BILL NUMBER: AB 1932	AMENDED
	BILL TEXT

	AMENDED IN ASSEMBLY  MAY 28, 2010
	AMENDED IN ASSEMBLY  MAY 3, 2010
	AMENDED IN ASSEMBLY  APRIL 15, 2010
	AMENDED IN ASSEMBLY  APRIL 5, 2010

INTRODUCED BY   Assembly Member Hernandez

                        FEBRUARY 17, 2010

   An act to add Article 5.7 (commencing with Section 14186) to
Chapter 7 of Part 3 of Division 9 of the Welfare and Institutions
Code, relating to Medi-Cal.



	LEGISLATIVE COUNSEL'S DIGEST


   AB 1932, as amended, Hernandez. Medi-Cal: ambulance transportation
services: reimbursement: service levels.
   Existing law provides for the Medi-Cal program, which is
administered by the State Department of Health Care Services, under
which health care services, including medical transportation
services, are provided to qualified low-income persons. The Medi-Cal
program is partially governed and funded under federal Medicaid
provisions. Existing law and regulations prescribe various
requirements governing payment policies and reimbursement rates for
these services.
   This bill would authorize the department to utilize certain
service levels for purposes of determining reimbursement rates for
emergency and nonemergency basic life and advance life support
transportation and specialty care transportation  , as
defined   . If the department utilizes   the
aforementioned service levels, this bill would require the department
to adopt the definitions and Healthcare Common Procedure Coding
System codes for those service levels that have been established by
the federal Centers for Medicare and Medicaid Services  .
   Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

  SECTION 1.  Article 5.7 (commencing with Section 14186) is added to
Chapter 7 of Part 3 of Division 9 of the Welfare and Institutions
Code, to read:

      Article 5.7.  Service Levels for Ambulance Transportation
Reimbursement Rates


   14186.  (a) For purposes of determining reimbursement rates for
emergency and nonemergency basic life and advanced life support
transportation and specialty care transportation, the department may
utilize the following service levels:
   (1) Advanced Life Support, Nonemergency Transport.
   (2) Advanced Life Support, Emergency Transport, Level 1.
   (3) Basic Life Support, Nonemergency Transport.
   (4) Basic Life Support, Emergency Transport.
   (5) Advanced Life Support, Level 2.
   (6) Specialty Care Transport. 
   (b) If the department utilizes the ground ambulance service levels
listed in subdivision (a), the department shall adopt the
definitions for those ground ambulance service levels that have been
established by the federal Centers for Medicare and Medicaid Services
(CMS) in Section 30.1.1 of Chapter 10 of the Medicare Benefit Policy
Manual and the Healthcare Common Procedure Coding System (HCPCS)
codes established by CMS in Section 30 of Chapter 15 of the Medicare
Claims Processing Manual for ground ambulance services delivered to
Medicare beneficiaries.  
   (b) For purposes of this section, the following definitions shall
apply:  
   (1) "Advanced Life Support, Level 2" means either one of the
following:  
   (A) Transportation by ground ambulance vehicle, medically
necessary supplies and services, and the administration of at least
three medications by intravenous push/bolus or by continuous
infusion, excluding crystalloid, hypotonic, isotonic, and hypertonic
solutions such as dextrose, normal saline, and Ringer's solution.
 
   (B) Transportation, medically necessary supplies and services, and
the provision of at least one of the following advanced life support
procedures:  
   (i) Manual defibrillation/cardioversion.  
   (ii) Endotracheal intubation.  
   (iii) Central venous line.  
   (iv) Cardiac pacing.  
   (v) Chest decompression.  
   (vi) Surgical airway.  
   (vii) Intraosseous line. 
   (2) "Specialty Care Transport" means interfacility transportation
of a critically injured or ill beneficiary by a ground ambulance
vehicle, including medically necessary supplies and services, at a
level of service beyond the scope of an emergency medical
technician-paramedic, as defined in Section 1797.84 of the Health and
Safety Code. Specialty Care Transport is necessary when a
beneficiary's condition requires ongoing care that must be furnished
by one or more health professionals in an appropriate specialty area,
including, but not limited to, nursing, emergency medicine,
respiratory care, cardiovascular care, or a paramedic with additional
training.