Ambulance & Chair Car Proposed
Regulations 5-1-2008 (Transportation rates)
NOTICE OF PUBLIC HEARING (114.3 CMR
27.00)
Pursuant to the provisions of M.G.L. c. 118G
and in accordance with M.G.L. c. 30A, as amended, a public hearing will be held
Tuesday, April 15, 2008, at 10:00 A.M. at the Division of Health Care Finance
and Policy (“Division”), 2 Boylston Street, 5th floor, Boston,
MA relative to the adoption of amendments to:
114.3 CMR 27.00:
Ambulance Services
The proposed amendments increase the
payment rates for ambulance and chair car transport services provided to
publicly aided individuals and individuals covered by the Workers Compensation
Act, M.G.L. c. 152, effective May 1, 2008. For ambulance services, the
Conversion Factor (CF) that is multiplied by the relative value unit assigned
to each service code is increased from $145.25 to $147.67. The revised CF was
calculated by dividing 2006 provider costs, adjusted for efficiency at the
standard of median unit cost for each major component of services, by the
number of trips expected to be delivered by providers operating at a level of
efficiency at least equal to the median of all providers, based on the number
of trips per vehicle hour. This result was inflated by a Massachusetts specific
cost adjustment factor of 1.03%, resulting in an increase of approximately 1.7
% for ambulance transport services. The amendments also increase the related
mileage rate by 3.9%, from $2.82 to $2.93, per loaded mile. The mileage rate is
based on fixed and variable vehicle costs. Fixed vehicle costs were adjusted by
applying a standard cap at the median of fixed costs per vehicle. Variable
vehicle costs were adjusted by applying an efficiency standard at the median
variable vehicle cost per loaded mile. Loaded miles were adjusted to a minimum
of the median loaded miles per available vehicle hour. For chair car services, due to wide variations in the trip cost data,
the proposal applies the same percentage increase proposed for the ambulance
trip and mileage rates. This results in a 1.7% increase in the chair car
transport rate, from $20.60 to $20.94 and a 3.9% increase in the mileage rate,
from $1.41 to $1.46 per loaded mile. In addition, the proposed
amendments establish a rate of $3,775 for air ambulance services (fixed or
rotary wing aircraft) which are currently paid pursuant to special contracts or
Preferred Provider Agreements. This rate was derived from the cost reports of
the two providers that serve Massachusetts and reflect the providers’ adjusted
average cost per trip for this service. The proposed amendments also add
standard language pertaining to administrative informational bulletins and
individual consideration payment methods.
The Division is proposing these amendments
to update the payment rates and ensure that these rates are consistent with
efficiency, economy, and quality of care. As a result of this proposal, it
is estimated that aggregate annual expenditures by MassHealth will increase by
approximately $1.27 million consisting of an increase of $794,000 or 2% for
ambulance and chair car services and $475,000 for air ambulance services. The
fiscal impact on other government purchasers, including cities and towns, will
vary depending on the mix and volume of services purchased. For those
cities and towns that provide ambulance and chair car services, revenues are
expected to increase based upon the mix and volume of services provided.
Interested parties are encouraged to
submit comments on these amendments. All persons desiring to be heard on
this matter are hereby notified to appear at the designated time and place.
Persons intending to speak will be afforded an early opportunity to testify if
the Division receives notice by 5 p.m. on Monday, April 14, 2008. All others
will be heard subsequently. Written comments may be sent to the Division
at Two Boylston Street, 5th floor, Boston, MA 02116.
Copies of the regulation are available for
inspection and/or purchase at the Division, Two Boylston Street, 5th floor,
Boston, MA 02116 or you can access them free of charge in the Regulations
section of the Division’s web site located at www.mass.gov/dhcfp.
Current
and Proposed Regulations