A BILL TO BE ENTITLED
AN ACT to establish medicaid reimbursement for ambulance transports of Medicaid recipients in behavioral health crisis to behavioral health clinics or alternative appropriate care locations.
The General Assembly of North Carolina enacts:
SECTION 1.  It is the intent of the General Assembly to provide opportunities to divert individuals in behavioral health crisis from hospital emergency departments to alternative appropriate care locations. Consistent with Option 1 outlined in the Department of Health and Human Services' (DHHS) March 1, 2015, report entitled "Ambulance Transports to Crisis Centers," DHHS shall evaluate the financial impact, including any anticipated cost to the Medicaid program, of establishing Medicaid reimbursement for ambulance transports of Medicaid recipients in behavioral health crisis to behavioral health clinics or other alternative appropriate care locations. Any reimbursement shall be contingent upon an Emergency Medical Services (EMS) System's ability to demonstrate its EMS providers have received appropriate education in caring for individuals in behavioral health crisis and that it has at least one partnership with a receiving facility that is able to provide care appropriate for those individuals. Additionally, an EMS System shall be required to include in its EMS System Plan a report on patient experiences and outcomes. Rules regarding the EMS System Plan requirements shall be adopted by the Department of Health and Human Services, Division of Health Regulation, Office of Emergency Medical Services.
SECTION 2.  No later than December 1, 2017, the Department of Health and Human Services, Division of Medical Assistance, shall report to the Joint Legislative Oversight Committee on Medicaid and NC Health Choice on the evaluation of the financial impact of establishing Medicaid reimbursement for ambulance transports of Medicaid recipients in behavioral health crisis to behavioral health clinics or other alternative appropriate care locations. The report shall also include a plan of implementation and a time line for submission of any State Plan amendments or any waivers necessary for implementation.
SECTION 3.  The Department of Health and Human Services, Division of Medical Assistance, shall submit any State Plan amendments or any waivers necessary to establish Medicaid reimbursement for ambulance transports of Medicaid recipients in behavioral health crisis to behavioral health clinics or other alternative appropriate care locations to the Centers for Medicare and Medicaid Services (CMS). Medicaid reimbursement for ambulance transports of Medicaid recipients in behavioral health crisis to behavioral health clinics or other alternative appropriate care locations shall not be implemented until CMS approval of any submitted State Plan amendments or waivers has been received.
SECTION 4.  If Medicaid reimbursement for ambulance transports of Medicaid recipients in behavioral health crisis cannot be implemented under the authority granted to the Department of Health and Human Services under G.S. 108A‑54(e), then it is the intent of the General Assembly to appropriate any funds necessary to cover the costs of implementation upon the approval of any submitted State Plan amendments or waivers by the Centers for Medicare and Medicaid Services.
SECTION 5.  This act is effective when it becomes law.