2021 -- H 5794

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LC001800

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2021

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A N   A C T

RELATING TO HUMAN SERVICES - MEDICAL ASSISTANCE

     Introduced By: Representative Patricia A. Serpa

     Date Introduced: February 24, 2021

     Referred To: House Finance

     It is enacted by the General Assembly as follows:

     SECTION 1. Chapter 40-8 of the General Laws entitled "Medical Assistance" is hereby

amended by adding thereto the following section:

     40-8-33. Payment to non-emergency medical transportation service providers.

     (a) To support the ability of non-emergency medical transportation service providers to

provide high quality non-emergency medical transportation services to patients, the executive

office of health and human services ("executive office") shall adopt and implement a methodology

for determining a Medicaid fee for services and reimbursement rate, for non-emergency medical

transportation service providers, that is at least comparable to the rates paid for similar services in

neighboring states. These fees and rates shall apply to Medicaid eligible services.

     (b) The rate determination methodology shall fairly recognize the reasonable costs of

providing these services. Recognized reasonable costs shall be those appropriate for the

organization, management, and direct provision of services.

     (c) The executive office may require non-emergency medical transportation service

providers to provide assurances to the executive office that services are provided in an effective

and efficient manner, consistent with industry standards.

     (d) The general assembly shall annually appropriate to the department of human services

such sums as it may deem necessary to carry out the purposes of this section. Authorization to pay

for non-emergency transportation services specified in this section shall be made by representatives

of the department of human services, and the state controller is hereby authorized and directed to

draw their orders upon the general treasurer for the payment of such sum or sums or so much thereof

as may be required from time to time, upon the receipt by them of properly authenticated vouchers;

provided, however, that the department of human services may enter into cooperative agreements

for the transfer of funds to effectuate the purposes set forth in this section.

     (e) Commencing July 1, 2021, non-emergent (routine) ambulance transportation, a covered

service for Medicaid beneficiaries, shall be added to the Rhode Island Medicaid fee-for-service

schedule using code A0428 with the minimum reimbursement for this service by any health

insurance payor of one hundred forty-seven dollars ($147) per each trip provided and one dollar

fifty cents ($1.50) per mile. This rate shall also apply to patients who are dually-eligible for

coverage through Medicaid and Medicare with no allowance for any co-payment by the patient.

     (f) Notwithstanding the provisions of any law to the contrary, any Rhode Island or out of

state based non-emergency medical transportation service provider seeking to do business within

this state wherever located on or after July 1, 2021 shall be subject to the certificate of need

licensing provisions set forth in chapter 15 of title 23. Rhode Island providers providing non-

emergency medical transportation services on or before January 1, 2021 shall be exempt from the

provisions of this section.

     SECTION 2. This act shall take effect upon passage.

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO HUMAN SERVICES - MEDICAL ASSISTANCE

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     This act would:

     (1) Direct the executive office of health and human services (EOHHS) to adopt and

implement a methodology for determining a Medicaid fee for services and reimbursement rate for

non-emergency medical transportation service providers that is at least comparable to the rates paid

for similar services in neighboring states;

     (2) Set a minimum fee for service at one hundred forty-seven dollars ($147) per trip and

one dollar fifty cents ($1.50) per mile; and

     (3) Require Rhode Island and out of state non-emergency providers seeking to do business

in this state on or after July 1, 2021 to obtain a certificate of need.

     This act would take effect upon passage.

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