Okla. Stat. tit. 63, § 63-3242.4

A. There is hereby created in the State Treasury a revolving

fund to be designated the "Ambulance Service Provider Access Payment

Program Fund".

B. The fund shall be a continuing fund, not subject to fiscal

year limitations, be interest bearing and consist of:

1. All monies received by the Oklahoma Health Care Authority

from ambulance services pursuant to the Ambulance Service Provider

Access Payment Program Act and otherwise specified or authorized by

law;

2. Any interest or penalties levied and collected in

conjunction with the administration of this section; and

3. All interest attributable to investment of money in the

fund.

C. 1. The Authority shall send a notice of assessment to each

ambulance service provider informing the ambulance service provider

of the assessment rate, the ambulance service provider's net

operating revenue calculation, and the assessment amount owed by the

ambulance service provider for the applicable year.

2. Annual notices of assessment shall be sent at least thirty

(30) days before the due date for the first quarterly assessment

payment of each year.

3. The first notice of assessment shall be sent within forty-

five (45) days after receipt by the Authority of notification from

the Centers for Medicare and Medicaid Services that assessments and

payments required under the Ambulance Service Provider Access

Payment Program Act and, if necessary, the waiver granted under 42

C.F.R., Section 433.68 have been approved.

4. The ambulance service provider shall have thirty (30) days

from the date of its receipt of a notice of assessment to review and

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verify the assessment rate, the ambulance service provider's net

operating revenue calculation and the assessment amount.

D. 1. The annual assessment imposed under Section 3 of this

act shall be due and payable on a quarterly basis. However, the

first installment payment of an assessment imposed by the Ambulance

Service Provider Access Payment Program Act shall not be due and

payable until:

a. the Authority issues written notice stating that the

assessment and payment methodologies required under

the Ambulance Service Provider Access Payment Program

Act have been approved by the Centers for Medicare and

Medicaid Services and the waiver under 42 C.F.R.,

Section 433.68, if necessary, has been granted by the

Centers for Medicare and Medicaid Services,

b. the thirty-day verification period required by

paragraph 4 of subsection C of this section has

expired, and

c. the Authority issues a notice giving a due date for

the first payment.

2. After the initial installment of an annual assessment has

been paid under this section, each subsequent quarterly installment

payment shall be due and payable by the fifteenth day of the first

month of the applicable quarter.

3. If an ambulance service provider fails to timely pay the

full amount of a quarterly assessment, the Authority shall add to

the assessment:

a. a penalty assessment equal to five percent (5%) of the

quarterly amount not paid on or before the due date,

and

b. on the last day of each quarter after the due date

until the assessed amount and the penalty imposed

under subparagraph a of this paragraph are paid in

full, an additional five-percent penalty assessment on

any unpaid quarterly and unpaid penalty assessment

amounts.

4. The quarterly assessment including applicable penalties must

be paid regardless of any appeals action requested by the ambulance

provider. If a provider fails to pay the Authority the assessment

within the time frames noted on the invoice to the provider, the

assessment and applicable penalty shall be deducted from the

provider's payment. Any change in payment amount resulting from an

appeals decision will be adjusted in future payments.

5. An ambulance service provider subject to the assessment
ested by the ambulance

provider. If a provider fails to pay the Authority the assessment

within the time frames noted on the invoice to the provider, the

assessment and applicable penalty shall be deducted from the

provider's payment. Any change in payment amount resulting from an

appeals decision will be adjusted in future payments.

5. An ambulance service provider subject to the assessment

under the Ambulance Service Provider Access Payment Program Act that

has not been previously licensed as an ambulance service in Oklahoma

and that commences operations during a year shall pay the required

assessment computed under Section 3 of this act and shall be

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eligible for ambulance service provider access payments under this

section on the date specified in the rules promulgated by the

Authority after consideration of input and recommendations of the

Oklahoma Ambulance Alliance.

E. 1. To preserve the quality and improve access to ambulance

services rendered on or after the effective date of this act, the

Authority shall make ambulance service provider access payments as

set forth in this section.

2. The Authority shall pay all quarterly ambulance service

provider access payments within ten (10) calendar days of the due

date for quarterly assessment payments established in subsection D

of this section.

3. The Authority shall calculate the ambulance service provider

access payment amount as the balance of the Ambulance Service

Provider Access Payment Program Fund plus any federal matching funds

earned on the balance up to, but not to exceed, the upper payment

limit gap for all ambulance service providers.

4. All ambulance service providers shall be eligible for

ambulance service provider access payments each year as set forth in

this subsection except ambulance services excluded or exempted in

subsection B of Section 3 of this act.

5. Access payments shall be made on a quarterly basis.

6. Ambulance service provider access payments shall not be used

to offset any other payment by Medicaid for services to Medicaid

beneficiaries.

7. If the Centers for Medicare and Medicaid Services finds that

the Authority has made payments to ambulance service providers that

exceed the upper payment limits, ambulance service providers shall

refund to the Authority a share of the recouped federal funds that

is proportionate to the ambulance services' contribution to the

upper payment limit.

F. 1. All monies accruing to the credit of the Ambulance

Service Provider Access Payment Program Fund are hereby appropriated

and shall be budgeted and expended by the Authority after

consideration of the input and recommendation of the Alliance.

2. Monies in the Ambulance Service Provider Access Payment

Program Fund shall be used only for:

a. transfers to the Medical Payments Cash Management

Improvement Act Programs Disbursing Fund for the state

share of ambulance service provider access payments

for ambulance service providers that participate in

the assessment,

b. transfers to the Administrative Revolving Fund for the

state share of payment of administrative expenses

incurred by the Authority or its agents and employees

in performing the activities authorized by the

Ambulance Service Provider Access Payment Program Act

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but not more than Two Hundred Thousand Dollars

($200,000.00) each year, and

c. the reimbursement of monies collected by the Authority

from ambulance services through error or mistake in

performing the activities authorized under the

Ambulance Service Provider Access Payment Program Act.

3. The Authority shall pay from the Ambulance Service Provider

Access Payment Program Fund quarterly installment payments to

ambulance service providers of amounts available for ambulance

service provider access payments.
by the Authority

from ambulance services through error or mistake in

performing the activities authorized under the

Ambulance Service Provider Access Payment Program Act.

3. The Authority shall pay from the Ambulance Service Provider

Access Payment Program Fund quarterly installment payments to

ambulance service providers of amounts available for ambulance

service provider access payments.

4. Monies in the Ambulance Service Provider Access Payment

Program Fund shall not be used to replace other general revenues

appropriated and funded by the Legislature or other revenues used to

support Medicaid.

5. The Ambulance Service Provider Access Payment Program Fund

and the program specified in the Ambulance Service Provider Access

Payment Program Act are exempt from budgetary reductions or

eliminations caused by the lack of general revenue funds or other

funds designated for or appropriated to the Authority.

6. No ambulance service provider shall be guaranteed, expressly

or otherwise, that any additional costs reimbursed to the provider

will equal or exceed the amount of the ambulance service provider

access payment program fee paid by the ambulance service.

G. After considering input and recommendations from the

Alliance, the Oklahoma Health Care Authority Board shall promulgate

rules that:

1. Allow for an appeal of the annual assessment of the

Ambulance Service Provider Access Payment Program payable under this

act; and

2. Allow for an appeal of an assessment of any fees or

penalties determined.