Fiscal Note & Local Impact Statement
127 th General Assembly of Ohio
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STATE FUND |
FY 2008 |
FY 2009 |
FUTURE YEARS |
|
General Revenue Fund |
|||
|
Revenues |
Gain in federal Medicaid
reimbursement |
Gain in federal Medicaid
reimbursement for FY 2010–2011 biennium; Annual gain of $59.3 million in
federal Medicaid reimbursement starting in FY 2012 |
|
|
Expenditures |
- 0 - |
Unspecified reimbursement
rate increase for medical transportation services |
Unspecified reimbursement
rate increase for medical transportation services for FY 2010–2011 biennium;
$98.8 million all funds annual increase starting in FY 2012 |
Note: The state
fiscal year is July 1 through June 30.
For example, FY 2008 is July 1, 2007 – June 30, 2008.
·
The
bill requires the Medicaid program to increase its reimbursement rate for
medical transportation services not later than 90 days after the bill's
effective date. This provision will
increase Medicaid costs in FY 2009. A
specific cost estimate cannot be determined, as the bill does not mandate a
particular rate increase in this provision.
·
The
bill requires that rules governing the Medicaid program include a mechanism
that will adjust the Medicaid reimbursement rate for medical transportation
services in each fiscal biennium. This
provision will affect Medicaid costs in the FY 2010-2011 biennium and each
biennium thereafter. A specific cost
estimate cannot be determined, as the bill does not mandate a particular rate
increase in this provision.
·
The
bill requires, beginning not later than July 1, 2011 (FY 2012), that the
Medicaid program set the reimbursement rates for medical transportation
services at an amount equal to at least 80% of the Medicare reimbursement rates
for medical transportation services, and to increase the reimbursement rates
for those medical transportation services not reimbursed by Medicare by the
same percentage. This provision would
increase GRF Medicaid costs by approximately $98.8
million all funds ($39.5 million state share)
in FY 2012 and annually thereafter.
The federal government reimburses the state approximately 60% of the
cost for medical transportation services.
·
The
bill creates the Ohio Medicaid Transportation Provider Advisory Council. It requires the Council to examine the
Medicaid program's reimbursement rates for medical transportation services and
make recommendations for adjusting rates to the Director of Job and Family
Services each biennium. This provision
would result in minimal costs for ODJFS associated with providing resources and
facility space for meetings.
|
LOCAL
GOVERNMENT |
FY 2008 |
FY 2009 |
FUTURE YEARS |
|
|
Counties, Municipalities
and Townships |
||||
|
Revenues |
- 0 - |
Potential gain |
Potential gain |
|
|
Expenditures |
- 0 - |
- 0 - |
- 0 - |
|
Note: For most local governments, the fiscal year is the calendar year. The school district fiscal year is July 1 through June 30.
·
Some
local governments provide medical transportation services. Any increase in Medicaid reimbursement rates
could result in additional revenue for those local governments that bill
Medicaid.
|
|
Medicaid reimbursement rates
Fiscal years 2009, 2010, and 2011
The bill requires the Medicaid program to increase its reimbursement
rate for medical transportation services not later than 90 days after the
bill's effective date. It also requires
the rules governing the Medicaid program to include a mechanism by which the
Medicaid program's reimbursement rate for medical transportation services is
adjusted each fiscal biennium.
Fiscal impact – The bill does not set a specific rate or percentage increase for
reimbursement rates for medical transportation services after the 90 days. The bill also does not mandate that the
reimbursement rate increase by a particular amount or percentage each biennium,
only that there is a formal mechanism to adjust the rate. The Director of Job and Family Services will
have discretion when setting the rates in fiscal years (FYs) 2009, 2010, and
2011. Any adjustments in the reimbursement
rate due to the bill would affect Medicaid costs. In addition, some local governments provide medical
transportation services. Any change in
reimbursement rates could affect reimbursement for those local governments that
bill Medicaid.
The bill requires, beginning not later than July 1, 2011 (FY 2012),
that the Medicaid reimbursement rate for each medical transportation service
that is also covered by the Medicare program be set at an amount equal to at
least 80% of the Medicare reimbursement rate for the service and that the
reimbursement rate for each medical transportation service that is not also
covered by the Medicare program be set at an amount equal to at least the
average of the Medicaid reimbursement rates for medical transportation services
that are also covered by the Medicare program.
Fiscal impact – This provision would increase Medicaid reimbursement for medical
transportation services by approximately $98.8 million
all funds ($39.5 million state share) in
FY 2012 and annually thereafter.
The federal government reimburses the state approximately 60% of the
cost for medical transportation services.
Medicaid currently reimburses ambulance services at approximately 32% of Medicare.
Medicare does not reimburse for ambulette services. In each of the last three state fiscal
years, Medicaid paid approximately $65 million all
funds ($26 million state share) for medical transportation services. Increasing the reimbursement for ambulance
services from approximately 32% of Medicare to
80% of Medicare and increasing reimbursement for ambulette services by the same
percentage would increase annual transportation payments to $163.8 million all funds ($65.5
million state share) in FY 2012, an increase of approximately 152%.
Respond but not transport
The bill requires the Medicaid program to cover the respond but not
transport service as part of medical transportation services.
Fiscal impact – The bill does not specify
a particular reimbursement rate for respond but not transport services. The Director of Job and Family Services
would set a reimbursement rate for this service. Since medical transportation providers are currently not
reimbursed for respond but not transport services, reimbursing this service
will result in additional Medicaid costs. The amount
of this additional cost will depend on the reimbursement rate and the numbers
of respond but not transport services provided.
Some local governments
provide medical transportation services.
Any increase in Medicaid reimbursement rates could result in additional
revenue for those local governments that bill Medicaid.
Ohio Medicaid Transportation Provider
Advisory Council
The bill creates the Ohio
Medicaid Transportation Provider Advisory Council and requires the Council to
examine whether the Medicaid program's reimbursement rate for medical
transportation services is sufficient to ensure that Medicaid recipients have access
to safe and efficient medical transportation services. The bill requires the Council to provide the
Director of Job and Family Services with recommendations regarding the Medicaid
program's reimbursement rate for medical transportation services. All members of the Council are to serve
without compensation or reimbursement, except as serving on the Council is
considered part of their usual duties.
The bill also requires ODJFS to provide the Council with accommodations
to hold its meetings and other administrative assistance needed to perform its
duties.
Fiscal impact – There would be minimal
costs for ODJFS associated with providing resources and facility space for
meetings.
LSC fiscal staff: Todd A. Celmar, Economist
HB0249IN.doc/lb