1 STATE OF OKLAHOMA
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2 1st Session of the 59th Legislature (2023)
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3 SENATE BILL 744 By: Thompson (Roger)
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6 AS INTRODUCED
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7 An Act relating to the Ambulance Service Provider
7 Access Payment Program; amending 63 O.S. 2021,
8 Section 3242, which relates to supplemental Medicaid
8 reimbursement for ground emergency transportation;
9 deleting certain requirement for reimbursement;
9 providing calculation and payment methodology for
10 certain services; allowing intergovernmental
10 agreements to substitute for certain requirements;
11 and declaring an emergency.
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14 BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
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15 SECTION 1. AMENDATORY 63 O.S. 2021, Section 3242, is
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16 amended to read as follows:
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17 Section 3242. A. An eligible provider, as described in
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18 subsection B of this section, in addition to the rate of payment
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19 that the provider would otherwise receive for Medicaid ground
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20 emergency medical transportation services, shall receive
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21 supplemental Medicaid reimbursement to the extent provided by law.
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22 B. A provider shall be eligible for supplemental reimbursement
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23 only if the provider meets the following conditions during the state
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24 fiscal year:
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 1 1. Provides ground emergency medical transportation services to
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2 Medicaid beneficiaries;
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3 2. Is a provider that is enrolled as a Medicaid provider for
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4 the period being claimed; and
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5 3. Is owned or operated by the state, a political subdivision
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6 or local government, that employs or contracts with persons who are
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7 licensed to provide emergency medical services in the State of
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8 Oklahoma, and includes private entities to the extent permissible
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9 under federal law.
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10 C. An eligible provider’s supplemental reimbursement pursuant
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11 to this section shall be calculated and paid as follows:
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12 1. The supplemental reimbursement to an eligible provider, as
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13 described in subsection B of this section, shall be equal to
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14 a. for services reimbursed through fee-for-service
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15 contracts, the amount of federal financial
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16 participation received because of the claims submitted
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17 pursuant to paragraph 3 of subsection F of this
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18 section, and
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19 b. for services reimbursed through capitated contracts,
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20 an amount to be determined in accordance with the
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21 approved directed payment pre-print, based on claims
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22 submitted pursuant to paragraph 3 of subsection F of
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23 this section;
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 1 2. In no instance shall the amount certified pursuant to
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2 paragraph 1 of subsection E of this section, when combined with the
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3 amount received from all other sources of reimbursement from the
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4 Medicaid program, exceed one hundred percent (100%) of actual costs,
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5 as determined pursuant to the Medicaid state plan, for ground
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6 emergency medical transportation services; and
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7 3. The supplemental Medicaid reimbursement provided by this
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8 section shall be distributed exclusively to eligible providers under
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9 a payment methodology based on ground emergency medical
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10 transportation services provided to Medicaid beneficiaries by
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11 eligible providers on a per-transport basis or other federally
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12 permissible basis. The Oklahoma Health Care Authority shall obtain
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13 approval from the Centers for Medicare and Medicaid Services for the
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14 payment methodology to be utilized, and shall not make any payment
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15 pursuant to this section prior to obtaining that approval.
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16 D. 1. It is the Legislature’s intent in enacting this section
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17 to provide the supplemental reimbursement described in this section
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18 without any expenditure from the state General Revenue Fund. An
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19 eligible provider, as a condition of receiving supplemental
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20 reimbursement pursuant to this section, shall enter into, and
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21 maintain, an agreement with the Authority for the purposes of
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22 implementing this section and reimbursing the state for the costs of
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23 administering this section.
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 1 2. The nonfederal share of the supplemental reimbursement
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2 submitted to the federal Centers for Medicare and Medicaid Services
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3 for purposes of claiming federal financial participation shall be
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4 paid only with funds from the governmental entities described in
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5 paragraph 3 of subsection B of this section and certified to the
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6 state as provided in subsection E of this section.
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7 E. Participation in the reimbursement program provided by this
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8 section by an eligible provider as set forth in subsection B of this
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9 section is voluntary. If an applicable governmental entity elects
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10 to seek supplemental reimbursement pursuant to this section on
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11 behalf of an eligible provider, the governmental entity shall do the
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12 following:
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13 1. Certify
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14 a. certify, in conformity with the requirements of 42
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15 C.F.R. § 433.51, that the claimed expenditures for the
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16 ground emergency medical transportation services are
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17 eligible for federal financial participation;,
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18 2. Provide
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19 b. provide evidence supporting the certification as
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20 specified by the Oklahoma Health Care Authority;,
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21 3. Submit
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22 c. submit data as specified by the Authority to determine
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23 the appropriate amounts to claim as expenditures
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24 qualifying for federal financial participation;, and
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 1 4. Keep
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2 d. keep, maintain, and have readily retrievable any
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3 records specified by the Authority to fully disclose
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4 reimbursement amounts to which the eligible provider
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5 is entitled, and any other records required by the
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6 Centers for Medicare and Medicaid Services; or
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7 2. Enter into and maintain an intergovernmental agreement with
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8 the Authority, as specified by the Authority.
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9 F. 1. The Authority shall promptly seek any necessary federal
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10 approvals for the implementation of this section. The Authority may
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11 limit the program to those costs that are allowable expenditures
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12 under Title XIX of the Social Security Act, 42 U.S.C. § 1396 et seq.
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13 If federal approval is not obtained for implementation of this
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14 section, this section shall not be implemented.
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15 2. The Authority shall submit claims for federal financial
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16 participation for the expenditures for the services delineated in
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17 subsection E of this section that are allowable expenditures under
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18 federal law.
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19 3. The Authority shall submit any necessary materials to the
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20 federal government to provide assurances that claims for federal
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21 financial participation will include only those expenditures that
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22 are allowable under federal law.
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23 SECTION 2. It being immediately necessary for the preservation
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24 of the public peace, health or safety, an emergency is hereby
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 1 declared to exist, by reason whereof this act shall take effect and
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2 be in full force from and after its passage and approval.
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4 59-1-753 DC 1/18/2023 5:09:51 PM
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