Bill Text: IL SB1960 | 2009-2010 | 96th General Assembly | Engrossed
Bill Title: Amends the Illinois Public Aid Code. Replaces provisions concerning medical assistance payments for ambulance services. Provides for payment for ground ambulance services under the medical assistance program. Provides that for ground ambulance services provided to a medical assistance recipient on or after July 1, 2009, the Department of Healthcare and Family Services shall provide payment to ground ambulance services providers for base charges and mileage charges based upon the lesser of the provider's charge, as reflected on the provider's claim form, or the Illinois Medicaid Ambulance Fee Schedule rates. Provides for establishment of the Illinois Medicaid Ambulance Fee Schedule, and provides for a 2-year phase-in of that Schedule. Provides that effective for dates of service on or after July 1, 2010, and on each July 1 thereafter, the Department shall update the Illinois Medicaid Ambulance Fee Schedule rates to be in compliance with the Medicare Ambulance Fee Schedule rates for ground ambulance services in effect at the time of the update. Makes other changes in connection with medical assistance payments for ground ambulance services. Effective immediately.
Spectrum: Moderate Partisan Bill (Democrat 4-1)
Status: (Engrossed - Dead) 2010-11-30 - Alternate Chief Sponsor Changed to Rep. Frank J. Mautino [SB1960 Detail]
Download: Illinois-2009-SB1960-Engrossed.html
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1 | AN ACT concerning public aid.
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2 | Be it enacted by the People of the State of Illinois,
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3 | represented in the General Assembly:
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4 | Section 5. The Illinois Public Aid Code is amended by | ||||||
5 | changing Section 5-4.2 as follows:
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6 | (305 ILCS 5/5-4.2) (from Ch. 23, par. 5-4.2)
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7 | Sec. 5-4.2. Ambulance services payments. For
ambulance
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8 | services provided to a recipient of aid under this Article on | ||||||
9 | or after
January 1, 1993, the the Illinois Department shall | ||||||
10 | reimburse ambulance service
providers at rates calculated in | ||||||
11 | accordance with this Section. It is the intent
of the General | ||||||
12 | Assembly to provide adequate reimbursement for ambulance
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13 | services so as to ensure adequate access to services for | ||||||
14 | recipients of aid
under this Article and to provide appropriate | ||||||
15 | incentives to ambulance service
providers to provide services | ||||||
16 | in an efficient and cost-effective manner. Thus,
it is the | ||||||
17 | intent of the General Assembly that the Illinois Department | ||||||
18 | implement
a reimbursement system for ambulance services that, | ||||||
19 | to the extent practicable
and subject to the availability of | ||||||
20 | funds appropriated by the General Assembly
for this purpose, is | ||||||
21 | consistent with the payment principles of Medicare. To
ensure | ||||||
22 | uniformity between the payment principles of Medicare and | ||||||
23 | Medicaid, the
Illinois Department shall follow, to the extent |
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1 | necessary and practicable and
subject to the availability of | ||||||
2 | funds appropriated by the General Assembly for
this purpose, | ||||||
3 | the statutes, laws, regulations, policies, procedures,
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4 | principles, definitions, guidelines, and manuals used to | ||||||
5 | determine the amounts
paid to ambulance service providers under | ||||||
6 | Title XVIII of the Social Security
Act (Medicare).
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7 | For ambulance services provided to a recipient of aid under | ||||||
8 | this Article
on or after January 1, 1996, the Illinois | ||||||
9 | Department shall reimburse ambulance
service providers based | ||||||
10 | upon the actual distance traveled if a natural
disaster, | ||||||
11 | weather conditions, road repairs, or traffic congestion | ||||||
12 | necessitates
the use of a
route other than the most direct | ||||||
13 | route.
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14 | For purposes of this Section, "ambulance services" | ||||||
15 | includes medical
transportation services provided by means of | ||||||
16 | an ambulance, medi-car, service
car, or
taxi.
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17 | This Section does not prohibit separate billing by | ||||||
18 | ambulance service
providers for oxygen furnished while | ||||||
19 | providing advanced life support
services.
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20 | Beginning with services rendered on or after July 1, 2008, | ||||||
21 | all providers of non-emergency medi-car and service car | ||||||
22 | transportation must certify that the driver and employee | ||||||
23 | attendant, as applicable, have completed a safety program | ||||||
24 | approved by the Department to protect both the patient and the | ||||||
25 | driver, prior to transporting a patient.
The provider must | ||||||
26 | maintain this certification in its records. The provider shall |
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1 | produce such documentation upon demand by the Department or its | ||||||
2 | representative. Failure to produce documentation of such | ||||||
3 | training shall result in recovery of any payments made by the | ||||||
4 | Department for services rendered by a non-certified driver or | ||||||
5 | employee attendant. Medi-car and service car providers must | ||||||
6 | maintain legible documentation in their records of the driver | ||||||
7 | and, as applicable, employee attendant that actually | ||||||
8 | transported the patient. Providers must recertify all drivers | ||||||
9 | and employee attendants every 3 years.
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10 | Notwithstanding the requirements above, any public | ||||||
11 | transportation provider of medi-car and service car | ||||||
12 | transportation that receives federal funding under 49 U.S.C. | ||||||
13 | 5307 and 5311 need not certify its drivers and employee | ||||||
14 | attendants under this Section, since safety training is already | ||||||
15 | federally mandated.
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16 | (Source: P.A. 95-501, eff. 8-28-07.)
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