Current through 2024 Regular Session legislation effective June 6, 2024
Section 413.235 - Emergency services intergovernmental transfer program(1) The Oregon Health Authority shall develop and implement an intergovernmental transfer program to provide for the transfer of funds from an emergency medical services provider to the authority to pay the costs of providing emergency medical services to members of a coordinated care organization. The authority shall pay any federal financial participation received by the authority as a result of the transfer of funds to the coordinated care organization. The coordinated care organization shall increase, by the same amount, the amount of reimbursement paid to the emergency medical services provider for the costs of the emergency medical services.(2) The increased reimbursement paid under subsection (1) of this section shall be at least actuarially equivalent to the Medicaid supplemental reimbursement for the emergency medical services paid under ORS 413.234.(3) General Fund moneys may not be used to implement this section. As a condition of participation in the intergovernmental transfer program described in subsection (1) of this section, an emergency medical services provider must agree to pay a fee to reimburse the authority for the costs of administering the program. The fee may not exceed 20 percent of the cost of the emergency medical services provided. The authority shall allow up to 120 percent of the fee to be counted as an operating cost for providers.(4) An emergency medical services provider shall make readily available to the authority documentation, data and certifications, as prescribed by the authority, necessary to establish that the emergency medical services expenditures qualify for federal financial participation and to calculate the amount due to a coordinated care organization for the expenditures.(5) If the authority determines that any expenditure made by an emergency medical services provider does not qualify for federal financial participation, the authority shall return the funds associated with the expenditure to the provider or refuse to accept the transfer of funds associated with the expenditure.(6) Participation by any coordinated care organization or emergency medical services provider in the program must be voluntary.(7) The authority shall consult with emergency medical services providers in the development, implementation and operation of the intergovernmental transfer program.