HB1366 94TH GENERAL ASSEMBLY

LRB094 05548 DRJ 35597 b

94TH GENERAL ASSEMBLY
State of Illinois
2005 and 2006
HB1366

Introduced 02/09/05, by Rep. Dave Winters

SYNOPSIS AS INTRODUCED:

305 ILCS 5/5-4.2

from Ch. 23, par. 5-4.2

Amends the Illinois Public Aid Code. In provisions concerning ambulance service payments under the Medicaid program, provides that for ambulance services provided to a Medicaid recipient on or after January 1, 2006, the Department of Public Aid shall reimburse providers of medical transportation services by means of a medi-car or service car at a rate that is uniform throughout the State and does not vary by county or other geographic region.

FISCAL NOTE ACT MAY APPLY

A BILL FOR

AN ACT concerning public aid.

Be it enacted by the People of the State of Illinois, represented in the General Assembly:

Section 5. The Illinois Public Aid Code is amended by changing Section 5-4.2 as follows:

(305 ILCS 5/5-4.2) (from Ch. 23, par. 5-4.2)

Sec. 5-4.2. Ambulance services payments. For ambulance services provided to a recipient of aid under this Article on or after January 1, 1993, the Illinois Department shall reimburse ambulance service providers at rates calculated in accordance with this Section. It is the intent of the General Assembly to provide adequate reimbursement for ambulance services so as to ensure adequate access to services for recipients of aid under this Article and to provide appropriate incentives to ambulance service providers to provide services in an efficient and cost-effective manner. Thus, it is the intent of the General Assembly that the Illinois Department implement a reimbursement system for ambulance services that, to the extent practicable and subject to the availability of funds appropriated by the General Assembly for this purpose, is consistent with the payment principles of Medicare. To ensure uniformity between the payment principles of Medicare and Medicaid, the Illinois Department shall follow, to the extent necessary and practicable and subject to the availability of funds appropriated by the General Assembly for this purpose, the statutes, laws, regulations, policies, procedures, principles, definitions, guidelines, and manuals used to determine the amounts paid to ambulance service providers under Title XVIII of the Social Security Act (Medicare).

For ambulance services provided to a recipient of aid under this Article on or after January 1, 1996, the Illinois Department shall reimburse ambulance service providers based upon the actual distance traveled if a natural disaster, weather conditions, road repairs, or traffic congestion necessitates the use of a route other than the most direct route.

Notwithstanding any other provision of this Section, for ambulance services provided to a recipient of aid under this Article on or after January 1, 2006, the Department of Public Aid shall reimburse providers of medical transportation services by means of a medi-car or service car at a rate that is uniform throughout the State and does not vary by county or other geographic region.

For purposes of this Section, "ambulance services" includes medical transportation services provided by means of an ambulance, medi-car, service car, or taxi.

This Section does not prohibit separate billing by ambulance service providers for oxygen furnished while providing advanced life support services.

(Source: P.A. 88-104; 89-43, eff. 1-1-96.)