Provides for medicaid reimbursement for ambulance services when treatment in place is administered and/or when transportation is provided to alternative health care settings instead of a general hospital.
NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A9102C
SPONSOR: Kelles TITLE OF BILL:
An act to amend the social services law, in relation to Medicaid
reimbursement for treatment in place and transportation to alternative
health care settings by ambulance services
PURPOSE:
This bill would authorize Medicaid reimbursement to emergency medical
service agencies for
*providing emergency medical care to Medicaid enrollees without requir-
ing the transportation of these patients from the location where the
medical care was administered
*providing emergency medical care to Medicaid enrollees and transporting
them to alternative destinations (i.e.locations other than a hospital),
such as an urgent ,care clinic or mental health or rehabilitation facil-
ity
SUMMARY OF PROVISIONS:
Section 1; Establishes and defines reimbursement for treatment in place
and transportation to alternative health care settings.
Section 2: Effective Date
JUSTIFICATION:
Under current law, when responding to a 911 call, EMS agencies must
transport Medicaid enrollees to a general hospital in order to receive
Medicaid reimbursement. Each medical scenario is unique. Not every call
requires a visit to a hospital or emergency room. In some cases, a
patient may be better served at the scene of the emergency, and in these
instances the EMS agency is faced with not being reimbursed for the cost
of care (let alone the cost of the time it takes to respond in more
rural or remote areas). This contributes to the already dire financial.
situations that many EMS providers already experience. Furthermore, when
EMS agencies do transport enrollees to a hospital unnecessarily, that is
valuable time lost that could have been spent responding to more serious
emergencies while further burdening emergency rooms in the process. The
first piece here would allow EMS practitioners to treat Medicaid enrol-
lees in place (when deemed appropriate by the agency's medical director)
and be reimbursed for such services, saving time and money for emergency
responders, patients, and hospital staff.
Additionally, since each emergency call is unique, there must be a
degree of discretion allowed regarding the best treatment options for
the patient. Whereas EMS agencies are hamstrung into a "one-size-fit-
sall" approach of transporting a patient to a general hospital for
reimbursement, this bill would also authorize Medicaid reimbursement for
transportation to alternative destinations-"hospitals" as defined in NYS
Public Health Law--which can include mental health or rehabilitation
facilities.
LEGISLATIVE HISTORY:
New bill.
FISCAL IMPLICATIONS:
To be determined.
EFFECTIVE DATE:
This act shall take effect on the first of October next succeeding the
date on which it shall have become a law.
