Ambulance Service Provider Assessment

Utah Code tit. 26B, ch. 26B-3, pt. 26B-3-P8

in effect

Utah Code § 26B-3-801 Definitions.

26B-3-801. Definitions. As used in this part: (1) "Ambulance service provider" means: (a) an ambulance provider as defined in Section 26B-4-101; or (b) a non-911 service provider as defined in Section 26B-4-101. (2) "Assessment" means the Medicaid ambulance service provider assessment established by this part. (3) "Division" means the Division of Integrated Healthcare within the department. (4) "Non-federal portion" means the non-federal share the division needs to seed amounts that will support fee-for-service ambulance service provider rates, as described in Section 26B-3-804. (5) "Total transports" means the number of total ambulance transports applicable to a given fiscal year, as determined under Subsection 26B-3-803(5). Renumbered and Amended by Chapter 306, 2023 General Session

Utah Code § 26B-3-802 Assessment, collection, and payment of ambulance service provider assessment.

26B-3-802. Assessment, collection, and payment of ambulance service provider assessment. (1) An ambulance service provider shall pay an assessment to the division: (a) in the amount designated in Section 26B-3-803; (b) in accordance with this part; (c) quarterly, on a day determined by the division by rule made under Subsection (2)(b); and (d) no more than 15 business days after the day on which the division issues the ambulance service provider notice of the assessment. (2) The division shall: (a) collect the assessment described in Subsection (1); (b) determine, by rule made in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, standards and procedures for implementing and enforcing the provisions of this part; and (c) transfer assessment proceeds to the state treasurer for deposit into the Ambulance Service Provider Assessment Expendable Revenue Fund created in Section 26B-1-317. Renumbered and Amended by Chapter 306, 2023 General Session

Utah Code § 26B-3-803 Calculation of assessment.

26B-3-803. Calculation of assessment. (1) The division shall calculate a uniform assessment per transport as described in this section. (2) The assessment due from a given ambulance service provider equals the non-federal portion divided by total transports, multiplied by the number of transports for the ambulance service provider. (3) The division shall apply any quarterly changes to the assessment rate, calculated as described in Subsection (2), uniformly to all assessed ambulance service providers. (4) The assessment may not generate more than the total of: (a) an annual amount of $20,000 to offset Medicaid administration expenses; and (b) the non-federal portion. (5) (a) For each state fiscal year, the division shall calculate total transports using ambulance service provider transports data from the Emergency Medical System for the calendar year ending 18 months before the end of the fiscal year. (b) If an ambulance service provider fails to submit transport information to the Emergency Medical System, the division may audit the ambulance service provider to determine the ambulance service provider's transports for a given fiscal year. Amended by Chapter 284, 2024 General Session

Utah Code § 26B-3-804 Medicaid ambulance service provider adjustment under fee-for-service rates.

26B-3-804. Medicaid ambulance service provider adjustment under fee-for-service rates. (1) Subject to Subsection (2), the division shall, if the assessment imposed by this part is approved by the Centers for Medicare and Medicaid Services, for fee-for-service rates effective on or after July 1, 2015, reimburse an ambulance service provider in an amount up to the Emergency Medical Services Ambulance Rates adopted annually by the Department of Public Safety under Section 53-2d-503. (2) Beginning July 1, 2026, the department shall pay a reimbursement rate for services described in Subsection (1) that is equal to the highest reimbursement rate allowed by the assessment imposed by this part. Amended by Chapter 468, 2026 General Session

Utah Code § 26B-3-805 Penalties.

26B-3-805. Penalties. The division shall require an ambulance service provider that fails to pay an assessment due under this part to pay the division, in addition to the assessment, a penalty determined by the division by rule made in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act. Renumbered and Amended by Chapter 306, 2023 General Session

Utah Code § 26B-3-806 Repeal of assessment.

26B-3-806. Repeal of assessment. (1) This part is repealed when, as certified by the executive director of the department, any of the following occurs: (a) an action by Congress that disqualifies the assessment imposed by this part from state Medicaid funds available to be used to determine the federal financial participation takes legal effect; or (b) an action, decision, enactment, or other determination by the Legislature or by any court, officer, department, or agency of the state or federal government takes effect that: (i) disqualifies the assessment from counting toward state Medicaid funds available to be used to determine federal financial participation for Medicaid matching funds; or (ii) creates for any reason a failure of the state to use the assessments for the Medicaid program as described in this part. (2) If this part is repealed under Subsection (1): (a) money in the Ambulance Service Provider Assessment Expendable Revenue Fund that was derived from assessments imposed by this part, deposited before the determination made under Subsection (1), shall be disbursed under Section 26B-1-317 to the extent federal matching is not reduced due to the impermissibility of the assessments; and (b) any funds remaining in the special revenue fund shall be refunded to each ambulance service provider in proportion to the amount paid by the ambulance service provider. Renumbered and Amended by Chapter 306, 2023 General Session

Source: Utah Office of Legislative Research and General Counsel (le.utah.gov)URL: https://le.utah.gov/xcode/Title26B/Chapter3/26B-3-P8.html?v=C26B-3-P8_2023050320230503Fetched: 10/26/2026