HBA-MPA C.S.H.B. 897 76(R)BILL ANALYSIS Office of House Bill AnalysisC.S.H.B. 897 By: Haggerty Public Health 4/11/1999 Committee Report (Substituted) BACKGROUND AND PURPOSE Currently, there is a shortfall between the cost of ambulance service and what Medicare will pay for this service. Medicare pays 80 percent of the cost of service for those who qualify for the program. Since many Medicare clients also qualify for medical assistance, that program could potentially make up for the shortfall, thereby removing ambulance operators, who are required by law to respond to all emergency calls, from the need to absorb this expense or pass it on to other clients. C.S.H.B. 897 requires the medical assistance program to pay the Medicare deductibles and coinsurance on ambulance service. This bill allows Medicare recipients to spend less on their Medicare benefits. Ambulance service providers would receive the same reimbursement rates that they currently receive. Medicare recipients would have their deductibles and coinsurance covered by the medical assistance program only if the service provided was an ambulance service. RULEMAKING AUTHORITY It is the opinion of the Office of House Bill Analysis that this bill does not expressly delegate any additional rulemaking authority to a state officer, department, agency, or institution. SECTION BY SECTION ANALYSIS SECTION 1. Amends Section 32.043, Human Resource Code, as added by Chapter 1153, Acts of the 75th Legislature, Regular Session, 1997, by adding Subsection (c), as follows: (c) Requires the medical assistance program, for ambulance service provided to an individual who is eligible under the medical assistance program and Medicare, to pay the Medicare deductibles and coinsurance. SECTION 2. Effective date: September 1, 1999. Makes application of this Act prospective. SECTION 3. Requires the Health and Human Services Commission, if it determines before this Act is implemented that a waiver or authorization from a federal agency is necessary, to request the waiver or authorization and authorizes the delay of implementation until such waiver is granted. SECTION 4. Emergency clause. COMPARISON OF ORIGINAL TO SUBSTITUTE C.S.H.B. 897 differs from the original bill in SECTION 1 by replacing, in proposed Subsection (c), language calling for the medical assistance program to pay the difference between the customary rate that prevails in the community for the service provided and the maximum Medicare allowable charge, with the phrase "pay the Medicare deductibles and coinsurance."