X hits on this document

Word document

I.EXECUTIVE ORDERS - page 326 / 359

1729 views

0 shares

0 downloads

0 comments

326 / 359

Department of Health and Hospitals

Office of the Secretary

Bureau of Health Services Financing

Medical Transportation Program Emergency Aircraft Transportation Rotor Winged Ambulance Rate Increase (LAC 50:XXVII.351 and 353)

The Department of Health and Hospitals, Office of the Secretary, Bureau of Health Services Financing proposes to adopt LAC 50:XXVII.351 and 353 in the Medical Assistance Program as authorized by R.S. 36:254 and pursuant to Title XIX of the Social Security Act. This proposed Rule is promulgated in accordance with the provisions of the Administrative Procedure Act, R.S. 49:950 et seq.

The Department of Health and Hospitals, Office of the Secretary, Bureau of Health Services Financing adopted provisions in the Medical Transportation Program establishing a new reimbursement methodology for emergency air ambulance services, including helicopters and fixed winged aircrafts, and implemented standards for payment (Louisiana Register, Volume 22, Number 2). Reimbursement for these services is a base rate derived from the Medicare rates plus mileage.

Act 19 of the 2008 Regular Session of the Louisiana Legislature authorized expenditures to the Medical Vendor Program to increase the reimbursement rate paid for rotor winged ambulance services. In compliance with the directives of Act 19, the bureau promulgated an Emergency Rule to amend the February 20, 1996, Rule governing the reimbursement methodology for emergency air medical transportation to increase the reimbursement rate paid for rotor winged emergency ambulance services. The bureau also clarified and repromulgated the existing Rule in its entirety for the purpose of adopting these provisions in a codified format for inclusion in the Louisiana Administrative Code (Louisiana Register, Volume 34, Number 9). This proposed Rule is being promulgated to continue the provisions of the September 16, 2008, Emergency Rule.

Title 50

PUBLIC HEALTHMEDICAL ASSISTANCE

Part XXVII.  Medical Transportation Program

Chapter 3.Emergency Medical Transportation

Subchapter C.Aircraft Transportation

§351.Standards for Participation

A.Rotor winged (helicopters) and fixed winged emergency aircraft must be certified by the Department of Health and Hospitals, Bureau of Health Services Financing in order to receive Medicaid reimbursement. All air ambulance services must be provided in accordance with state laws and regulations governing the administration of these services.

B.All air ambulance services must comply with state laws and regulations governing the personnel certifications of the emergency medical technicians, registered nurses, respiratory care technicians, physicians and pilots as

administered by the appropriate agency of competent jurisdiction.

C.Prior Authorization. The Prior Authorization Unit of the fiscal intermediary must approve the medical necessity for all air ambulance services.

1.Air ambulance claims will be reviewed and a determination will be made based on the following requirements. Air ambulance services are covered only if:
a.speedy admission of the patient is essential and the point of pick-up of the patient is inaccessible by a land vehicle; or
b.great distance or other obstacles are involved in getting the patient to the nearest hospital with appropriate services.

AUTHORITY NOTE:Promulgated in accordance with R.S. 36:254 and Title XIX of the Social Security Act.

HISTORICAL NOTE:Promulgated by the Department of Health and Hospitals, Office of the Secretary, Bureau of Health Services Financing, LR 35:

§353.Reimbursement

A.Fixed Winged Air Ambulance. The reimbursement for fixed winged air ambulance services is the Medicare base rate plus mileage in effect as of January 1, 1995.

1.Payment for air mileage is limited to actual air mileage from the point of pick-up to the point of delivery of the patient.
2.Payment for a round trip transport on the same day between two hospitals is the base rate plus the round trip mileage.

B.Rotor Winged (Helicopters) Air Ambulance. Effective for dates of service on or after September 17, 2008, the reimbursement rate paid for rotor winged air ambulance services shall be increased to 100 percent of the 2008 Louisiana Medicare allowable rate.

C.If a land-based ambulance must be used for part of the transport, the land-based ambulance provider will be reimbursed separately according to the provisions governing emergency ground transportation.

D.Reimbursement for oxygen and disposable supplies is made separately when the provider incurs these costs. Reimbursement for these services is based on Medicare rates as established in the state’s fee schedule effective April 1, 1995.

AUTHORITY NOTE:Promulgated in accordance with R.S. 36:254 and Title XIX of the Social Security Act.

HISTORICAL NOTE:Promulgated by the Department of Health and Hospitals, Office of the Secretary, Bureau of Health Services Financing, LR 35:

Family Impact Statement

In compliance with Act 1183 of the 1999 Regular Session of the Louisiana Legislature, the impact of this proposed Rule on the family has been considered. It is anticipated that this proposed Rule will have no impact on family functioning, stability and autonomy as described in R.S. 49:972.

Implementation of the provisions of this Rule shall be contingent upon the approval of the U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services (CMS) if it is determined that submission to CMS for review and approval is required.

Louisiana Register   Vol. 34, No. 10   October 20, 2008

Document info
Document views1729
Page views1732
Page last viewedFri Dec 09 15:57:48 UTC 2016
Pages359
Paragraphs18243
Words293762

Comments