Sec. 47.07.085. Supplemental reimbursement for emergency medical transportation services.

AK Stat § 47.07.085 (2019) (N/A)
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(a) The department shall develop a program to provide supplemental reimbursement to eligible emergency medical transportation service providers for the cost of providing services to medical assistance recipients. Except as provided in (b) of this section, the amount of the supplemental reimbursement paid to a provider must be equal to the amount of federal financial participation that the department receives for the nonfederal matching funds paid by the provider through intergovernmental transfers or certified public expenditures, less any administrative fee described in (d) or (e) of this section. Under the program, the department shall use intergovernmental transfers, or certified public expenditures, or both, for the nonfederal share of emergency medical transportation services that are eligible for federal financial participation under the medical assistance program.

(b) The amount a provider receives in supplemental reimbursements under the program, when combined with the amount the provider receives from all other sources, including medical assistance reimbursement under the state plan, may not exceed the provider's actual cost for providing emergency medical transportation services to medical assistance recipients.

(c) An emergency medical transportation service provider is eligible to participate in the program if the provider

(1) is enrolled with the department as a medical assistance provider;

(2) voluntarily enters into an agreement with the department to participate in the program;

(3) is owned or operated by the state, a political subdivision of the state, or a federally recognized tribe or tribal organization;

(4) charges for emergency medical transportation services on a fee-for- service or other federally permissible basis; and

(5) certifies that the provider's expenditures for emergency medical transportation services qualify for federal financial participation.

(d) If the department authorizes the use of intergovernmental transfers under the program, the department shall charge an administrative fee to a provider to cover the department's costs of administering the program. The administrative fee may not exceed 20 percent of the nonfederal share the provider pays to the department. A provider may include the administrative fee in the provider's cost for providing an emergency medical transportation service to a medical assistance recipient.

(e) If the department authorizes the use of certified public expenditures under the program, the department may establish an administrative fee for a provider. If the department establishes an administrative fee under this subsection, the department may allow a provider to include the administrative fee in the provider's cost for providing an emergency medical transportation service to a medical assistance recipient.

(f) This section authorizes the department to provide supplemental reimbursements to a ground, water, or air emergency medical transportation service provider only if the United States Department of Health and Human Services approves payments to that type of emergency medical transportation service provider.

(g) If the United States Department of Health and Human Services revokes approval of the program, the department shall provide notice to the legislature. The department shall submit written notice to the secretary of the senate and the chief clerk of the house of representatives as early as possible after the United States Department of Health and Human Services expresses its intent to revoke approval of the program.

(h) Supplemental reimbursement payments are subject to appropriation.

(i) In this section,

(1) “program” means the supplemental reimbursement program developed by the department under this section;

(2) “provider” means an eligible emergency medical transportation service provider;

(3) “state plan” means the state plan for medical assistance coverage developed under AS 47.07.040.