IL SB2325

Illinois Department shall reimburse ambulance service providers using Medicare payment principles and methods to ensure consistency and adequate reimbursement for ambulance services provided to Medicaid recipients beginning January 1, 1993.

Reimbursement shall be based on actual distance traveled when natural disasters, weather, road repairs, or traffic congestion necessitate use of alternative routes rather than the most direct route beginning January 1, 1996.

Non-emergency medi-car and service car transportation providers must certify that drivers and attendants completed Department-approved safety training prior to July 1, 2008, with recertification required every 3 years; public transportation providers receiving federal funding are exempt.

Ground ambulance service providers may appeal Department decisions denying non-emergency transportation approval or approving service at lower compensation levels, with appeals due within 60 days of decision; criteria for determination must be published in the Illinois Register before denials can be issued.

Base reimbursement rates for ground ambulance providers shall increase to not lower than 112% of rates in effect as of June 30, 2018, effective July 1, 2018; $2,000,000 allocated to reimburse claims denied due to missing Medical Certification Forms between December 15, 2012 and January 1, 2021 if medical necessity is proven.