the base rate and $2.40 per mile for protected transport; and
5.12 (7) $60 for the base rate and $2.40 per mile for stretcher transport, and $9 per trip for
5.13an additional attendant if deemed medically necessary.
5.14 (n) The base rate for nonemergency medical transportation services in areas defined
5.15under RUCA to be super rural is equal to 111.3 percent of the respective base rate in
5.16paragraph (m), clauses (1) to (7). The mileage rate for nonemergency medical transportation
5.17services in areas defined under RUCA to be rural or super rural areas is:
5.18 (1) for a trip equal to 17 miles or less, equal to 125 percent of the respective mileage
5.19rate in paragraph (m), clauses (1) to (7); and
5.20 (2) for a trip between 18 and 50 miles, equal to 112.5 percent of the respective mileage
5.21rate in paragraph (m), clauses (1) to (7).
5.22 (o) For purposes of reimbursement rates for nonemergency medical transportation
5.23services under paragraphs (m) and (n), the zip code of the recipient's place of residence
5.24shall determine whether the urban, rural, or super rural reimbursement rate applies.
5.25 (p) For purposes of this subdivision, "rural urban commuting area" or "RUCA" means
5.26a census-tract based classification system under which a geographical area is determined
5.27to be urban, rural, or super rural.
5.28 (q) The commissioner, when determining reimbursement rates for nonemergency medical
5.29transportation under paragraphs (m) and (n), shall exempt all modes of transportation listed
5.30under paragraph (i) from Minnesota Rules, part 9505.0445, item R, subitem (2).
5Section 1.
REVISOR AGW/AK 23-0016301/03/23 6.1 (r) Effective for the first day of each calendar quarter in which the price of gasoline as
6.2posted publicly by the United States Energy Information Administration exceeds $3.00 per
6.3gallon, the commissioner shall adjust the rate paid per mile in paragraph (m) by one percent
6.4up or down for every increase or decrease of ten cents for the price of gasoline. The increase
6.5or decrease must be calculated using a base gasoline price of $3.00. The percentage increase
6.6or decrease must be calculated using the average of the most recently available price of all
6.7grades of gasoline for Minnesota as posted publicly by the United States Energy Information
6.8Administration.
6.9 EFFECTIVE DATE.This section is effective July 1, 2023.
6.10 Sec. 2. Minnesota Statutes 2022, section 256B.0625, subdivision 17a, is amended to read:
6.11 Subd. 17a.Payment for ambulance services.(a) Medical assistance covers ambulance
6.12services. Providers shall bill ambulance services according to Medicare criteria.
6.13Nonemergency ambulance services shall not be paid as emergencies. Effective for services
6.14rendered on or after July 1, 2001, medical assistance payments for ambulance services shall
6.15be paid at the Medicare reimbursement rate or at the medical assistance payment rate in
6.16effect on July 1, 2000, whichever is greater.
6.17 (b) Effective for services provided on or after July 1, 2016, medical assistance payment
6.18rates for ambulance services identified in this paragraph are increased by five percent.
6.19Capitation payments made to managed care plans and county-based purchasing plans for
6.20ambulance services provided on or after January 1, 2017, shall be increased to reflect this
6.21rate increase. The increased rate described in this paragraph applies to ambulance service
6.22providers whose base of operations as defined in section 144E.10 is located:
6.23 (1) outside the metropolitan counties listed in section 473.121, subdivision 4, and outside
6.24the cities of Duluth, Mankato, Moorhead, St. Cloud, and Rochester; or
6.25 (2) within a municipality with a population of less than 1,000.
6.26 (c) Effective for the first day of each calendar quarter in which the price of gasoline as
6.27posted publicly by the United States Energy Information Administration exceeds $3.00 per
6.28gallon, the commissioner shall adjust the rate paid per mile in paragraphs (a) and (b) by one
6.29percent up or down for every increase or decrease of ten cents for the price of gasoline. The
6.30increase or decrease must be calculated using a base gasoline price of $3.00. The percentage
6.31increase or decrease must be calculated using the average of the most recently available
6.32price of all grades of gasoline for Minnesota as posted publicly by the United States Energy
6.33Information Administration.
6Sec. 2.
REVISOR AGW/AK 23-0016301/03/23 7.1 EFFECTIVE DATE.This section is effective July 1, 2023.
7.2 Sec. 3. Minnesota Statutes 2022, section 256B.0625, subdivision 18h, is amended to read:
7.3 Subd. 18h.Nonemergency medical transportation provisions related to managed
7.4care.(a) The following nonemergency medical transportation subdivisions apply to managed
7.5care plans and county-based purchasing plans:
7.6 (1) subdivision 17, paragraphs (a), (b), (i), and (n);
7.7 (2) subdivision 18; and
7.8 (3) subdivision 18a.
7.9 (b) A nonemergency medical transportation provider must comply with the operating
7.10standards for special transportation service specified in sections 174.29 to 174.30 and
7.11Minnesota Rules, chapter 8840. Publicly operated transit systems, volunteers, and not-for-hire
7.12vehicles are exempt from the requirements in this paragraph.
7.13 (c) Managed care and county-based purchasing plans must provide a fuel adjustment
7.14for nonemergency medical transportation payment rates when the price of gasoline exceeds
7.15$3.00 per gallon.
7.16 EFFECTIVE DATE.This section is effective July 1, 2023.
7Sec. 3.
REVISOR AGW/AK 23-0016301/03/23