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HB231 INTRODUCED
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HB231
FKR3755-1
By Representative Reynolds
RFD: Ways and Means General Fund
First Read: 14-Jan-26
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FKR3755-1 01/12/2026 TEW (F)TEW 2026-139
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First Read: 14-Jan-26
SYNOPSIS:
Under current law, emergency medical transport
providers pay a quarterly assessment to provide
additional Medicaid enhancement payments for
maintenance and expansion of emergency medical
transport services. The assessment expires at the end
of the fiscal quarter starting July 1, 2028.
This bill would remove the sunset clause and
make the quarterly assessment permanent.
A BILL
TO BE ENTITLED
AN ACT
Relating to emergency medical transport providers; to
amend Sections 40-26B-91, 40-26B-94, and 40-26B-95, Code of
Alabama 1975, as last amended by Act 2025-370, 2025 Regular
Session; to make the assessment on emergency medical providers
permanent.
BE IT ENACTED BY THE LEGISLATURE OF ALABAMA:
Section 1. Sections 40-26B-91, 40-26B-94, and
40-26B-95, Code of Alabama 1975, as last amended by Act
2025-370, 2025 Regular Session, are amended as follows:
"§40-26B-91
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"§40-26B-91
To provide further for the availability of indigent
health care, the operation of the Medicaid Program, and the
maintenance and expansion of emergency medical transport
services:
(1) Commencing no later than the fiscal quarter
starting April 1, 2023, and through and including the fiscal
quarter starting July 1, 2028, an assessment is imposed on
each emergency medical transport provider based on the number
of emergency medical transports. The quarterly assessment for
each emergency medical transport provider shall be calculated
based on the product of the assessment rate and the total
revenue received from emergency medical transports rendered by
the emergency medical transport provider from the previous
fiscal quarter.
(2) In consultation with the Alabama Medicaid Agency,
the department shall set an assessment rate each fiscal
quarter. The assessment rate shall be a maximum of 5.3
percent, subject to Section 40-26B-98(b). In consultation with
the Alabama Medicaid Agency, the department may change the
assessment rate each quarter to reduce the amount of surplus
assessments. Any surplus assessment from a previous quarter
may be used to reduce the assessment rate.
(3) The assessment imposed by this article is in
addition to all other taxes and assessments of any kind now
imposed by law."
"§40-26B-94
(a) Commencing no later than the fiscal quarter
starting April 1, 2023, and through and including the fiscal
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starting April 1, 2023, and through and including the fiscal
quarter starting July 1, 2028, on or before the 15th day after
the close of each fiscal quarter, every emergency medical
transport provider shall file with the department a statement
under penalty of perjury on forms prescribed by the
department, showing the total number of emergency medical
transports, the total amount of gross receipts for the subject
fiscal quarter, and other reasonable and necessary information
as the department, after consultation with the Alabama
Medicaid Agency and adoption of appropriate rules, may require
for the proper enforcement of this article.
(b) It shall be the duty of each emergency medical
transport provider to keep and preserve suitable books and
records as may be necessary to determine the amount of
assessments for which it is liable under this article. The
books and records shall be kept and preserved for a period of
not less than three years, and all such books and records
shall be open for examination during business hours by the
department or its duly authorized agents.
(c) All information secured pursuant to this article by
the department shall be confidential, as prescribed by Section
40-2A-10, except that the department may provide such
information to the Alabama Medicaid Agency as necessary for
the proper administration of the Medicaid Program, or for the
department's proper administration of the assessment levied by
this article.
(d) The department from time to time, as it deems
desirable, shall adopt reasonable rules as necessary to
provide for the orderly and efficient administration of the
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provide for the orderly and efficient administration of the
assessment levied by this article."
"§40-26B-95
(a) Commencing no later than the fiscal quarter
starting April 1, 2023, and through and including the fiscal
quarter starting July 1, 2028, the Alabama Medicaid Agency
shall pay an emergency medical transport enhancement each
fiscal quarter to emergency medical transport providers as set
forth in this section on or before the last day of the
quarter, except that Section 40-26B-97 shall apply to any
fiscal quarter for which federal approval has not been
obtained as of the first day of the fiscal quarter. The
emergency medical transport enhancement shall be paid in
addition to any other amounts payable to emergency medical
transport providers with respect to those services and shall
not affect any other payments to emergency medical transport
providers.
(b) For each fiscal quarter, the emergency medical
transport enhancement to each emergency medical transport
provider shall be calculated as the total number of emergency
medical transports reimbursed by the Alabama Medicaid Agency
as the primary payor in accordance with Chapter 8 of the
Medicaid Provider Manual to the emergency medical transport
provider in the preceding fiscal quarter multiplied by the
transport enhancement rate. The total emergency medical
transport enhancement to all providers shall not be greater
than the assessment pool.
(c) For each fiscal quarter, the Alabama Medicaid
Agency shall establish the transport enhancement rate based on
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Agency shall establish the transport enhancement rate based on
the difference between the Medicaid rate for each emergency
medical transport and the average rate paid by commercial
insurers."
Section 2. This act shall become effective on October
1, 2026.
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