Amends TCA Title 71.
This bill rewrites the present law provisions under the Medical Assistance Act regarding the reimbursement of a public or private ground-based rural or urban ambulance service that bills for transports and has a base of operations in this state ("ambulance service providers"), and which provides covered service to TennCare recipients. This bill requires the bureau of TennCare ("bureau") to (i) reimburse an ambulance service provider for providing a covered urban ambulance service to a TennCare recipient at a rate not less than 67.5 percent of the federal medicare program's allowable charge for participating providers; and (ii) reimburse an ambulance service provider for providing a covered rural ambulance service to a TennCare recipient at a rate not less than 100 percent of the federal medicare program's allowable charge for participating providers. FUNDING This bill does not affect the Ground Ambulance Service Provider Assessment Act. This bill provides that funds described under this bill and those under the Ground Ambulance Service Provider Assessment Act must not be used to fund the other. This bill requires the bureau to seek an intergovernmental transfer of funds in consultation with, and subject to approval of, the commissioner of finance and administration for the sole purpose of increasing the rate of reimbursement to ambulance service providers that provide covered services to TennCare recipients at a rate greater than the rates described under this bill. Additionally, this bill requires the bureau, in consultation with and subject to approval of the commissioner of finance and administration, to develop and implement a program substantially similar to the federal centers for medicare and medicaid services' Emergency Triage, Treat, and Transport (ET3) model in a manner that complies with this bill. This bill further provides that for-profit ambulance service providers providing an ambulance service in which the point of pick up occurs in a rural area are eligible to receive emergency medical services equipment grants.
This bill rewrites the present law provisions under the Medical Assistance Act regarding the reimbursement of a public or private ground-based rural or urban ambulance service that bills for transports and has a base of operations in this state ("ambulance service providers"), and which provides covered service to TennCare recipients. This bill requires the bureau of TennCare ("bureau") to (i) reimburse an ambulance service provider for providing a covered urban ambulance service to a TennCare recipient at a rate not less than 67.5 percent of the federal medicare program's allowable charge for participating providers; and (ii) reimburse an ambulance service provider for providing a covered rural ambulance service to a TennCare recipient at a rate not less than 100 percent of the federal medicare program's allowable charge for participating providers. FUNDING This bill does not affect the Ground Ambulance Service Provider Assessment Act. This bill provides that funds described under this bill and those under the Ground Ambulance Service Provider Assessment Act must not be used to fund the other. This bill requires the bureau to seek an intergovernmental transfer of funds in consultation with, and subject to approval of, the commissioner of finance and administration for the sole purpose of increasing the rate of reimbursement to ambulance service providers that provide covered services to TennCare recipients at a rate greater than the rates described under this bill. Additionally, this bill requires the bureau, in consultation with and subject to approval of the commissioner of finance and administration, to develop and implement a program substantially similar to the federal centers for medicare and medicaid services' Emergency Triage, Treat, and Transport (ET3) model in a manner that complies with this bill. This bill further provides that for-profit ambulance service providers providing an ambulance service in which the point of pick up occurs in a rural area are eligible to receive emergency medical services equipment grants.
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