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§ 3242.3. Access payment program fee

Oklahoma Statutes AnnotatedTitle 63. Public Health and SafetyEffective: November 1, 2021

Oklahoma Statutes Annotated
Title 63. Public Health and Safety (Refs & Annos)
Chapter 62A-2. Ambulance Service Provider Access Payment Program Act
Effective: November 1, 2021
63 Okl.St.Ann. § 3242.3
§ 3242.3. Access payment program fee
A. For the purpose of assuring access to quality emergency and nonemergency transports for state Medicaid beneficiaries, the Oklahoma Health Care Authority shall, after considering input and recommendations from the Oklahoma Ambulance Alliance, assess ambulance service providers licensed in Oklahoma, unless exempt under subsection B of this section, an ambulance service provider access payment program fee.
B. The following ambulance services shall be exempt from the ambulance service provider access payment fee:
1. An ambulance service that is owned or operated by the state or a state agency, the federal government, a federally recognized Indian tribe, or the Indian Health Service;
2. An ambulance service that is eligible for supplemental Medicaid reimbursement under Section 3242 of Title 63 of the Oklahoma Statutes;
3. An ambulance service that provides air ambulance services only; or
4. An ambulance service that provides nonemergency transports only or a de minimis amount of emergency medical transportation services, as determined by the Authority.
C. 1. The ambulance service provider access payment program fee shall be an assessment imposed on each ambulance service provider, except those exempted under subsection B of this section, for each calendar year in an amount calculated as a percentage of each ambulance service provider's net operating revenue.
2. The assessment rate shall be determined annually based upon the percentage of net operating revenue needed to generate an amount up to the sum of:
a. the nonfederal portion of the upper payment limit gap for all ambulance service providers eligible to receive Medicaid ambulance service provider access payments, plus
b. the annual fee to be paid to the Authority under subparagraph b of paragraph 2 of subsection F of Section 4 of this act,1 plus
c. the amount to be transferred by the Authority to the Medical Payments Cash Management Improvement Act Programs Disbursing Fund under subparagraph a of paragraph 2 of subsection F of Section 4 of this act.
In no event shall the assessment rate exceed the maximum rate allowed by federal law or regulation.
3. The assessment rate described in this subsection shall be determined after consultation with the Alliance. The base year for assessment, the method for calculating net operating revenue and related matters not provided for in this section shall be determined by rules promulgated by the Oklahoma Health Care Authority Board.
D. 1. If an ambulance service provider conducts, operates or maintains more than one licensed ambulance service, the ambulance service provider shall pay the ambulance service provider access payment program fee for each ambulance service separately. However, if the ambulance service provider operates more than one ambulance service under one Medicaid provider number, the ambulance service provider may pay the fee for the ambulance services in the aggregate.
2. Notwithstanding any other provision of this section, if an ambulance service provider subject to the ambulance service provider access payment fee operates or conducts business only for a portion of a year, the assessment for the year shall be adjusted by multiplying the annual assessment by a fraction, the numerator of which is the number of days in the year during which the ambulance service operates and the denominator of which is three hundred sixty-five (365). Immediately upon ceasing to operate, the ambulance service provider shall pay the assessment for the year as so adjusted, to the extent not previously paid.
3. The Authority shall determine the assessment for new ambulance services and ambulance services that undergo a change of ownership, in accordance with this section, using the best available information, as determined by the Authority.
E. 1. In the event that federal financial participation pursuant to Title XIX of the Social Security Act is not available to the state Medicaid program for purposes of matching expenditures from the Ambulance Service Provider Access Payment Program Fund at the approved federal medical assistance percentage for the applicable year, the ambulance service provider access payment program fee shall be null and void as of the date of the nonavailability of such federal funding through and during any period of nonavailability.
2. In the event of an invalidation of the Ambulance Service Provider Access Payment Program by any court of last resort, the program shall be null and void as of the effective date of that invalidation.
3. In the event that the Ambulance Service Provider Access Payment Program is determined to be null and void for any of the reasons described in this subsection, any ambulance service provider access payment program fee assessed and collected for any period to which such invalidation applies shall be returned in full within forty-five (45) days by the Authority to the ambulance service from which it was collected.
F. The Oklahoma Health Care Authority Board, after considering the input and recommendations of the Alliance, shall promulgate rules for the implementation and enforcement of the ambulance service provider access payment program fee. Unless otherwise provided, the rules promulgated under this subsection shall not grant any exceptions to or exemptions from the ambulance service provider access payment program fee imposed under this section.
G. The Authority shall provide for administrative penalties in the event an ambulance service provider fails to:
1. Submit the ambulance service provider access payment program fee;
2. Submit the fee in a timely manner;
3. Submit reports as required by the Authority; or
4. Submit reports timely.
H. The Oklahoma Health Care Authority Board shall have the power to promulgate emergency rules to implement the provisions of the Ambulance Service Provider Access Payment Program Act.

Credits

Laws 2021, c. 540, § 3, eff. Nov. 1, 2021.

Footnotes

Title 63, § 3242.4.
63 Okl. St. Ann. § 3242.3, OK ST T. 63 § 3242.3
Current with emergency effective legislation through Chapter 449 of the Second Regular Session of the 59th Legislature (2024). Some sections may be more current, see credits for details.
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