Rep. Dave Winters

Filed: 4/6/2005

 

 


 

 


 
09400HB1366ham001 LRB094 05548 DRJ 44463 a

1
AMENDMENT TO HOUSE BILL 1366

2     AMENDMENT NO. ______. Amend House Bill 1366 by replacing
3 everything after the enacting clause with the following:
 
4     "Section 5. The Illinois Public Aid Code is amended by
5 changing Section 5-4.2 as follows:
 
6     (305 ILCS 5/5-4.2)  (from Ch. 23, par. 5-4.2)
7     Sec. 5-4.2. Ambulance services payments. For ambulance
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
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

 

 

09400HB1366ham001 - 2 - LRB094 05548 DRJ 44463 a

1 funds appropriated by the General Assembly for this purpose,
2 the statutes, laws, regulations, policies, procedures,
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).
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.
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.
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.
30     This Section does not prohibit separate billing by
31 ambulance service providers for oxygen furnished while
32 providing advanced life support services.
33 (Source: P.A. 88-104; 89-43, eff. 1-1-96.)".