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| 1 | AMENDMENT TO HOUSE BILL 1366
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| 2 | AMENDMENT NO. ______. Amend House Bill 1366 by replacing | ||||||
| 3 | everything after the enacting clause with the following:
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| 4 | "Section 5. The Illinois Public Aid Code is amended by | ||||||
| 5 | changing Section 5-4.2 as follows:
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| 6 | (305 ILCS 5/5-4.2) (from Ch. 23, par. 5-4.2)
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| 7 | Sec. 5-4.2. Ambulance services payments. For
ambulance
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| 8 | services provided to a recipient of aid under this Article on | ||||||
| 9 | or after
January 1, 1993, the Illinois Department shall | ||||||
| 10 | reimburse ambulance service
providers at rates calculated in | ||||||
| 11 | accordance with this Section. It is the intent
of the General | ||||||
| 12 | Assembly to provide adequate reimbursement for ambulance
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| 13 | services so as to ensure adequate access to services for | ||||||
| 14 | recipients of aid
under this Article and to provide appropriate | ||||||
| 15 | incentives to ambulance service
providers to provide services | ||||||
| 16 | in an efficient and cost-effective manner. Thus,
it is the | ||||||
| 17 | intent of the General Assembly that the Illinois Department | ||||||
| 18 | implement
a reimbursement system for ambulance services that, | ||||||
| 19 | to the extent practicable
and subject to the availability of | ||||||
| 20 | funds appropriated by the General Assembly
for this purpose, is | ||||||
| 21 | consistent with the payment principles of Medicare. To
ensure | ||||||
| 22 | uniformity between the payment principles of Medicare and | ||||||
| 23 | Medicaid, the
Illinois Department shall follow, to the extent | ||||||
| 24 | necessary and practicable and
subject to the availability of | ||||||
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| 1 | funds appropriated by the General Assembly for
this purpose, | ||||||
| 2 | the statutes, laws, regulations, policies, procedures,
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| 3 | principles, definitions, guidelines, and manuals used to | ||||||
| 4 | determine the amounts
paid to ambulance service providers under | ||||||
| 5 | Title XVIII of the Social Security
Act (Medicare).
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| 6 | For ambulance services provided to a recipient of aid under | ||||||
| 7 | this Article
on or after January 1, 1996, the Illinois | ||||||
| 8 | Department shall reimburse ambulance
service providers based | ||||||
| 9 | upon the actual distance traveled if a natural
disaster, | ||||||
| 10 | weather conditions, road repairs, or traffic congestion | ||||||
| 11 | necessitates
the use of a
route other than the most direct | ||||||
| 12 | route.
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| 13 | Notwithstanding any other provision of this Section, for | ||||||
| 14 | ambulance services provided to a recipient of aid under this | ||||||
| 15 | Article
on or after January 1, 2006, the Department of Public | ||||||
| 16 | Aid shall reimburse providers of medical transportation | ||||||
| 17 | services by means of a medi-car, service car, or taxi at a rate | ||||||
| 18 | that is based on the cost of providing the services. The rate | ||||||
| 19 | may not vary between different regions of the State unless any | ||||||
| 20 | such variation is based on differences in the cost of providing | ||||||
| 21 | the services between those regions. The Department need not | ||||||
| 22 | establish the rate or rates to provide reimbursement of any | ||||||
| 23 | particular percentage of the cost of providing the services. | ||||||
| 24 | The Department may determine the cost of providing the services | ||||||
| 25 | through the use of cost reports or in any other appropriate | ||||||
| 26 | manner determined by the Department.
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| 27 | For purposes of this Section, "ambulance services" | ||||||
| 28 | includes medical
transportation services provided by means of | ||||||
| 29 | an ambulance, medi-car, service
car, or
taxi.
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| 30 | This Section does not prohibit separate billing by | ||||||
| 31 | ambulance service
providers for oxygen furnished while | ||||||
| 32 | providing advanced life support
services.
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| 33 | (Source: P.A. 88-104; 89-43, eff. 1-1-96.)".
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