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§ 3242.4. Ambulance Service Provider Access Payment Program Fund

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. § 3242.4
§ 3242.4. Ambulance Service Provider Access Payment Program Fund
A. There is hereby created in the State Treasury a revolving fund to be designated the “Ambulance Service Provider Access Payment Program Fund”.
B. The fund shall be a continuing fund, not subject to fiscal year limitations, be interest bearing and consist of:
1. All monies received by the Oklahoma Health Care Authority from ambulance services pursuant to the Ambulance Service Provider Access Payment Program Act and otherwise specified or authorized by law;
2. Any interest or penalties levied and collected in conjunction with the administration of this section; and
3. All interest attributable to investment of money in the fund.
C. 1. The Authority shall send a notice of assessment to each ambulance service provider informing the ambulance service provider of the assessment rate, the ambulance service provider's net operating revenue calculation, and the assessment amount owed by the ambulance service provider for the applicable year.
2. Annual notices of assessment shall be sent at least thirty (30) days before the due date for the first quarterly assessment payment of each year.
3. The first notice of assessment shall be sent within forty-five (45) days after receipt by the Authority of notification from the Centers for Medicare and Medicaid Services that assessments and payments required under the Ambulance Service Provider Access Payment Program Act and, if necessary, the waiver granted under 42 C.F.R., Section 433.68 have been approved.
4. The ambulance service provider shall have thirty (30) days from the date of its receipt of a notice of assessment to review and verify the assessment rate, the ambulance service provider's net operating revenue calculation and the assessment amount.
D. 1. The annual assessment imposed under Section 3 of this act1 shall be due and payable on a quarterly basis. However, the first installment payment of an assessment imposed by the Ambulance Service Provider Access Payment Program Act shall not be due and payable until:
a. the Authority issues written notice stating that the assessment and payment methodologies required under the Ambulance Service Provider Access Payment Program Act have been approved by the Centers for Medicare and Medicaid Services and the waiver under 42 C.F.R., Section 433.68, if necessary, has been granted by the Centers for Medicare and Medicaid Services,
b. the thirty-day verification period required by paragraph 4 of subsection C of this section has expired, and
c. the Authority issues a notice giving a due date for the first payment.
2. After the initial installment of an annual assessment has been paid under this section, each subsequent quarterly installment payment shall be due and payable by the fifteenth day of the first month of the applicable quarter.
3. If an ambulance service provider fails to timely pay the full amount of a quarterly assessment, the Authority shall add to the assessment:
a. a penalty assessment equal to five percent (5%) of the quarterly amount not paid on or before the due date, and
b. on the last day of each quarter after the due date until the assessed amount and the penalty imposed under subparagraph a of this paragraph are paid in full, an additional five-percent penalty assessment on any unpaid quarterly and unpaid penalty assessment amounts.
4. The quarterly assessment including applicable penalties must be paid regardless of any appeals action requested by the ambulance provider. If a provider fails to pay the Authority the assessment within the time frames noted on the invoice to the provider, the assessment and applicable penalty shall be deducted from the provider's payment. Any change in payment amount resulting from an appeals decision will be adjusted in future payments.
5. An ambulance service provider subject to the assessment under the Ambulance Service Provider Access Payment Program Act that has not been previously licensed as an ambulance service in Oklahoma and that commences operations during a year shall pay the required assessment computed under Section 3 of this act and shall be eligible for ambulance service provider access payments under this section on the date specified in the rules promulgated by the Authority after consideration of input and recommendations of the Oklahoma Ambulance Alliance.
E. 1. To preserve the quality and improve access to ambulance services rendered on or after the effective date of this act,2 the Authority shall make ambulance service provider access payments as set forth in this section.
2. The Authority shall pay all quarterly ambulance service provider access payments within ten (10) calendar days of the due date for quarterly assessment payments established in subsection D of this section.
3. The Authority shall calculate the ambulance service provider access payment amount as the balance of the Ambulance Service Provider Access Payment Program Fund plus any federal matching funds earned on the balance up to, but not to exceed, the upper payment limit gap for all ambulance service providers.
4. All ambulance service providers shall be eligible for ambulance service provider access payments each year as set forth in this subsection except ambulance services excluded or exempted in subsection B of Section 3 of this act.
5. Access payments shall be made on a quarterly basis.
6. Ambulance service provider access payments shall not be used to offset any other payment by Medicaid for services to Medicaid beneficiaries.
7. If the Centers for Medicare and Medicaid Services finds that the Authority has made payments to ambulance service providers that exceed the upper payment limits, ambulance service providers shall refund to the Authority a share of the recouped federal funds that is proportionate to the ambulance services' contribution to the upper payment limit.
F. 1. All monies accruing to the credit of the Ambulance Service Provider Access Payment Program Fund are hereby appropriated and shall be budgeted and expended by the Authority after consideration of the input and recommendation of the Alliance.
2. Monies in the Ambulance Service Provider Access Payment Program Fund shall be used only for:
a. transfers to the Medical Payments Cash Management Improvement Act Programs Disbursing Fund for the state share of ambulance service provider access payments for ambulance service providers that participate in the assessment,
b. transfers to the Administrative Revolving Fund for the state share of payment of administrative expenses incurred by the Authority or its agents and employees in performing the activities authorized by the Ambulance Service Provider Access Payment Program Act but not more than Two Hundred Thousand Dollars ($200,000.00) each year, and
c. the reimbursement of monies collected by the Authority from ambulance services through error or mistake in performing the activities authorized under the Ambulance Service Provider Access Payment Program Act.
3. The Authority shall pay from the Ambulance Service Provider Access Payment Program Fund quarterly installment payments to ambulance service providers of amounts available for ambulance service provider access payments.
4. Monies in the Ambulance Service Provider Access Payment Program Fund shall not be used to replace other general revenues appropriated and funded by the Legislature or other revenues used to support Medicaid.
5. The Ambulance Service Provider Access Payment Program Fund and the program specified in the Ambulance Service Provider Access Payment Program Act are exempt from budgetary reductions or eliminations caused by the lack of general revenue funds or other funds designated for or appropriated to the Authority.
6. No ambulance service provider shall be guaranteed, expressly or otherwise, that any additional costs reimbursed to the provider will equal or exceed the amount of the ambulance service provider access payment program fee paid by the ambulance service.
G. After considering input and recommendations from the Alliance, the Oklahoma Health Care Authority Board shall promulgate rules that:
1. Allow for an appeal of the annual assessment of the Ambulance Service Provider Access Payment Program payable under this act; and
2. Allow for an appeal of an assessment of any fees or penalties determined.

Credits

Laws 2021, c. 540, § 4, eff. Nov. 1, 2021.

Footnotes

Title 63, § 3242.3.
O.S.L. 2021, c. 540, eff. Nov. 1, 2021.
63 Okl. St. Ann. § 3242.4, OK ST T. 63 § 3242.4
Current with legislation of the Second Regular Session of the 59th Legislature (2024). Some sections may be more current, see credits for details.
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