AN ACT TO ESTABLISH MEDICAID REIMBURSEMENT FOR AMBULANCE TRANSPORTS OF MEDICAID RECIPIENTS IN BEHAVIORAL HEALTH CRISIS TO BEHAVIORAL HEALTH CLINICS OR ALTERNATIVE APPROPRIATE CARE LOCATIONS.
Senate committee substitute makes the following changes to the 1st edition.
Makes technical, clarifying, and organizational changes.
Modifies the act's first directive to require the Department of Health and Human Service (Department) to design a plan for adding Medicaid coverage for ambulance transports of Medicaid recipients in behavioral health crisis to behavioral health clinics or other alternative appropriate care locations, consistent with the Department's March 1, 2015, legislative report previously specified. Clarifies and adds to the required content of the plan, specifying that Medicaid reimbursement must be contingent upon an emergency medical services (EMS) system's ability to demonstrate its appropriate education and partnership requirements, and requiring the report on patient experiences and outcomes provided for in an EMS System Plan be in accordance with rules adopted by the Department's Division of Health Regulation, Office of Emergency Medical Services.
Amends the content of the report to the Joint Legislative Oversight Committee on Medicaid and NC Health Choice to require the Department's Division of Medical Assistance (Division) to report on the plan for adding Medicaid coverage for ambulance transports of Medicaid recipients in behavioral health crises to behavioral health clinics or other alternative appropriate care locations. Modifies and adds to the required components of the report to now include: (1) the proposed reimbursement methodology to be utilized; (2) an analysis of the financial impact of adding the coverage, including any anticipated costs to the Medicaid program; (3) whether the Department intends to add this coverage pursuant to its authority under GS 108A‑54(e) or whether additional appropriations are required; and (4) if the Department intends to add this coverage pursuant to its authority under GS 108A‑54(e), a time line for submission of any State Plan amendments or any waivers necessary for implementation, and the expected implementation date.
Deletes the act's provisions directing the Division to submit any State Plan amendments or waivers necessary to establish the Medicaid reimbursements described above to the Centers for Medicare and Medicaid Services (CMS), and providing that new Medicaid reimbursement is not to be implemented until CMS approves any submitted State Plan amendments or waivers.
Also deletes the statement of intent of the General Assembly to appropriate any necessary funds.
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