SR0314 96TH GENERAL ASSEMBLY

SR0314 LRB096 13208 KTG 27824 r

SENATE RESOLUTION

WHEREAS, The costs of operating ground ambulance services have climbed dramatically in the post 9-11 era; and

WHEREAS, Ground ambulance services are provided by local governments, including counties, municipalities, and fire protection districts, as well as by hospitals, not for profit organizations, and private companies who all rely on Medicaid payments to offset their costs for providing ground ambulance services to Medicaid recipients; and

WHEREAS, The costs for inputs such as fuel, insurance, workers' compensation, and labor are increasing at a rate that is outpacing inflation; and

WHEREAS, There are fewer licensed ground ambulance providers in Illinois; and

WHEREAS, Some areas of the state are experiencing decreases in the level of service available, and significant increases in response times; and

WHEREAS, The United States Government Accountability Office (GAO) published a report in 2007, titled Ambulance Providers: Costs and Expected Medicare Margins Vary Greatly, and concluded that on average Medicare payments for ground ambulance services are 6% below the cost to provide such service; and

WHEREAS, Current Medicaid payment rates are substantially below Medicare payment rates; and

WHEREAS, Illinois law recognizes that it is the intent of the General Assembly to provide adequate reimbursement for ambulance services so as to ensure access to those services for Public Aid recipients, and that the Department of Healthcare and Family Services should implement a reimbursement system for ambulance services providers consistent with payment principles and practices of Medicare to the extent practicable and subject to the availability of funds appropriated by the General Assembly; and

WHEREAS, The current Medicaid payment for ground ambulance services is based upon an inaccurate and inappropriate reasonable charge system that is no longer recognized by Medicare; and

WHEREAS, Emergency ground ambulance services providers cannot refuse service based on a person's inability to pay; and

WHEREAS, Medicaid rates for both emergency ground ambulance services and non-emergency ground ambulance services were rolled back 6% on July 1, 2002 and have been frozen since; and

WHEREAS, Low Medicaid payment rates for providing emergency ground ambulance services to Medicaid recipients combined with the chronic delay of payments for providing life saving emergency services threatens the economic viability of many ground ambulance service providers and further erodes the ground ambulance services safety net statewide; therefore, be it

RESOLVED, BY THE SENATE OF THE NINETY-SIXTH GENERAL ASSEMBLY OF THE STATE OF ILLINOIS, that no later than January 15, 2010, the Commission on Government Forecasting and Accountability shall submit to the General Assembly a report on the access, supply, quality, and cost of providing ground ambulance services in urban, rural, and super rural areas; and be it further

RESOLVED, That to determine what constitutes urban, rural, and super rural areas, the Commission shall use the criteria which has already been established by the United States Department of Health and Human Services' Centers for Medicare and Medicaid Services (CMS) for use with the Medicare Program; and be it further

RESOLVED, That the report shall detail how costs differ among the types of ambulance providers, including, but not limited to full cost providers and volunteer providers; and be it further

RESOLVED, That the report shall detail how current Medicaid payment rates relate to the cost of providing ground ambulance services within the framework provided by the Medicare Ambulance Fee Schedule, and that the base year used in developing the report shall be the most recent calendar year or fiscal year for which complete financial information is available to the Commission.