SB744 HFLR Page 1 BOLD FACE denotes Committee Amendments. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 HOUSE OF REPRESENTATIVES - FLOOR VERSION STATE OF OKLAHOMA 1st Session of the 59th Legislature (2023) ENGROSSED 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. SB744 HFLR Page 2 BOLD FACE denotes Committee Amendments. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 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 medi cal transportation services to Medicaid beneficiaries; 2. Is a provider that is enrolle d 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 who 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 b e calculated and paid as follows: 1. The supplemental reimbursement to an eligible prov ider, 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 SB744 HFLR Page 3 BOLD FACE denotes Committee Amendments. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 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 the 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. The 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 suppleme ntal 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 w ith the Authority for the purposes of SB744 HFLR Page 4 BOLD FACE denotes Committee Amendments. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 implementing this sectio n and reimbursing the state for the costs of administering this section. 2. The nonfederal shar e of the supplemental reimbursement submitted to the federal Cen ters for Medicare and Medicaid Ser vices 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 and 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 ar e eligible for federal financial participation ;, 2. Provide b. provide evidence supporting the certification as specified by the Oklahoma Health Care Authority ;, 3. Submit SB744 HFLR Page 5 BOLD FACE denotes Committee Amendments. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 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 Auth ority to fully disclose 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 fed eral 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, 42 U.S.C. § 1396 et seq. If federal approval is not obtained for impleme ntation 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 s ervices delineated 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 SB744 HFLR Page 6 BOLD FACE denotes Committee Amendments. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 financial participation wil l include only those 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 effect and be in full force from and af ter its passage and approval. COMMITTEE REPORT BY: COMMITTEE ON APPROPRIATIONS AND BUDGET, dated 04/05/2023 - DO PASS.