IC 12-15-14.5
    Chapter 14.5. Supplemental Payments to AmbulanceTransportation Service Providers

IC 12-15-14.5-1
Application of chapter
    Sec. 1. This chapter applies to a Medicaid provider that receivesreimbursement from the office during a state fiscal year for providingambulance transportation services.
As added by P.L.224-2003, SEC.83.

IC 12-15-14.5-2
Reimbursement of ambulance transportation service provider
    Sec. 2. (a) Subject to section 6 of this chapter, for each state fiscalyear beginning July 1, 2003, an ambulance transportation serviceprovider may receive reimbursement under this chapter that is inaddition to the following reimbursement:
        (1) Reimbursement under this article.
        (2) The state plan for medical assistance.
        (3) Rules and policies adopted by the office to provideambulance transportation services.
    (b) Any additional reimbursement allowed under subsection (a)is subject to the approval by the United States Department of Healthand Human Services to an amendment of the state Medicaid plan.
As added by P.L.224-2003, SEC.83.

IC 12-15-14.5-3
Schedule of payments
    Sec. 3. The office shall:
        (1) develop a schedule for payments made under this chapter;and
        (2) make a payment under this chapter in accordance with theschedule.
As added by P.L.224-2003, SEC.83.

IC 12-15-14.5-4
Calculation of payment
    Sec. 4. (a) Except as provided in subsection (b), the office shallcalculate and make a payment under this chapter in an amount equalto the amount calculated in STEP SIX of the following formula:
        STEP ONE: The office shall identify a Medicaid providerdescribed in section 1 of this chapter that receivedreimbursement for ambulance transportation services during atime frame determined by the office.
        STEP TWO: For each Medicaid provider described in STEPONE, the office shall identify the ambulance transportationservices for which the Medicaid provider was reimbursed.
        STEP THREE: For each Medicaid provider described in STEPONE, the office shall calculate the reimbursement paid to theMedicaid provider for the ambulance transportation services

identified under STEP TWO.
        STEP FOUR: For each Medicaid provider described in STEPONE, the office shall calculate the Medicaid provider's usualand customary charges for each of the Medicaid provider'sservices identified under STEP TWO.
        STEP FIVE: For each Medicaid provider described in STEPONE, the office shall subtract an amount equal to thereimbursement calculation for each of the ambulancetransportation services under STEP THREE from an amountequal to the amount calculated for each of the ambulancetransportation services under STEP FOUR.
        STEP SIX: For each Medicaid provider described in STEPONE, the office shall calculate the sum of each of the amountscalculated for each ambulance transportation services underSTEP FIVE.
    (b) For any Medicaid provider described in STEP ONE ofsubsection (a), the office may decline to base the calculations underSTEP FOUR of subsection (a) on the Medicaid provider's usual andcustomary charges if the office determines a formula or criteria thatwill increase the amount calculated for the provider under STEP SIXof subsection (a).
As added by P.L.224-2003, SEC.83.

IC 12-15-14.5-5
Calculation of usual and customary charges
    Sec. 5. The office shall establish a methodology for calculating aprovider's usual and customary charges for purpose of STEP FOURof the formula in section 4(a) of this chapter.
As added by P.L.224-2003, SEC.83.

IC 12-15-14.5-6
Intergovernmental transfer required
    Sec. 6. (a) A Medicaid provider that receives reimbursement fromthe office during a state fiscal year for ambulance transportationservices is eligible for payment under this chapter only if anintergovernmental transfer under this section is made by the provideror on behalf of the provider to the office.
    (b) The amount of the intergovernmental transfer undersubsection (a) must be an amount of at least eighty-five percent(85%) of the amount calculated for the provider under STEP SIX ofsection 4 of this chapter.
As added by P.L.224-2003, SEC.83.

IC 12-15-14.5-7
Appeal by Medicaid provider
    Sec. 7. A Medicaid provider that receives reimbursement from theoffice during a state fiscal year for ambulance transportation servicesmay appeal under IC 4-21.5 the amount determined by the office tobe paid to the Medicaid provider under STEP SIX of section 4 of thischapter.As added by P.L.224-2003, SEC.83.

IC 12-15-14.5-8
Determination of services covered
    Sec. 8. The office shall determine the services to be consideredambulance transportation services under this chapter. The servicesmust at least include the following:
        (1) Air.
        (2) Basic life support services.
        (3) Advanced life support services.
As added by P.L.224-2003, SEC.83.