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| To enact sections 5111.028 and 5111.029 of the | 1 |
| Revised Code to modify the Medicaid program's | 2 |
| reimbursement rate for medical transportation | 3 |
| services. | 4 |
| Section 1. That sections 5111.028 and 5111.029 of the Revised | 5 |
| Code be enacted to read as follows: | 6 |
| Sec. 5111.028. (A) As used in this section and section | 7 |
| 5111.029 of the Revised Code: | 8 |
| "Fiscal biennium" means a period of time beginning the first | 9 |
| day of July of an odd-numbered calendar year and ending the last | 10 |
| day of June of the next odd-numbered calendar year. | 11 |
| "Medical transportation services" means the services of a | 12 |
| land ambulance, air ambulance, or ambulette provider. | 13 |
| "Respond but not transport service" means the service of a | 14 |
| land ambulance, air ambulance, or ambulette provider responding to | 15 |
| a medicaid recipient's emergency situation and treating the | 16 |
| recipient but not transporting the recipient. | 17 |
| (B) The director of job and family services shall adopt rules | 18 |
| under section 5111.02 of the Revised Code governing the medicaid | 19 |
| program's coverage of medical transportation services. The rules | 20 |
| shall do all of the following: | 21 |
| (1) Provide for the medicaid program to cover the respond but | 22 |
| not transport service as part of medical transportation services. | 23 |
| (2) Include a mechanism by which the medicaid program's | 24 |
| reimbursement rate for medical transportation services is adjusted | 25 |
| each fiscal biennium. | 26 |
| (3) Beginning not later than July 1, 2011, set the | 27 |
| reimbursement rate for each medical transportation service that is | 28 |
| also covered by the medicare program at an amount equal to at | 29 |
| least eighty per cent of the medicare reimbursement rate for the | 30 |
| service. | 31 |
| (4) Beginning not later than July 1, 2011, set the | 32 |
| reimbursement rate for each medical transportation service that is | 33 |
| not also covered by the medicare program at an amount equal to at | 34 |
| least the average of the medicaid reimbursement rates for medical | 35 |
| transportation services that are also covered by the medicare | 36 |
| program. | 37 |
| Sec. 5111.029. (A) There is hereby created the Ohio medicaid | 38 |
| transportation provider advisory council. The council shall | 39 |
| consist of the following members: | 40 |
| (1) Three representatives of the Ohio ambulance and medical | 41 |
| transportation association, appointed by the governor from | 42 |
| recommendations the association makes to the governor; | 43 |
| (2) Two representatives of the work unit within the | 44 |
| department of job and family services primarily responsible for | 45 |
| the administration of the medicaid program, appointed by the | 46 |
| director of job and family services; | 47 |
| (3) One representative of the Ohio medical transportation | 48 |
| board, appointed by the board; | 49 |
| (4) The auditor of state or the auditor's designee. | 50 |
| (B) Each member of the Ohio medicaid transportation provider | 51 |
| advisory council appointed to the board pursuant to divisions | 52 |
| (A)(1) to (3) of this section shall serve a term of four years. | 53 |
| Original appointments shall be made not later than ninety days | 54 |
| after the effective date of this section. Each member shall hold | 55 |
| office from the date of appointment until the end of the term for | 56 |
| which the member was appointed. Members may be reappointed. | 57 |
| Vacancies shall be filled in the manner provided for original | 58 |
| appointments. Any member appointed to fill a vacancy occurring | 59 |
| before the expiration date of the term for which the member's | 60 |
| predecessor was appointed shall hold office as a member for the | 61 |
| remainder of that term. A member shall continue in office | 62 |
| subsequent to the expiration date of the member's term until the | 63 |
| member's successor takes office or until a period of sixty days | 64 |
| has elapsed, whichever occurs first. | 65 |
| (C) All members of the council shall serve without | 66 |
| compensation or reimbursement, except as serving on the council is | 67 |
| considered part of their usual job duties. | 68 |
| (D) The members of the council shall elect one of the members | 69 |
| of the council to serve as the council's chairperson for a | 70 |
| two-year term. The chairperson may be reelected to successive | 71 |
| terms. | 72 |
| (E) The member of the Ohio medicaid transportation provider | 73 |
| advisory council who represents the Ohio medical transportation | 74 |
| board shall call the council to meet the first time. The | 75 |
| chairperson of the council shall call the council to subsequent | 76 |
| meetings. The council shall meet at least once every two years and | 77 |
| at other times requested by the director of job and family | 78 |
| services or the chief of the work unit within the department of | 79 |
| job and family services primarily responsible for the | 80 |
| administration of the medicaid program. At its meetings, the | 81 |
| council shall examine whether the medicaid program's reimbursement | 82 |
| rate for medical transportation services is sufficient to ensure | 83 |
| that medicaid recipients have access to safe and efficient medical | 84 |
| transportation services. In making the examination, the council | 85 |
| may consider both of the following: | 86 |
| (1) Whether the reimbursement rate in effect at the time of | 87 |
| the examination complies with federal and state laws governing the | 88 |
| medicaid program and adequately covers providers' costs of | 89 |
| providing the services; | 90 |
| (2) The change in the following since the last time the | 91 |
| medicaid program's reimbursement for medical transportation | 92 |
| services was adjusted: | 93 |
| (a) The consumer price index; | 94 |
| (b) The average price of fuel; | 95 |
| (c) The average cost of workers' compensation and insurance | 96 |
| for medical liability, automobiles, and other business matters; | 97 |
| (d) The cost to purchase or lease medical transport vehicles | 98 |
| and other necessary medical supplies; | 99 |
| (e) Other economic indicators the council deems worthy to | 100 |
| consider. | 101 |
| (F) The Ohio medicaid transportation provider advisory | 102 |
| council shall provide the director of job and family services with | 103 |
| recommendations regarding the medicaid program's reimbursement | 104 |
| rate for medical transportation services. The director may | 105 |
| consider the council's recommendations when adjusting the medicaid | 106 |
| program's reimbursement for medical transportation services for a | 107 |
| fiscal biennium in rules adopted under section 5111.02 of the | 108 |
| Revised Code. | 109 |
| (G) The department of job and family services shall provide | 110 |
| the Ohio medicaid transportation provider advisory council with | 111 |
| accommodations for the council to hold its meetings and shall | 112 |
| provide the council with other administrative assistance that the | 113 |
| council needs to perform its duties. | 114 |
| Section 2. As used in this section, "medical transportation | 115 |
| services" means the services of a land ambulance, air ambulance, | 116 |
| or ambulette provider. | 117 |
| The Medicaid program shall increase its reimbursement rate | 118 |
| for medical transportation services not later than ninety days | 119 |
| after the effective date of this section. The Director of Job and | 120 |
| Family Services shall amend the Medicaid program's rules adopted | 121 |
| under section 5111.02 of the Revised Code as necessary to | 122 |
| accomplish this increase. | 123 |