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PA Bulletin, Doc. No. 04-1865

NOTICES

DEPARTMENT OF PUBLIC WELFARE

Fee Increase for Ambulance Services

[34 Pa.B. 5652]

   The Department of Public Welfare (Department) announces that fees on the Medical Assistance (MA) Program Fee Schedule for ambulance services will be increased, effective with dates of service on and after July 1, 2004.

   Ambulance companies provide a direct link to medically necessary health care for MA recipients in this Commonwealth. The costs associated with the provision of ambulance services have increased substantially over the years. In recent years the price of gasoline alone has taxed this industry immensely, compounded by increased costs for state-of-the-art life-saving equipment and certified, trained staff.

   For MA recipients to continue to have access to this vital service, the Department will increase the MA fee for the following procedure codes on the MA Program Fee Schedule:

Procedure Code Description of Service Current Fee Increased Fee Effective July 1, 2004
W0011 Mileage $1 per mile after the first 20 miles (round trip) $2 per mile after the first 20 miles (round trip)
W0012 VASC Certified, Nonemergency Transportation Service   $60 $120
W0013 VASC Certified, Nonemergency Transportation Service, Other Unusual Circumstances   $60 $120
W0015 VASC Certified, Emergency (Prehospital) Transportation Service   $60 $120
W0016 Advanced Life Support (ALS) Service
with Transport (Prehospital)
$100 $200
W0017 Advanced Life Support (ALS) Service Without Transport (Prehospital)   $40   $80
W0018 Specialized Services (Critical Care, with Transport, Interfacility Cases such as Neonatal, Prenatal or Cardiac Care Service) $100 $200

Fiscal Impact

   The estimated cost relating to Fiscal Year 2004-2005 is $6.378 million ($3.212 million in State funds). Of this amount, $3.218 million ($1.669 million in State funds) relates to the Outpatient program while $3.16 million ($1.543 million in State funds) is for MA--Capitation services.

   The estimated cost for Fiscal Year 2005-2006 is $10.639 million ($5.272 million in State funds). Of this amount, $4.023 million ($2.065 million in State funds) relates to the Outpatient program while $6.616 million ($3.207 million in State funds) is for MA--Capitation services.

Public Comment

   Interested persons are invited to submit written comments to this notice within 30 days of publication to the Department of Public Welfare, Office of Medical Assistance Programs, c/o Deputy's Secretary Office, Attn: Regulations Coordinator, Room 515, Health and Welfare Building, Harrisburg, PA 17120. Comments will be considered in future revisions to the MA Program Fee Schedule. Persons with a disability may use the AT&T Relay Service, (800) 654-5984 (TDD users) or (800) 654-5988 (voice users).

ESTELLE B. RICHMAN,   
Secretary

   Fiscal Note: 14-NOT-400. (1) General Fund;

Outpatient Capitation
(2)  Implementing Year 2004-05 is $1,669,000 $1,543,000
(3)  1st Succeeding Year 2005-06 is $2,065,000 $3,207,000
      2nd Succeeding Year 2006-07 is $2,133,000 $3,311,000
      3rd Succeeding Year 2007-08 is $2,133,000 $3,311,000
      4th Succeeding Year 2008-09 is $2,133,000 $3,311,000
      5th Succeeding Year 2009-10 is $2,133,000 $3,311,000
OutpatientCapitation
(4)  2003-04 Program-- $727,979,000 $2,298,102,000
      2002-03 Program-- $666,832,000 $1,863,772,000
      2001-02 Program-- $705,750,000 $1,711,084,000
(7)  MA--Outpatient and Capitation; (8) recommends adoption. Costs for 2004-05 have been included in Act 7-A of 2004, the General Appropriation Act of 2004.
[Pa.B. Doc. No. 04-1865. Filed for public inspection October 8, 2004, 9:00 a.m.]



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