Oklahoma 2023 Regular Session

Oklahoma Senate Bill SB744 Latest Draft

Bill / Amended Version Filed 04/06/2023

                             
 
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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.   
 
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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 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   
 
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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 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   
 
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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 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   
 
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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 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   
 
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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.