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1
SENATE RESOLUTION

 
2     WHEREAS, The costs of operating ground ambulance services
3 have climbed dramatically in the post 9-11 era; and
 
4     WHEREAS, Ground ambulance services are provided by local
5 governments, including counties, municipalities, and fire
6 protection districts, as well as by hospitals, not for profit
7 organizations, and private companies who all rely on Medicaid
8 payments to offset their costs for providing ground ambulance
9 services to Medicaid recipients; and
 
10     WHEREAS, The costs for inputs such as fuel, insurance,
11 workers' compensation, and labor are increasing at a rate that
12 is outpacing inflation; and
 
13     WHEREAS, There are fewer licensed ground ambulance
14 providers in Illinois; and
 
15     WHEREAS, Some areas of the state are experiencing decreases
16 in the level of service available, and significant increases in
17 response times; and
 
18     WHEREAS, The United States Government Accountability
19 Office (GAO) published a report in 2007, titled Ambulance
20 Providers: Costs and Expected Medicare Margins Vary Greatly,

 

 

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1 and concluded that on average Medicare payments for ground
2 ambulance services are 6% below the cost to provide such
3 service; and
 
4     WHEREAS, Current Medicaid payment rates are substantially
5 below Medicare payment rates; and
 
6     WHEREAS, Illinois law recognizes that it is the intent of
7 the General Assembly to provide adequate reimbursement for
8 ambulance services so as to ensure access to those services for
9 Public Aid recipients, and that the Department of Healthcare
10 and Family Services should implement a reimbursement system for
11 ambulance services providers consistent with payment
12 principles and practices of Medicare to the extent practicable
13 and subject to the availability of funds appropriated by the
14 General Assembly; and
 
15     WHEREAS, The current Medicaid payment for ground ambulance
16 services is based upon an inaccurate and inappropriate
17 reasonable charge system that is no longer recognized by
18 Medicare; and
 
19     WHEREAS, Emergency ground ambulance services providers
20 cannot refuse service based on a person's inability to pay; and
 
21     WHEREAS, Medicaid rates for both emergency ground

 

 

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1 ambulance services and non-emergency ground ambulance services
2 were rolled back 6% on July 1, 2002 and have been frozen since;
3 and
 
4     WHEREAS, Low Medicaid payment rates for providing
5 emergency ground ambulance services to Medicaid recipients
6 combined with the chronic delay of payments for providing life
7 saving emergency services threatens the economic viability of
8 many ground ambulance service providers and further erodes the
9 ground ambulance services safety net statewide; therefore, be
10 it
 
11     RESOLVED, BY THE SENATE OF THE NINETY-SIXTH GENERAL
12 ASSEMBLY OF THE STATE OF ILLINOIS, that no later than January
13 15, 2010, the Commission on Government Forecasting and
14 Accountability shall submit to the General Assembly a report on
15 the access, supply, quality, and cost of providing ground
16 ambulance services in urban, rural, and super rural areas; and
17 be it further
 
18     RESOLVED, That to determine what constitutes urban, rural,
19 and super rural areas, the Commission shall use the criteria
20 which has already been established by the United States
21 Department of Health and Human Services' Centers for Medicare
22 and Medicaid Services (CMS) for use with the Medicare Program;
23 and be it further
 

 

 

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1     RESOLVED, That the report shall detail how costs differ
2 among the types of ambulance providers, including, but not
3 limited to full cost providers and volunteer providers; and be
4 it further
 
5     RESOLVED, That the report shall detail how current Medicaid
6 payment rates relate to the cost of providing ground ambulance
7 services within the framework provided by the Medicare
8 Ambulance Fee Schedule, and that the base year used in
9 developing the report shall be the most recent calendar year or
10 fiscal year for which complete financial information is
11 available to the Commission.