Missouri Code of State Regulations › Title 13 - DEPARTMENT OF SOCIAL SERVICES › Division 70 - MO HealthNet Division › Chapter 6 - Emergency Ambulance Program › Section 13 CSR 70-6.010 - Ambulance Treat No Transport

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This rule establishes the regulatory basis
				  for the administration of the emergency ambulance program. This rule provides
				  for such methods and procedures relating to the utilization of, and the payment
				  for, care and services available under the MO HealthNet program as may be
				  necessary to safeguard against unnecessary utilization of such care and
				  services and to assure that payments are consistent with efficiency, economy,
				  and quality of care and are sufficient to enlist enough providers so that care
				  and services are available under the plan at least to the extent that such care
				  and services are available to the general population in the geographic area.
				  Specific details of provider participation, criteria and methodology for
				  provider reimbursement, participant eligibility, and amount, duration and scope
				  of services covered are included in the ambulance program manual, which is
				  incorporated by reference in this rule and available at the
				  website.
PURPOSE: This amendment establishes the regulatory
				  basis for the administration of the emergency ambulance program when services
				  are provided on-site by a licensed emergency medical technician or by a
				  paramedic and transportation is not required.
PUBLISHER'S NOTE: The secretary of state has
				  determined that the publication of the entire text of the material which is
				  incorporated by reference as a portion of this rule would be unduly cumbersome
				  or expensive. This material as incorporated by reference in this rule shall be
				  maintained by the agency at its headquarters and shall be made available to the
				  public for inspection and copying at no more than the actual cost of
				  reproduction. This note applies only to the reference material. The entire text
				  of the rule is printed here.
(1) Administration. The MO HealthNet
				ambulance program shall be administered by the Department of Social Services,
				MO HealthNet Division. The ambulance program services covered and not covered,
				the limitations under which services are covered, and the maximum allowable
				fees for all covered services shall be determined by the MO HealthNet Division
				and shall be included in the ambulance program provider manual, which is
				incorporated by reference and made part of this rule as published by the
				Department of Social Services, MO HealthNet Division, 615 Howerton Court,
				Jefferson City, MO 65109, at its website at
www.dss.mo.gov/mhd
, May 15,
				2019. This rule does not incorporate any subsequent amendments or
				additions.
(2) Eligible Providers.
				To be eligible for participation in MO HealthNet, the following requirements
				shall be met:
(A) Ground Ambulance.
1. The provider must be licensed by the
				Missouri Department of Health and Senior Services if located in Missouri or
				licensed by the state regulating authority if located outside the state of
				Missouri.
2. The provider must be
				certified to participate in the Title XVIII Medicare program and have a signed
				and accepted Participation Agreement in effect with the Missouri Department of
				Social Services, MO HealthNet Division; and