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