1.1 A bill for an act
1.2 relating to human services; establishing an ambulance provider assessment program;
1.3 providing supplemental medical assistance payments for ambulance services;
1.4 exempting certain ambulance services from the MinnesotaCare provider tax;
1.5 requiring report; appropriating money; amending Minnesota Statutes 2024, sections
1.6 295.50, subdivision 4; 295.52, by adding a subdivision; proposing coding for new
1.7 law in Minnesota Statutes, chapter 256B; repealing Minnesota Statutes 2024,
1.8 section 295.52, subdivision 5.
1.9BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.10 Section 1. [256B.1951] AMBULANCE ASSESSMENT AND PAYMENT PROGRAM.
1.11 Subdivision 1.Definitions.(a) For purposes of this section, the following definitions
1.12apply.
1.13 (b) "Ambulance provider" means an ambulance service licensed under chapter 144E,
1.14with the exception of:
1.15 (1) ambulance services operated by a public or governmental entity, including but not
1.16limited to a municipal fire department or police department; and
1.17 (2) ambulance services that exclusively provide air ambulance services.
1.18 (c) "Emergency ambulance services" means any services delivered by an ambulance
1.19provider other than air ambulance services.
1.20 (d) "Fee" means the ambulance service assessment fee authorized by this section.
1.21 (e) "Gross revenues" has the meaning provided in section 295.50, subdivision 3.
1.22 Subd. 2.Ambulance provider assessment fee.(a) The commissioner, on a quarterly
1.23basis, shall charge every ambulance provider an ambulance service assessment fee. The
1Section 1.
25-00868 as introduced12/13/24 REVISOR AGW/VJ
SENATE
STATE OF MINNESOTA
S.F. No. 3011NINETY-FOURTH SESSION
(SENATE AUTHORS: SEEBERGER)
OFFICIAL STATUSD-PGDATE
Introduction and first reading03/27/2025
Referred to Health and Human Services 2.1commissioner shall implement the fee as a health care related tax as defined under United
2.2States Code, title 42, section 1396b(w)(3)(A), and the commissioner shall collect the fee
2.3only to the extent and for the periods that the commissioner determines that revenues
2.4generated by the fee qualify as the state share of medical assistance expenditures eligible
2.5for federal financial participation. The commissioner shall assess the fee on each ambulance
2.6provider's gross revenues at a rate determined annually by the commissioner. The
2.7commissioner shall calculate the rate such that the assessment generates the state share
2.8necessary to fund the expenditures described in subdivision 4, provided that the fee must
2.9not exceed the maximum percentage specified under Code of Federal Regulations, title 42,
2.10section 433.68(f)(3)(i)(A). The commissioner shall establish each provider's fee amount
2.11using the best data available, as determined by the commissioner in consultation with the
2.12Minnesota Ambulance Association, and shall update each ambulance provider's fee at least
2.13annually.
2.14 (b) All gross revenues received for emergency ambulance services, regardless of payer,
2.15are subject to the fee, including but not limited to gross revenues received for emergency
2.16ambulance services from commercial insurance and public health care programs under
2.17fee-for-service and managed care arrangements. In the case of a transfer of ownership, an
2.18ambulance provider's liability for the fee must be assumed by the successor in interest to
2.19the ambulance provider.
2.20 (c) The commissioner of human services shall consult with the commissioner of revenue
2.21when administering this subdivision.
2.22 Subd. 3.Ambulance fee fund.(a) The ambulance fee fund is established in the state
2.23treasury. The commissioner of management and budget shall deposit the following revenues
2.24into the fund:
2.25 (1) all revenues generated from the fee collected under subdivision 2;
2.26 (2) an amount equal to any federal financial participation revenues received by the state
2.27for eligible expenditures made from the fund;
2.28 (3) any other appropriations to the fund authorized by law; and
2.29 (4) interest earned on any money in the fund.
2.30 (b) Money in the fund is annually appropriated to the commissioner of human services
2.31for the purposes specified in subdivision 4.
2.32 Subd. 4.Expenditures from the ambulance fee fund.(a) The commissioner shall use
2.33money in the ambulance fee fund only to provide supplemental payments to ambulance
2Section 1.
25-00868 as introduced12/13/24 REVISOR AGW/VJ 3.1providers, in order to increase medical assistance payments to ambulance providers to a
3.2level that does not exceed the average commercial insurance rate. The commissioner may
3.3expend money in the fund for this purpose without further legislative authorization. The
3.4commissioner shall not use money in the fund to supplant or replace existing general fund
3.5appropriations and payment commitments.
3.6 (b) The commissioner shall make expenditures from the fund in a manner consistent
3.7with the requirements and conditions of federal financial participation under United States
3.8Code, title 42, section 1396b(w), and Code of Federal Regulations, title 42, section 433.68,
3.9and consistent with federal payment requirements and payment limits as determined by the
3.10secretary of the United States Department of Health and Human Services. The commissioner
3.11shall expend money in the fund in a manner that maximizes federal financial participation.
3.12 (c) The commissioner shall make supplemental payments to ambulance providers on a
3.13quarterly basis. The commissioner shall consult with the Minnesota Ambulance Association
3.14in the development and implementation of the payments.
3.15 (d) Beginning January 1, 2027, and each January 1 thereafter, the commissioner shall
3.16report annually to the chairs and ranking minority members of the legislative committees
3.17with jurisdiction over health care spending and policy on expenditures from the ambulance
3.18fee fund.
3.19 Subd. 5.Rulemaking.The commissioner of human services may adopt rules necessary
3.20to accomplish the purposes of this section.
3.21 Subd. 6.Federal approval required.(a) The implementation of subdivisions 1 to 5 is
3.22contingent on federal approval. If the Centers for Medicare and Medicaid Services does not
3.23approve of, or withdraws approval of, the payments made to ambulance providers under
3.24this section, all money remaining in the fund must be returned to ambulance providers. If
3.25the commissioner no longer collects the fee, the commissioner shall return all money
3.26remaining in the fund to ambulance providers.
3.27 (b) The commissioner shall submit to the Centers for Medicare and Medicaid Services
3.28all Medicaid state plan amendments, waiver requests, and other documents required to
3.29implement this section.
3.30 EFFECTIVE DATE.Subdivisions 1 to 5 are effective January 1, 2026, or upon federal
3.31approval, whichever is later. The commissioner of human services shall notify the revisor
3.32of statutes when federal approval is obtained. Subdivision 6 is effective the day following
3.33final enactment.
3Section 1.
25-00868 as introduced12/13/24 REVISOR AGW/VJ 4.1 Sec. 2. Minnesota Statutes 2024, section 295.50, subdivision 4, is amended to read:
4.2 Subd. 4.Health care provider.(a) "Health care provider" means:
4.3 (1) a person whose health care occupation is regulated or required to be regulated by
4.4the state of Minnesota furnishing any or all of the following goods or services directly to a
4.5patient or consumer: medical, surgical, optical, visual, dental, hearing, nursing services,
4.6drugs, laboratory, diagnostic or therapeutic services;
4.7 (2) a person who provides goods and services not listed in clause (1) that qualify for
4.8reimbursement under the medical assistance program provided under chapter 256B;
4.9 (3) a staff model health plan company;
4.10 (4) an ambulance service required to be licensed operated by a hospital;
4.11 (5) a person who sells or repairs hearing aids and related equipment or prescription
4.12eyewear; or
4.13 (6) a person providing patient services, who does not otherwise meet the definition of
4.14health care provider and is not specifically excluded in clause (b), who employs or contracts
4.15with a health care provider as defined in clauses (1) to (5) to perform, supervise, otherwise
4.16oversee, or consult with regarding patient services.
4.17 (b) Health care provider does not include:
4.18 (1) hospitals; medical supplies distributors, except as specified under paragraph (a),
4.19clause (5); nursing homes licensed under chapter 144A or licensed in any other jurisdiction;
4.20wholesale drug distributors; pharmacies; surgical centers; bus and taxicab transportation,
4.21or any other providers of transportation services other than ambulance services required to
4.22be licensed operated by a hospital; supervised living facilities for persons with developmental
4.23disabilities, licensed under Minnesota Rules, parts 4665.0100 to 4665.9900; housing with
4.24services establishments required to be registered under chapter 144D; board and lodging
4.25establishments providing only custodial services that are licensed under chapter 157 and
4.26registered under section 157.17 to provide supportive services or health supervision services;
4.27adult foster homes as defined in Minnesota Rules, part 9555.5105; day training and
4.28habilitation services for adults with developmental disabilities as defined in section 252.41,
4.29subdivision 3; boarding care homes, as defined in Minnesota Rules, part 4655.0100; and
4.30adult day care centers as defined in Minnesota Rules, part 9555.9600;
4.31 (2) home health agencies as defined in Minnesota Rules, part 9505.0175, subpart 15; a
4.32person providing personal care services and supervision of personal care services as defined
4.33in Minnesota Rules, part 9505.0335; a person providing home care nursing services as
4Sec. 2.
25-00868 as introduced12/13/24 REVISOR AGW/VJ 5.1defined in Minnesota Rules, part 9505.0360; and home care providers required to be licensed
5.2under chapter 144A for home care services provided under chapter 144A;
5.3 (3) a person who employs health care providers solely for the purpose of providing
5.4patient services to its employees;
5.5 (4) an educational institution that employs health care providers solely for the purpose
5.6of providing patient services to its students if the institution does not receive fee for service
5.7payments or payments for extended coverage; and
5.8 (5) a person who receives all payments for patient services from health care providers,
5.9surgical centers, or hospitals for goods and services that are taxable to the paying health
5.10care providers, surgical centers, or hospitals, as provided under section 295.53, subdivision
5.111, paragraph (b), clause (3) or (4), or from a source of funds that is excluded or exempt from
5.12tax under sections 295.50 to 295.59.
5.13 EFFECTIVE DATE.This section is effective for gross revenues received on or after
5.14January 1, 2026.
5.15 Sec. 3. Minnesota Statutes 2024, section 295.52, is amended by adding a subdivision to
5.16read:
5.17 Subd. 5a.Ambulance services operated by a hospital.An ambulance service operated
5.18by a hospital must pay the tax under this section directly to the commissioner as provided
5.19under section 295.55. Gross revenues from an ambulance service operated by a hospital
5.20must not be included in hospital gross revenues for purposes of payment of the tax.
5.21 EFFECTIVE DATE.This section is effective for gross revenues received on or after
5.22January 1, 2026.
5.23 Sec. 4. REPEALER.
5.24 Minnesota Statutes 2024, section 295.52, subdivision 5, is repealed.
5.25 EFFECTIVE DATE.This section is effective for gross revenues received on or after
5.26January 1, 2026.
5Sec. 4.
25-00868 as introduced12/13/24 REVISOR AGW/VJ 295.52 TAXES IMPOSED.
Subd. 5.Volunteer ambulance services.Volunteer ambulance services are not subject to the
tax under this section. For purposes of this requirement, "volunteer ambulance service" means an
ambulance service in which all of the individuals whose primary responsibility is direct patient care
meet the definition of volunteer under section 144E.001, subdivision 15. The ambulance service
may employ administrative and support staff, and remain eligible for this exemption, if the primary
responsibility of these staff is not direct patient care.
1R
APPENDIX
Repealed Minnesota Statutes: 25-00868