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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AN ACT
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:
1 SECTION 1. Chapter 40-8 of the General Laws entitled "Medical Assistance" is hereby
2 amended by adding thereto the following section:
3 40-8-33. Payment to non-emergency medical transportation service providers.
4 (a) To support the ability of non-emergency medical transportation service providers to
5 provide high quality non-emergency medical transportation services to patients, the executive
6 office of health and human services ("executive office") shall adopt and implement a methodology
7 for determining a Medicaid fee for services and reimbursement rate, for non-emergency medical
8 transportation service providers, that is at least comparable to the rates paid for similar services in
9 neighboring states. These fees and rates shall apply to Medicaid eligible services.
10 (b) The rate determination methodology shall fairly recognize the reasonable costs of
11 providing these services. Recognized reasonable costs shall be those appropriate for the
12 organization, management, and direct provision of services.
13 (c) The executive office may require non-emergency medical transportation service
14 providers to provide assurances to the executive office that services are provided in an effective
15 and efficient manner, consistent with industry standards.
16 (d) The general assembly shall annually appropriate to the department of human services
17 such sums as it may deem necessary to carry out the purposes of this section. Authorization to pay
18 for non-emergency transportation services specified in this section shall be made by representatives
19 of the department of human services, and the state controller is hereby authorized and directed to
 1 draw their orders upon the general treasurer for the payment of such sum or sums or so much thereof
2 as may be required from time to time, upon the receipt by them of properly authenticated vouchers;
3 provided, however, that the department of human services may enter into cooperative agreements
4 for the transfer of funds to effectuate the purposes set forth in this section.
5 (e) Commencing July 1, 2021, non-emergent (routine) ambulance transportation, a covered
6 service for Medicaid beneficiaries, shall be added to the Rhode Island Medicaid fee-for-service
7 schedule using code A0428 with the minimum reimbursement for this service by any health
8 insurance payor of one hundred forty-seven dollars ($147) per each trip provided and one dollar
9 fifty cents ($1.50) per mile. This rate shall also apply to patients who are dually-eligible for
10 coverage through Medicaid and Medicare with no allowance for any co-payment by the patient.
11 (f) Notwithstanding the provisions of any law to the contrary, any Rhode Island or out of
12 state based non-emergency medical transportation service provider seeking to do business within
13 this state wherever located on or after July 1, 2021 shall be subject to the certificate of need
14 licensing provisions set forth in chapter 15 of title 23. Rhode Island providers providing non-
15 emergency medical transportation services on or before January 1, 2021 shall be exempt from the
16 provisions of this section.
17 SECTION 2. This act shall take effect upon passage.
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 EXPLANATION
BY THE LEGISLATIVE COUNCIL
OF
AN ACT
RELATING TO HUMAN SERVICES - MEDICAL ASSISTANCE
***
1 This act would:
2 (1) Direct the executive office of health and human services (EOHHS) to adopt and
3 implement a methodology for determining a Medicaid fee for services and reimbursement rate for
4 non-emergency medical transportation service providers that is at least comparable to the rates paid
5 for similar services in neighboring states;
6 (2) Set a minimum fee for service at one hundred forty-seven dollars ($147) per trip and
7 one dollar fifty cents ($1.50) per mile; and
8 (3) Require Rhode Island and out of state non-emergency providers seeking to do business
9 in this state on or after July 1, 2021 to obtain a certificate of need.
10 This act would take effect upon passage.
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