Definitions

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As used in this subchapter:

  1. (1) “Air ambulance services” means services authorized and licensed by the Department of Health to provide care and air transportation of patients;

  2. (2) “Ambulance services” means services authorized and licensed by the department to provide care and transportation of patients upon the streets and highways of Arkansas;

  3. (3) “Emergency medical services” means:

    1. (A) The transportation and medical care provided an ill or injured person before arrival at a medical facility by licensed emergency medical services personnel or other healthcare provider;

    2. (B) Continuation of the initial emergency care within a medical facility subject to the approval of the medical staff and governing board of that facility; and

    3. (C) Integrated medical care in emergency and nonurgent settings with the oversight of a physician;

  4. (4)

    1. (A) “Medical transportation” means emergency medical services provided through ambulance services and air ambulance services.

    2. (B) “Medical transportation” does not include nonemergency ambulance services;

  5. (5) “Medical transportation provider” means a licensed provider of medical transportation;

  6. (6) “Net operating revenue” means the gross revenues earned for providing medical transportation in Arkansas, excluding amounts refunded to or recouped, offset, or otherwise deducted by a patient or payer for medical transportation;

  7. (7)

    1. (A) “Nonemergency ambulance services” means the transport in a motor vehicle to or from medical facilities, including without limitation hospitals, nursing homes, physicians' offices, and other healthcare facilities of persons who are ill or injured and who are transported in a reclining position.

    2. (B) “Nonemergency ambulance services” does not include transportation provided by licensed hospitals that own and operate the ambulance for their own admitted patients;

  8. (8) “Specialty-hospital-based ambulance services” means ambulance services provided by an acute care general hospital that limits healthcare services primarily to children and qualifies as exempt from the Medicare prospective payment system regulation;

  9. (9) “Upper payment limit” means the lesser of the customary charges of the medical transportation provider or the prevailing charges in the locality of the medical transportation provider for comparable services under comparable circumstances, calculated according to methodology in an approved state plan amendment for the Arkansas Medicaid Program; and

  10. (10)

    1. (A) “Upper payment limit gap” means the difference between the upper payment limit of the medical transportation provider and the Medicaid payments not financed using medical transportation assessment made to all medical transportation providers.

    2. (B) “Upper payment limit gap” is calculated separately for ambulance services and air ambulance services.


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