202 Ky. Admin. Regs. 7:575

Current through Register Vol. 51, No. 5, November 1, 2024

Section 202 KAR 7:575 - Fee schedules of licensed ambulance providers

RELATES TO: KRS 311A.010, 311A.032, 61.870-61.884

NECESSITY, FUNCTION, AND CONFORMITY: KRS 311A.032 requires the Kentucky Board of Emergency Medical Services to promulgate administrative regulations concerning the posting of fee schedules of licensed ambulance providers. This administrative regulation establishes standards and criteria governing the mandatory posting of fees, modification of fee schedules, reporting requirements, public posting requirements, and penalties for nonconformity.

Section 1. Fee Schedule Disclosure.

(1) Licensed Ground and Air Ambulance Services, and Medical First Response agencies shall provide a comprehensive fee schedule consistent with KRS 311A.032.

(2) The fee schedule shall be consistent with the Healthcare Common Procedure Coding System (HCPCS). Itemized charges shall be reflected for each of the following:

(a) A0428- Ambulance service, BLS, non-emergency transport;

(b) A0429- Ambulance service, BLS, emergency transport;

(c) A0426- Ambulance service, ALS1, non-emergency transport;

(d) A0427- Ambulance service, ALS1, emergency transport;

(e) A0430- Ambulance service, conventional air services, transport, one way (fixed wing);

(f) A0431- Ambulance service, conventional air services, transport, one way (rotary wing);

(g) A0433- Advanced life support, level 2 (ALS2);

(h) A0434- Specialty Care Transport (SCT);

(i) A0425- Ground mileage, per statute mile;

(j) A0436- Rotary Wing Air Mileage, per statute mile;

(k) A0435- Fixed Wing Air Mileage, per statute mile; and

(l) Other charges.

Section 2. Posting Requirements. Licensed Ground and Air Ambulance Services, and Medical First Response agencies shall post fee schedules as established in KRS 311A.032(1)(a).

Section 3. Reporting Requirements.

(1) Licensed Ground and Air Ambulance Services, and Medical First Response agencies shall submit:

(a) An initial fee schedule to the Kentucky Board of Emergency Medical Services through an electronic Application for Initial Fee Schedule in the agency KEMSIS account; and

(b) An annual fee schedule to the Kentucky Board of Emergency Medical Services at the time of agency licensure renewal with the electronic Renewal and Inspection Application for Class I, II, III, IV, VII, and VIII Agencies, and the Renewal and Inspection Application for Class VI Agencies.

(2) Fee schedules that are modified shall be updated and posted as established in KRS 311A.032, and an electronic Application for Ambulance Fee Schedule Modification shall be submitted to the Kentucky Board of Emergency Medical Services within fifteen (15) days of fee schedule modification.

Section 4. Accountability and Oversight.

(1) Posting provisions as required by KRS 311A.032(1)(a) shall be evaluated by staff of the Kentucky Board of Emergency Medical Services at least annually as part of the agency annual inspection.

(2) Unannounced inspections may be conducted for a:

(a) Verification of posting requirements;

(b) Complaint allegation;

(c) Follow-up visit; or

(d) Relicensing inspection.

(3) The Kentucky Board of Emergency Medical Services shall:

(a) Assess a licensed ambulance agency a monetary penalty of $150 as required by KRS 311A.032(2)(a) and Sections 2 and 3 of this administrative regulation; and

(b) Issue a statement of violation consistent with 202 KAR 7:501.

Section 5. Incorporation by Reference.

(1) The following material is incorporated by reference:

(a) "Application for Initial Fee Schedule", April 2019;

(b) "Application for Ambulance Fee Schedule Modification", April 2019;

(c) "Renewal and Inspection Application for Class I, II, III, IV, and VII Agencies", April 2019; and

(d) "Renewal and Inspection Application for Class VI Agencies", April 2019.

(2) This material may be inspected, copied, or obtained, subject to applicable copyright law, at the Kentucky Board of Emergency Medical Services, 118 James Court, Suite 50, Lexington, Kentucky 40505, Monday through Friday, 8:30 a.m. to 4:30 p.m.

202 KAR 7:575

45 Ky.R. 2805, 3408; eff. 7-5-2019.

STATUTORY AUTHORITY: KRS 311A.032