Home Table of Contents

016.06.79-1. Definitions

AR ADC 016.06.79-1Arkansas Administrative CodeEffective: November 1, 2020

West's Arkansas Administrative Code
Title 016. Department of Human Services
Division 06. Division of Medical Services
Rule 79. Administrative Procedures for the Emergency Medical Transportation Assessment Fee and Access Payment
Effective: November 1, 2020
Ark. Admin. Code 016.06.79-1
016.06.79-1. Definitions
Currentness
(1) “Accounts Receivable” means the Accounts Receivable Unit of the Office of Finance of the Department of Human Services;
(2) “Air ambulance services” means services authorized and licensed by the Department of Health to provide care and air transportation of patients;
(3) “Ambulance services” means services authorized and licensed by the department to provide care and transportation of patients upon the streets and highways of Arkansas;
(4) “Division” means the Division of Medical Services of the Department of Human Services;
(5) “Medical transportation” means emergency medical services provided through ambulance services and air ambulance services. The term does not include nonemergency ambulance services;
(6) “Medical transportation provider” means a licensed provider of medical transportation;
(7) “Net operating revenue” means the gross revenues earned for providing medical transportation in Arkansas, excluding amounts refunded to or recouped, offset, or otherwise deducted by a patient or payer for medical transportation;
(8)(A) “Nonemergency ambulance services” means the transport in a motor vehicle to or from medical facilities, including without limitation medical transportation providers, nursing homes, physicians' offices, and other healthcare facilities, of persons who are ill or injured and who are transported in a reclining position.
(B) “Nonemergency ambulance services” does not include transportation provided by licensed medical transportation providers that own and operate the ambulance for their own admitted patients;
(9) “Specialty medical transportation provider-based ambulance services” means ambulance services provided by an acute care general medical transportation provider that limits healthcare services primarily to children and qualifies as exempt from the Medicare prospective payment system regulation;
(10) “State plan amendment” means a change or update to the state Medicaid plan;
(11) “Upper payment limit” means the lesser of the customary charges of the medical transportation provider for medical transportation or the prevailing charges in the locality of the medical transportation provider for comparable services under comparable circumstances, calculated according to methodology in an approved state plan amendment for the Arkansas Medicaid Program; and
(12)(A) “Upper payment limit gap” means the difference between the upper payment limit of the medical transportation provider and the Medicaid payments not financed using medical transportation assessment made to all medical transportation providers.
(B) “Upper payment limit gap” is calculated separately for ambulance services and air ambulance services.

Credits

Adopted Nov. 1, 2020.
Current with amendments received through February 15, 2024. Some sections may be more current, see credit for details.
Ark. Admin. Code 016.06.79-1, AR ADC 016.06.79-1
End of Document