BILL ANALYSIS                                                                                                                                                                                                    




                   Senate Appropriations Committee Fiscal Summary
                           Senator Christine Kehoe, Chair

                                           1932 (Hernandez)
          
          Hearing Date:  7/15/2010        Amended: 5/28/2010
          Consultant: Katie Johnson       Policy Vote: Health 6-0
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          ____
          BILL SUMMARY:  AB 1932 would revise ambulance transportation  
          services categories for Medi-Cal reimbursement rates to be  
          consistent with Medicare categories.
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          ____
                            Fiscal Impact (in thousands)

           Major Provisions         2010-11      2011-12       2012-13     Fund
                                                                  
          Increase ambulance service      potentially $100  
          millionGeneral/*
          reimbursement rates      annually in cost pressureFederal

          *Medi-Cal costs shared 50 percent General Fund and 50 percent  
          federal funds
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          ____

          STAFF COMMENTS: This bill meets the criteria for referral to the  
          Suspense File.
          This bill would permit the Department of Health Care Services  
          (DHCS), the department that administers the Medi-Cal program, to  
          utilize the following service levels when determining  
          reimbursement rates for emergency and nonemergency basic life  
          and advanced life support transportation and specialty care  
          transportation:

             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.

          If DHCS were to exercise the option to utilize the above service  
          levels, this bill would require the department to adopt the  
          definitions for those ground ambulance service levels that have  










          been established by the federal Centers for Medicare and  
          Medicaid Services (CMS). On April 1, 2002, CMS implemented a  
          national fee schedule for the Medicare reimbursement of  
          ambulance services, which included the six Medicare "service  
          levels" listed above and the phase-in of new rates. State  
          Medicaid programs are also required to conform to the service  
          levels above.

          If DHCS were to adopt the corresponding Medicare rates for the  
          different service levels, the costs to Medi-Cal would be  
          approximately $100 million in total funds. Medi-Cal costs are  
          generally shared 50 percent General Fund and 50 percent federal  
          funds. DHCS is currently in the process of adopting the six  
          codes listed in this bill. However, unlike with the Medicare  
          implementation, there is no simultaneously planned rate  
          increase. Medi-Cal currently pays ambulance providers two base  
          reimbursement rates-non-emergency basic and advanced life  
          support at $107.16 per transport and emergency basic and  
          advanced life support at $118.20 per transport.