SB 409-FN - AS AMENDED BY THE SENATE
02/08/2024 0408s
2024 SESSION
24-3045
05/10
SENATE BILL 409-FN
AN ACT relative to reimbursement for ambulance services under the state Medicaid plan.
SPONSORS: Sen. Prentiss, Dist 5; Sen. Fenton, Dist 10; Sen. Watters, Dist 4; Sen. Bradley, Dist 3; Sen. Altschiller, Dist 24; Sen. Perkins Kwoka, Dist 21; Sen. Rosenwald, Dist 13; Sen. Whitley, Dist 15; Sen. Gannon, Dist 23; Sen. Innis, Dist 7; Sen. Soucy, Dist 18; Sen. Chandley, Dist 11; Sen. Carson, Dist 14; Sen. D'Allesandro, Dist 20; Rep. Goley, Hills. 21; Rep. S. Pearson, Rock. 13; Rep. Stringham, Graf. 3; Rep. Wolf, Merr. 7
COMMITTEE: Health and Human Services
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ANALYSIS
This bill directs the department of health and human services to submit an amendment to the state Medicaid plan regarding reimbursement for ambulance services.
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Explanation: Matter added to current law appears in bold italics.
Matter removed from current law appears [in brackets and struckthrough.]
Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
02/08/2024 0408s 24-3045
05/10
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Twenty Four
AN ACT relative to reimbursement for ambulance services under the state Medicaid plan.
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 New Paragraph; Commissioner of the Department of Health and Human Services; State Medicaid Plan Amendment Regarding Ambulance Services. Amend RSA 126-A:5 by inserting after paragraph XXXIV the following new paragraph:
XXXV. The commissioner shall submit to the Centers for Medicare and Medicaid Services (CMS) an amendment to the state Medicaid plan to provide reimbursement for ambulance services when care is provided in response to an emergency call to a member’s home or on a scene, when an ambulance is dispatched, and treatment is provided to the patient without the patient being transported to another site. Providers shall be eligible for Medicaid reimbursement under this paragraph only when all the following requirements are met:
(a) The response originated through a 9-1-1 call.
(b) The patient consents to evaluation and treatment.
(c) After the evaluation, and when indicated, treatment, the licensed paramedic or emergency medical technician (EMT) and the patient agree there is not a need for transportation by ambulance; this shall include when resuscitation efforts are terminated.
(d) The patient does not request and actively refuses transport to an emergency department for evaluation.
(e) The patient is stable for referral to the patient’s physician, other community resource or is deceased.
(f) The patient has the ability, including mental capacity and transportation resources, to obtain assistance and medically indicated follow-up.
2 Contingency. Section 1 of this act shall take effect on the date the Centers for Medicare and Medicaid Services certifies the approval of the amendment to the state Medicaid plan to the director of legislative services and the secretary of state.
I. Section 1 of this act shall take effect as provided in section 2 of this act.
II. The remainder of this act shall take effect upon its passage.
24-3045
Amended 2/20/24
SB 409-FN- FISCAL NOTE
AS AMENDED BY THE SENATE (AMENDMENT #2024-0408s)
AN ACT relative to reimbursement for ambulance services under the state Medicaid plan.
FISCAL IMPACT: [ X ] State [ ] County [ ] Local [ ] None
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Estimated State Impact - Increase / (Decrease) | ||||||
| FY 2024 | FY 2025 | FY 2026 | FY 2027 | ||
Revenue | $0 | $0 | $0 | $0 | ||
Revenue Fund(s) | None | |||||
Expenditures | $0 | $1 million+ general funds; $1 million+ federal funds | $1 million+ general funds; $1 million+ federal funds | $1 million+ general funds; $1 million+ federal funds | ||
Funding Source(s) | General Fund Federal matching funds | |||||
Appropriations | $0 | $0 | $0 | $0 | ||
Funding Source(s) | None | |||||
• Does this bill provide sufficient funding to cover estimated expenditures? [X] No • Does this bill authorize new positions to implement this bill? [X] No | ||||||
METHODOLOGY:
This bill requires the Department of Health and Human Services to submit an amendment to the Medicaid state plan to provide reimbursement for ambulance services under certain circumstances in which transportation is not required. The Department states that it does not maintain data on ambulance calls which do not result in transportation, and is therefore unable to provide a cost estimate based on actual data. However, the Department notes that in recent years it has expended approximately $11.2 million (total funds) annually on all ambulance services, with approximately $4.2 million (total funds) being attributed to services involving basic life support with either emergency or non-emergency transport. Subtracting the costs of transportation, the Department anticipates that the bill will result in an additional increase of at least $2 million in total funds, of which $1 million will be state general funds and $1 million will be matching federal funds.
It is assumed any fiscal impact would not occur until after FY 2024.
AGENCIES CONTACTED:
Department of Health and Human Services
| Date | Amendment |
|---|---|
| Jan. 31, 2024 | 2024-0408s |
| April 24, 2024 | 2024-1563h |
| Date | Body | Type |
|---|---|---|
| Jan. 10, 2024 | Senate | Hearing |
| Feb. 8, 2024 | Senate | Floor Vote |
| March 21, 2024 | Senate | Floor Vote |
| April 10, 2024 | House | Hearing |
| April 17, 2024 | House | Exec Session |
| April 17, 2024 | House | Exec Session |
| April 24, 2024 | House | Floor Vote |
April 25, 2024: Committee Report: Ought to Pass with Amendment # 2024-1563h 04/24/2024 (Vote 18-2; CC)
April 12, 2024: Executive Session: 04/17/2024 03:00 pm LOB 206-208
April 10, 2024: Executive Session: 04/17/2024 02:30 pm LOB 206-208
April 10, 2024: Full Committee Work Session: 04/17/2024 09:30 am LOB 206-208
April 5, 2024: Public Hearing: 04/10/2024 10:00 am LOB 203
April 2, 2024: Introduced (in recess of) 03/28/2024 and referred to Health, Human Services and Elderly Affairs HJ 10
March 21, 2024: Ought to Pass: MA, VV; OT3rdg; 03/21/2024; SJ 7
March 5, 2024: Committee Report: Ought to Pass, 03/21/2024, Vote 7-0; SC 11
Feb. 8, 2024: Ought to Pass with Amendment 2024-0408s, MA, VV; Refer to Finance Rule 4-5; 02/08/2024; SJ 3
Feb. 8, 2024: Committee Amendment # 2024-0408s, AA, VV; 02/08/2024; SJ 3
Feb. 1, 2024: Committee Report: Ought to Pass with Amendment # 2024-0408s, 02/08/2024; Vote 5-0; CC; SC 6
Jan. 4, 2024: Hearing: 01/10/2024, Room 101, LOB, 09:00 am; SC 2
Dec. 12, 2023: To Be Introduced 01/03/2024 and Referred to Health and Human Services; SJ 1