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SENATE FLOOR VERSION
February 23, 2023
SENATE BILL NO. 744 By: Thompson (Roger) of the
Senate
and
Wallace of the House
An Act relating to the Ambulance Service Provider
Access Payment Program ; amending 63 O.S. 2021,
Section 3242, which relates to supplemental Medicaid
reimbursement for ground emergency transportation ;
deleting certain requirement for reimbursement;
providing calculation and payment method ology for
certain services; allowing intergovernmental
agreements to substitute for certain requirements;
and declaring an emergency .
BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
SECTION 1. AMENDATORY 63 O.S. 2021, Section 3242, is
amended to read as follows:
Section 3242. A. An eligible provider, as described in
subsection B of this section, in addition to the rate of payment
that the provider would otherwise receive for Medica id ground
emergency medical transportation services, shall receive
supplemental Medicaid reimbursement to the ex tent provided by law.
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B. A provider shall be eligible for supplemental reimbursement
only if the provider meets the following conditions during the state
fiscal year:
1. Provides ground emergency medical transportat ion services to
Medicaid beneficiaries;
2. Is a provider that is enrolled as a Medicaid provider for
the period being claimed; and
3. Is owned or operated by the state, a political subdivision
or local government, that employs or contracts with persons w ho are
licensed to provide emergency me dical services in the State of
Oklahoma, and includes private entities to the extent permissible
under federal law.
C. An eligible provider ’s supplemental reimbursement pursuant
to this section shall be calculated an d paid as follows:
1. The supplemental reimbursement to an eligible provider, as
described in subsection B of this section, shall be e qual to
a. for services reimburse d through fee-for-service
contracts, the amount of federal financial
participation received because of the claims submitted
pursuant to paragraph 3 of subsection F of this
section, and
b. for services reimbursed through cap itated contracts,
an amount to be determined in accordance with the
approved directed payment pre -print, based on claims
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submitted pursuant to paragraph 3 of subsection F of
this section;
2. In no instance shall the amount certified pursuant to
paragraph 1 of subsection E of this section, when combined with the
amount received from all other sources of reimbursement from th e
Medicaid program, exceed one hundred percent (100%) of actual costs,
as determined pursuant to the Medicaid state plan, for ground
emergency medical transportation services; and
3. The supplemental Medicaid reimbursement provide d by this
section shall be distributed exclusively to eligible p roviders under
a payment methodology based on ground emergency medical
transportation services p rovided to Medicaid beneficiaries by
eligible providers on a per-transport basis or other federa lly
permissible basis. T he Oklahoma Health Care Authority shall obtain
approval from the Centers for Medicare and Medicaid Services for the
payment methodology to be utilized, and shall not make any payment
pursuant to this section prior to obtaining that approval.
D. 1. It is the Legislature’s intent in enacting th is section
to provide the supplemental reimbursement described in this section
without any expenditure from the state General Revenue Fund. An
eligible provider, as a condition of receiving s upplemental
reimbursement pursuant to this section, shall enter into, and
maintain, an agreement with the Authority for the purposes of
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implementing this sectio n and reimbursing the state for the costs of
administering this section.
2. The nonfederal shar e of the supplemental rei mbursement
submitted to the federal Cen ters for Medicare and Medicaid Services
for purposes of claiming federal financial participation shall be
paid only with funds from the governme ntal entities described in
paragraph 3 of subsec tion B of this section an d certified to the
state as provided in subsection E of this section.
E. Participation in the reimbursement program provided by this
section by an eligible provider as set forth in s ubsection B of this
section is voluntary. If an applicable governmental entity elects
to seek supplemental reim bursement pursuant to this section on
behalf of an eligible provider, the governmental entity sh all do the
following:
1. Certify
a. certify, in conformity with the requirements of 42
C.F.R. § 433.51, that the claimed expenditures for the
ground emergency medical transportation services are
eligible for federal financial participation ;,
2. Provide
b. provide evidence supporting the certification as
specified by the Oklahoma Health Care Authority ;,
3. Submit
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c. submit data as specified by the Authority to determine
the appropriate amounts to claim as expenditures
qualifying for federal financial par ticipation;, and
4. Keep
d. keep, maintain, and have readily retrievable any
records specified by the Authority to fully d isclose
reimbursement amounts to which the eligible provider
is entitled, and any other records required by the
Centers for Medicare and Medicaid Services ; or
2. Enter into and maintain an intergovernmental agree ment with
the Authority, as specified by the Authority.
F. 1. The Authority sha ll promptly seek any necessary federal
approvals for the implementation of this section. Th e Authority may
limit the program to those costs t hat are allowable expenditures
under Title XIX of the Social Security Act, 4 2 U.S.C. § 1396 et seq.
If federal approval is not obtained for implementation of this
section, this section shall not be impleme nted.
2. The Authority shall submit claims for fe deral financial
participation for the expenditures for the services delineat ed in
subsection E of this section tha t are allowable expenditures under
federal law.
3. The Authority shall submit any necessary materials to the
federal government to provide as surances that claims for federal
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financial participation will include only t hose expenditures that
are allowable under federal law.
SECTION 2. It being immediately necessary for the preservation
of the public peace, health or safety, an emergency is hereby
declared to exist, by reason whereof this act shall take e ffect and
be in full force from and af ter its passage and approval.
COMMITTEE REPORT BY: COMMITTEE ON HEALTH AND HUMAN SERVICES
February 23, 2023 - DO PASS