26B-3-803.  Calculation of assessment.

(1)  The division shall calculate a uniform assessment per transport as described in this section.

Terms Used In Utah Code 26B-3-803

  • Ambulance service provider: means :
(a) an ambulance provider as defined in Section 26B-4-101; or
(b) a non-911 service provider as defined in Section 26B-4-101. See Utah Code 26B-3-801
  • Assessment: means the Medicaid ambulance service provider assessment established by this part. See Utah Code 26B-3-801
  • Division: means the Division of Integrated Healthcare within the department. See Utah Code 26B-3-801
  • Fiscal year: The fiscal year is the accounting period for the government. For the federal government, this begins on October 1 and ends on September 30. The fiscal year is designated by the calendar year in which it ends; for example, fiscal year 2006 begins on October 1, 2005 and ends on September 30, 2006.
  • Non-federal portion: means the non-federal share the division needs to seed amounts that will support fee-for-service ambulance service provider rates, as described in Section 26B-3-804. See Utah Code 26B-3-801
  • State: when applied to the different parts of the United States, includes a state, district, or territory of the United States. See Utah Code 68-3-12.5
  • Total transports: means the number of total ambulance transports applicable to a given fiscal year, as determined under Subsection 26B-3-803(5). See Utah Code 26B-3-801
    • (2)  The assessment due from a given ambulance service provider equals the non-federal portion divided by total transports, multiplied by the number of transports for the ambulance service provider.

    (3)  The division shall apply any quarterly changes to the assessment rate, calculated as described in Subsection (2), uniformly to all assessed ambulance service providers.

    (4)  The assessment may not generate more than the total of:

    (a)  an annual amount of $20,000 to offset Medicaid administration expenses; and

    (b)  the non-federal portion.

    (5) 

    (a)  For each state fiscal year, the division shall calculate total transports using data from the Emergency Medical System as follows:

    (i)  for state fiscal year 2016, the division shall use ambulance service provider transports during the 2014 calendar year; and

    (ii)  for a fiscal year after 2016, the division shall use ambulance service provider transports during the calendar year ending 18 months before the end of the fiscal year.

    (b)  If an ambulance service provider fails to submit transport information to the Emergency Medical System, the division may audit the ambulance service provider to determine the ambulance service provider’s transports for a given fiscal year.

    Renumbered and Amended by Chapter 306, 2023 General Session

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