Illinois General Assembly - Bill Status for SB2300

Amends the Illinois Public Aid Code. Provides a guideline for Medicaid reimbursement for ambulance services for emergency ambulance services, non-emergency ambulance services, mileage, advanced life support services, and specialty care transport services. Provides that the requirement for payment of ground ambulance services by the Illinois Department of Healthcare and Family Services is met if the services are provided pursuant to a request for evaluation, treatment, and transport for an individual with a condition of such a nature that a prudent layperson would have reasonably expected that a delay in seeking immediate medical attention would have been hazardous to life or health. Requires the Department to annually update the ambulance fee schedule rates on July 1 of each year.

Replaces everything after the enacting clause. Amends the Illinois Public Aid Code. Replaces all of the provisions concerning ambulance services payments under the medical assistance program (except does not replace the amendatory provisions added by P.A. 95-501 concerning non-emergency transportation by medi-car and service car). Provides that for ground ambulance services provided to a recipient of medical assistance on or after July 1, 2008, the Department of Healthcare and Family Services shall reimburse 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 calculated in accordance with these provisions. Provides that effective July 1, 2008 the Illinois Medicaid Ambulance Fee Schedule shall be established and shall include only the ground ambulance services rates outlined in the Medicare Ambulance Fee Schedule as promulgated by the Centers for Medicare and Medicaid Services and adjusted for the 4 Medicare Localities in Illinois, with an adjustment of 100% of the Medicare Ambulance Fee Schedule, by Medicare Locality, for both base rates and mileage for rural counties, and an adjustment of 80% of the Medicare Ambulance Fee Schedule for all other counties; provides for the transition from the current payment system to the Illinois Medicaid Ambulance Fee Schedule by means of a 3-year phase-in. Provides that the requirement for payment of ground ambulance services by the Department is deemed to be met if the services are provided pursuant to a request for evaluation, treatment, and transport from an individual with a condition of such a nature that a prudent layperson would have reasonably expected that a delay in seeking immediate medical attention would have been hazardous to life or health. Sets forth provisions concerning mileage payments, payments by Medicaid Managed Care Plans, and out-of-State providers. Effective immediately.

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