(a) Upon approval by the centers for medicare and medicaid services of the assessment imposed by this part, the bureau shall reimburse each ambulance provider with qualifying ground ambulance service medicaid transports in an amount calculated by the bureau. This calculation must be determined by the bureau’s estimate of assessment collections and the resulting available program funding, less an annual amount of seventy-five thousand dollars ($75,000) to offset medicaid administration expenses and an annual amount of eighty thousand dollars ($80,000) to offset administrative expenses for the Tennessee Ambulance Services Association. If less than these amounts is needed to offset the administrative expenses, the bureau shall only deduct the amount needed. The bureau’s estimate of assessment collections and the resulting program funding, netting out any amounts for offset administrative expenses, must be divided by the bureau’s projected number of medicaid transports. The resulting amounts are the additional payment amount made for each medicaid transport reported by the MCOs on a quarterly basis. This amount may change from quarter to quarter.
Terms Used In Tennessee Code 71-5-1505
Ambulance provider: means a public or private ground-based ambulance service, other than an ambulance service based on federal property, that bills for transports and has a base of operations within this state. See Tennessee Code 71-5-1502
Assessment: means the medicaid ambulance provider assessment established by this part. See Tennessee Code 71-5-1502
Medicaid transport: means qualifying ground ambulance services approved by CMS, and consistent with services identified in 42 C. See Tennessee Code 71-5-1502
(b) The bureau shall disburse directed payments to ambulance providers based on qualified medicaid transports from the base period as determined by the bureau and as authorized by the centers for medicare and medicaid services.
