BILL ANALYSIS
AB 2173
Page 1
CONCURRENCE IN SENATE AMENDMENTS
AB 2173 (Beall)
As Amended August 20, 2010
Majority vote
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|ASSEMBLY: |65-8 |(June 2, 2010) |SENATE: |23-7 |(August 24, |
| | | | | |2010) |
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Original Committee Reference: HEALTH
SUMMARY : Establishes a $4 fee on every vehicle code violation
to be collected by the county and transferred to the Department
of Health Care Services (DHCS) for deposit in the Emergency
Medical Air Transportation Act (EMATA) Fund to be used in the
Medi-Cal Program to obtain federal funds and to fund
supplemental payments for emergency medical air transportation
services.
The Senate amendments :
1)Increase the vehicle code violation penalty fee from $3 to $4.
2)Authorize, prior to the transfer of EMATA funds to DHCS, the
county to withhold a sufficient amount to reimburse the county
and court for actual, reasonable and necessary administrative
costs.
3)Specify that the EMATA funds are to be used as follows:
a) Payment of administrative costs;
b) Twenty percent of the remaining funds for the
non-federal share of the Medi-Cal reimbursement rate for
emergency medical air transportation; and,
c) Eighty percent to augment Medi-Cal emergency medical air
transportation reimbursement rates.
4)Require, by March 1, 2011, the Director of DHCS to meet with
medical air transportation providers to determine a
methodology to distribute the funds and implement the most
appropriate methodology in a timely manner.
AB 2173
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5)Authorizes the distribution of funds in the absence of federal
approval.
6)Ensure that there is no General Fund impact from an increase
in Medi-Cal reimbursement for emergency medical air
transportation services.
7)Authorize DHCS to implement by means of all county letters,
plan letters, plan or provider bulletins, or similar
instructions without taking regulatory action.
8)Terminate the penalty assessment on January 1, 2016, allows
payments to continue until March 2, 2017 and sunsets all
provisions on January 1, 2018.
AS PASSED BY THE ASSEMBLY , this bill established a $3 penalty on
every vehicle code violation to be matched with federal funds
through the Medi-Cal Program, pursuant to a federal waiver, and
to make supplemental payments for emergency air medical
transportation services in the Medi-Cal Program.
FISCAL EFFECT : According to the Senate Appropriations
Committee:
Fiscal Impact (in thousands)
Major Provisions 2010-11 2011-12 2012-13 Fund
Estimated fee revenue ($13,000)
($26,000)($26,000)Special*
Estimated corresponding$13,000 $26,000 $26,000
Special/**
increase in Medi-Cal rates $13,000 $26,000
$26,000Federal
DHCS staff $50 $100 $100
Special/**
Federal
*Emergency Air Medical Transportation Act Fund
**Costs would be shared 50% EMATA Fund, 50% federal funds
COMMENTS : According to the author, this bill is intended to
provide a mechanism for supplemental payments for air ambulance
providers who serve Medi-Cal patients. The author states that
revenue generated by imposing a flat $4 fee on each motor
AB 2173
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vehicle violation can be matched with federal funds through the
Medi-Cal Program. The author points out that Medi-Cal pays air
ambulance services far below the cost of providing emergency air
transportation and 40% of the average Medicare rate. The author
asserts that unlike hospitals, federal law does not permit a
provider fee to be assessed. Furthermore, air ambulance
providers must provide emergency services but are not covered by
other supplemental emergency payment funds that are collected
from fines and penalties. They also do not receive any type of
disproportionate share provider supplemental payments.
Air ambulance services provide emergency transportation for the
most critical patients from automobile scenes directly to trauma
centers. Emergency helicopters also transport patients from
rural areas or acute care hospitals to tertiary care hospitals
such as trauma centers, heart/stroke centers, burn units, and
children's specialty hospitals. They are also used for disaster
response. Air ambulance services providers are a mix of public
and private entities. For instance, the City of Los Angeles
provides its own services, whereas the California Shock Trauma
Air Rescue is a not-for profit community based provider that
provides services throughout Central and Northern California.
The services are not self-dispatched, but are called for by on
scene first responders, a hospital physician, or other emergency
medical services agency. No one is denied service, regardless
of ability to pay.
Analysis Prepared by : Marjorie Swartz / HEALTH / (916)
319-2097
FN: 0006679