September 19, 2024
S8486-C was recently signed into law by Governor Hochul. Below please find bill language for this important new law that pertains to reimbursement for emergency medical transport under the NYS Medicaid Program by an ambulance service or similar licensed, certified or registered entity.
Notes:
- There is a reference (below) to Section 7.17 of the NYS Mental Hygiene Law. The reference is to state operated psychiatric centers.
- There are also references to eligible emergency service providers. This includes emergency medical services (EMS) and ambulance services.
- Finally, implementation of the new law appears to be contingent upon NYS securing federal financial participation that contributes to reimbursement for the services in question.
S T A T E O F N E W Y O R K
________________________________________________________________________
8486--C
AN ACT to amend the social services law, in relation to Medicaid
reimbursement for treatment in place and transportation to alternative
health care settings by ambulance services
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
Section 1. The social services law is amended by adding a new section
367-y to read as follows:
§ 367-Y. REIMBURSEMENT FOR TREATMENT IN PLACE AND TRANSPORTATION TO
ALTERNATIVE HEALTH CARE SETTINGS.
1. NOTWITHSTANDING ANY PROVISION OF LAW TO THE CONTRARY, ANY PROVISION OF THIS TITLE PROVIDING FOR REIMBURSEMENT OF TRANSPORTATION COSTS FOR AN AMBULANCE SERVICE SHALL ALSO APPLY WHERE, INSTEAD OF PROVIDING TRANSPORTATION TO A GENERAL HOSPITAL, SUCH AMBULANCE SERVICE WHEN RESPONDING TO AN EMERGENCY CALL:
(A) ADMINISTERS TREATMENT IN PLACE, INCLUDING BUT NOT LIMITED TO TELE- HEALTH VISITS APPROVED BY MEDICAID FOR REIMBURSEMENT WHEN DEEMED NECES- SARY; AND/OR (B) TRANSPORTS AN INDIVIDUAL TO AN ALTERNATIVE HEALTH CARE SETTING.
2. FOR THE PURPOSES OF THIS SECTION, THE FOLLOWING TERMS SHALL HAVE THE FOLLOWING MEANINGS:
(A) "ALTERNATIVE HEALTH CARE SETTING" MEANS THE FOLLOWING FACILITIES OR INSTITUTIONS APPROVED BY MEDICAID FOR REIMBURSEMENT AND ACCEPTING MEDICAID RECIPIENTS: (I) A CRISIS STABILIZATION CENTER OR CERTIFIED COMMUNITY BEHAVIORAL HEALTH CLINIC OPERATING PURSUANT TO ARTICLE THIRTY-SIX OF THE MENTAL HYGIENE LAW; (II) A FACILITY UNDER SECTION 7.17 OF THE MENTAL HYGIENE LAW; (III) A FACILITY PROVIDING ADDICTION DISORDER SERVICES OR BEHAVIORAL HEALTH SERVICES, AS SUCH TERMS ARE DEFINED BY SECTION 1.03 OF THE MENTAL HYGIENE LAW; (IV) A DIAGNOSTIC AND TREATMENT CENTER ESTABLISHED PURSUANT TO ARTICLE TWENTY-EIGHT OF THE PUBLIC HEALTH LAW, OR AN UPGRADED DIAGNOSTIC AND TREATMENT CENTER DESIGNATED AS SUCH PURSUANT TO SECTION TWENTY-NINE HUNDRED FIFTY-SIX OF THE PUBLIC HEALTH LAW; (V) A FEDERALLY QUALIFIED HEALTH CENTER; OR (VI) AN URGENT CARE CENTER, WHICH FOR THE PURPOSES OF THIS SECTION SHALL MEAN A FACILITY THAT PROVIDES EPISODIC CARE RELATED TO AN ACUTE ILLNESS OR MINOR TRAUMAS THAT ARE NOT LIFE-THREATENING OR PERMANENTLY DISABLING.
(B) "AMBULANCE SERVICE" SHALL HAVE THE SAME MEANING AS DEFINED BY SECTION THREE THOUSAND ONE OF THE PUBLIC HEALTH LAW.
(C) "GENERAL HOSPITAL" SHALL HAVE THE SAME MEANING AS DEFINED BY SECTION TWENTY-EIGHT HUNDRED ONE OF THE PUBLIC HEALTH LAW.
(D) "TREATMENT IN PLACE" MEANS THE ADMINISTRATION OF EMERGENCY MEDICAL SERVICES, AS DEFINED BY SECTION THREE THOUSAND ONE OF THE PUBLIC HEALTH LAW, BY AN EMPLOYEE OR VOLUNTEER OF AN AMBULANCE SERVICE. SUCH SERVICES SHALL BE CONSISTENT WITH PROTOCOLS PROMULGATED PURSUANT TO ARTICLE THIR- TY OF THE PUBLIC HEALTH LAW.
3. THIS SECTION SHALL BE EFFECTIVE IF, AND AS LONG AS, FEDERAL FINAN- CIAL PARTICIPATION IS AVAILABLE THEREFOR.
4. NOTHING IN THIS SECTION SHALL BE DEEMED TO ALLOW A PERSON TO PROVIDE ANY SERVICE FOR WHICH A LICENSE, REGISTRATION, CERTIFICATION OR OTHER AUTHORIZATION UNDER TITLE EIGHT OF THE EDUCATION LAW IS REQUIRED AND WHICH THE PERSON DOES NOT POSSESS.
§ 2. This act shall take effect on the first of October next succeed- ing the date on which it shall have become a law.