Alabama § 40-26B-90 - Definitions.

§ 40-26B-90. Definitions.

The following words, terms, and phrases, when used in this article have the meanings ascribed to them in this section, except where the context clearly indicates a different meaning:

(1) ASSESSMENT POOL. The total assessments collected pursuant to this article as of a date determined by the Commissioner of Alabama Medicaid, which date shall be no later than the 60th day of a fiscal quarter, that have not been expended for the purposes of this article, net of the amounts specified in Section 40-26B-93(c)(1), plus any Medicaid federal financial participation.

(2) ASSESSMENT RATE. A monetary amount per emergency medical transport applied to calculate emergency medical transport assessments pursuant to this article.

(3) DEPARTMENT. The Department of Revenue of the State of Alabama.

(4) EMERGENCY MEDICAL TRANSPORT. The act of transporting an individual from any point of origin to the nearest medical facility capable of meeting the emergency medical needs of the patient by an ambulance licensed, operated, and equipped in accordance with applicable state or local statutes, ordinances, or regulations. This term shall only include services that are billable utilizing Healthcare Common Procedure Coding System (HCPCS) emergency transport codes A0429 BLS Emergency, A0427 ALS Emergency (Level 1), A0433 ALS Emergency (Level 2), A0434 Specialty Care Transport, and A0225 Neonatal Emergency Transport. In consultation with the Alabama Medicaid Agency, the department may include additional HCPCS Codes when approved by the federal government. This term shall not include transportation of beneficiaries by passenger cars, taxicabs, litter vans, wheelchair vans, or other forms of public or private conveyances, nor shall it include transportation by an air ambulance provider or a transport not paid by any payor.

(5) EMERGENCY MEDICAL TRANSPORT ENHANCEMENT. An additional Medicaid payment to emergency medical transport providers authorized by Section 40-26B-95.

(6) EMERGENCY MEDICAL TRANSPORT PROVIDER. A provider of emergency medical transports licensed by the Alabama Department of Public Health’s Office of Emergency Medical Services as a transport provider. The term includes both public and private providers.

(7) FISCAL QUARTER. A state fiscal quarter within a state fiscal year.

(8) FISCAL YEAR. An accounting period of 12 months beginning on the first day of the first month of the state fiscal year.

(9) GROSS RECEIPTS. Gross payments received as patient care revenue for emergency medical transports, determined on a cash basis of accounting.

(10) MEDICAID PROGRAM. The medical assistance program as established in Title XIX of the Social Security Act and as administered in the State of Alabama by the Alabama Medicaid Agency pursuant to executive order and Title 560 of the Alabama Administrative Code.

(11) TRANSPORT ENHANCEMENT RATE. An additional Medicaid payment per emergency medical transport authorized pursuant to this article.