BILL ANALYSIS
AB 1932
Page 1
ASSEMBLY THIRD READING
AB 1932 (Hernandez)
As Amended May 28, 2010
Majority vote
HEALTH 15-0 APPROPRIATIONS 12-0
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|Ayes:|Monning, Fletcher, |Ayes:|Fuentes, Conway, Hill, |
| |Ammiano, Conway, | |Bradford, Charles |
| |Caballero, Emmerson, Eng, | |Calderon, Coto, Davis, |
| |Hayashi, Hernandez, | |Hall, Skinner, Solorio, |
| |Jones, Bonnie Lowenthal, | |Torlakson, Torrico |
| |Nava, V. Manuel Perez, | | |
| |Salas, Audra Strickland | | |
| | | | |
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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)Specifies that if DHCS adopts the categories specified in 1)
above than the definitions should be those established by the
Centers for Medicare and Medicaid Services (CMS) as specified.
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
AB 1932
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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 CMS
implemented a national fee schedule for 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 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: 0004514