BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 1932
                                                                  Page  1


          ASSEMBLY THIRD READING
          AB 1932 (Hernandez)
          As Amended May 3, 2010
          Majority vote 

           HEALTH              15-0        APPROPRIATIONS      12-0        
           
           ----------------------------------------------------------------- 
          |Ayes:|Monning, Fletcher,        |Ayes:|Fuentes, Conway, Hill,    |
          |     |Ammiano, Conway,          |     |Bradford, Charles         |
          |     |Caballero, Emmerson, Eng, |     |Calderon, Coto, Davis,    |
          |     |Hayashi, Hernandez,       |     |Hall, Skinner, Solorio,   |
          |     |Jones,                    |     |Torlakson, Torrico        |
          |     |Bonnie Lowenthal, Nava,   |     |                          |
          |     |V. Manuel Perez, Salas,   |     |                          |
          |     |Audra Strickland          |     |                          |
          |     |                          |     |                          |
           ----------------------------------------------------------------- 
           SUMMARY  :  Revises the Medi-Cal reimbursement rate categories for  
          ambulance transportation services to be consistent with Medicare  
          categories.  Specifically,  this bill  : 

          1)Authorizes the Department of Health Care services (DHCS) to  
            utilize the following categories for reimbursement of   
            ambulance transportation services:

             a)   Advanced Life Support, Non-emergency;

             b)   Advanced Life Support Emergency; 

             c)   Basic Life Support, Non-emergency; 

             d)   Basic Life Support, Emergency; 

             e)   Advanced Life Support, Level 2; and, 

             f)   Specialty Care Transport.  

          2)Defines the following:  

             a)   Advanced Life Support, Level 2; and,

             b)   Specialty Care Transport









                                                                  AB 1932
                                                                  Page  2


           FISCAL EFFECT  :  According to the Assembly Appropriations  
          Committee, absorbable costs to the Medi-Cal Program.  This bill  
          codifies a process underway to adopt the use of these six levels  
          of emergency medical transport, per recent requirements of  
          federal law.  This bill does not modify reimbursement for  
          emergency medical transport.  Under current law, Medi-Cal Basic  
          Life Support nonemergency transportation is reimbursed at $107  
          and Basic Life Support emergency transportation is reimburse at  
          $118 per trip. 

           COMMENTS :  The purpose of this bill is to revise Medi-Cal  
          reimbursement categories to be consistent with the six levels of  
          service used by Medicare.  The Health Insurance Portability and  
          Accountability Act of 1996 requires administrative  
          simplification and standardization of health care data including  
          claims billing procedures.  On April 1, 2002, the Centers for  
          Medicare and Medicaid Services implemented a national fee  
          schedule for the Medicare reimbursement of ambulance services  
          developed in consultation with national experts and  
          stakeholders.  Following implementation of the national Medicare  
          Ambulance Fee Schedule, most state Medicaid programs have  
          adopted the Healthcare Common Procedure Coding System (HCPCS)  
          codes that correspond to the six levels of ambulance service  
          established by Medicare.  

          Medi-Cal provides medical transportation only when ordinary  
          public or private transport is not appropriate and  
          transportation is required for obtaining needed medical care.   
          To receive reimbursement, a recipient must be eligible for  
          Medi-Cal on the date of service.  Current medical transportation  
          services reimbursement rates, including rates for ambulance  
          transportation are in state regulation.  The current categories  
          do not correspond to the HCPCS Codes and include complex  
          add-ons.  For instance, there is a supplemental calculation for  
          night calls, for use of certain medical supplies and procedures  
          and per hour charges.  This bill authorizes DHCS to utilize  
          standardized billing and service levels instead. 


           Analysis Prepared by  :    Marjorie Swartz / HEALTH / (916)  
          319-2097 

                                                                FN: 0004400