Division of the Budget
Landon State Office Building Phone: (785) 296-2436
900 SW Jackson Street, Room 504 adam.c.proffitt@ks.gov
Topeka, KS 66612 Division of the Budget http://budget.kansas.gov
Adam Proffitt, Director Laura Kelly, Governor


May 27, 2021


The Honorable Brenda Landwehr, Chairperson
House Committee on Health and Human Services
Statehouse, Room 352C-S
Topeka, Kansas 66612
Dear Representative Landwehr:
SUBJECT: Fiscal Note for HB 2372 by House Committee on Health and Human
Services
In accordance with KSA 75-3715a, the following fiscal note concerning HB 2372 is
respectfully submitted to your committee.
HB 2372 would require the Kansas Department of Health and Environment (KDHE) to
impose a Medicaid provider assessment on ground ambulance service providers. KDHE would
be required to reimburse each ground ambulance service provider based on the emergency
ambulance rates as determined by the U.S. Centers for Medicare and Medicaid Services (CMS)
for similar payment rates. KDHE would be responsible for calculating the assessment and
disbursing assessment revenues. Assessment revenues would be remitted to the Medicaid Ground
Ambulance Service Provider Assessment Fund, which would be a new fund created by the bill.
Assessment revenues would be expended in the following order of priority:
1. To provide funds for KDHE expenses to administer the program, which would include the
greater of $200,000 or 3.0 percent of the total amount of assessment revenue received;
2. To increase Medicaid payment rates for fee-for-service Medicaid ground ambulance
services to a rate not higher than the maximum rate authorized by CMS or to make
supplemental payments to ground ambulance service providers that are proportional to
each provider’s total Medicaid ambulance service; and
3. To increase nonemergency medical transport reimbursement rates, if any monies remain
after items 1 and 2.
The bill would prohibit ground ambulance service providers from increasing charges or
fees based on the assessment. The bill would require KDHE to determine by October 1, 2021, if
federal approval is necessary to implement HB 2372. KDHE would be prohibited from
implementing the bill before receiving approval from CMS.
The Honorable Brenda Landwehr, Chairperson
Page 2—HB 2372

The Emergency Medical Services Board estimates the bill could require additional
expenditures ranging from $9.8 million to $10.5 million from all funds. Of the total amount,
approximately $4.2 million to $4.4 million would be the state share which would be funded by the
provider assessment. The estimate assumes reimbursement is set at the maximum Kansas
Adjusted Medicare Allowable for Rural Zip Codes.
KDHE indicates that any costs incurred to administer the program would be covered by
the provision in the bill that allows a portion of assessment revenues to be used for program
operating expenses. Any fiscal effect associated with HB 2372 is not reflected in The FY 2022
Governor’s Budget Report.


Sincerely,

Adam Proffitt
Director of the Budget

cc: Dan Thimmesch, Health & Environment
Joe House, EMS