{"data":{"id":"us-ok/okla.-stat.-tit.-63-63-3242","jurisdiction":"us-ok","citation":"Okla. Stat. tit. 63, § 63-3242","heading":"Supplemental Medicaid reimbursement for ground emergency","body":"transportation.\n\nA. An eligible provider, as described in subsection B of this\n\nsection, in addition to the rate of payment that the provider would\n\notherwise receive for Medicaid ground emergency medical\n\ntransportation services, shall receive supplemental Medicaid\n\nreimbursement to the extent provided by law.\n\nB. A provider shall be eligible for supplemental reimbursement\n\nonly if the provider meets the following conditions during the state\n\nfiscal year:\n\n1. Provides ground emergency medical transportation services to\n\nMedicaid beneficiaries;\n\n2. Is a provider that is enrolled as a Medicaid provider for\n\nthe period being claimed; and\n\n3. Is owned or operated by the state, a political subdivision\n\nor local government, that employs or contracts with persons who are\n\nlicensed to provide emergency medical services in this state, and\n\nincludes private entities to the extent permissible under federal\n\nlaw.\n\nC. An eligible provider’s supplemental reimbursement pursuant\n\nto this section shall be calculated and paid as follows:\n\n1. a. for services reimbursed through fee-for-service\n\ncontracts, the amount of federal financial\n\nparticipation received because of the claims submitted\n\npursuant to paragraph 3 of subsection F of this\n\nsection, and\n\nb. for services reimbursed through capitated contracts,\n\nan amount to be determined in accordance with the\n\napproved directed payment pre-print, based on claims\n\nsubmitted pursuant to paragraph 3 of subsection F of\n\nthis section;\n\n2. In no instance shall the amount certified pursuant to\n\nparagraph 1 of subsection E of this section, when combined with the\n\namount received from all other sources of reimbursement from the\n\nMedicaid program, exceed one hundred percent (100%) of actual costs,\n\nas determined pursuant to the Medicaid state plan, for ground\n\nemergency medical transportation services; and\n\n3. The supplemental Medicaid reimbursement provided by this\n\nsection shall be distributed exclusively to eligible providers under\n\na payment methodology based on ground emergency medical\n\ntransportation services provided to Medicaid beneficiaries by\n\neligible providers on a per-transport basis or other federally\n\npermissible basis. The Oklahoma Health Care Authority shall obtain\n\napproval from the Centers for Medicare and Medicaid Services for the\n\npayment methodology to be utilized, and shall not make any payment\n\npursuant to this section prior to obtaining that approval.\n\nD. 1. It is the Legislature’s intent in enacting this section\n\nto provide the supplemental reimbursement described in this section\n\nwithout any expenditure from the state General Revenue Fund. An\n\neligible provider, as a condition of receiving supplemental\n\nreimbursement pursuant to this section, shall enter into, and\n\nmaintain, an agreement with the Authority for the purposes of\n\nimplementing this section and reimbursing the state for the costs of\n\nadministering this section.\n\n2. The nonfederal share of the supplemental reimbursement\n\nsubmitted to the federal Centers for Medicare and Medicaid Services\n\nfor purposes of claiming federal financial participation shall be\n\npaid only with funds from the governmental entities described in\n\nparagraph 3 of subsection B of this section and certified to the\n\nstate as provided in subsection E of this section.\n\nE. Participation in the reimbursement program provided by this\n\nsection by an eligible provider as set forth in subsection B of this\n\nsection is voluntary. If an applicable governmental entity elects\n\nto seek supplemental reimbursement pursuant to this section on\n\nbehalf of an eligible provider, the governmental entity shall do the\n\nfollowing:\n\n1. a. certify, in conformity with the requirements of 42\n\nC.F.R., Section 433.51, that the claimed expenditures\n\nfor the ground emergency medical transportation\n\nservices are eligible for federal financial\n- Title 63. Public Health and Safety Page 1560\n\nto seek supplemental reimbursement pursuant to this section on\n\nbehalf of an eligible provider, the governmental entity shall do the\n\nfollowing:\n\n1. a. certify, in conformity with the requirements of 42\n\nC.F.R., Section 433.51, that the claimed expenditures\n\nfor the ground emergency medical transportation\n\nservices are eligible for federal financial\n\nparticipation,\n\nb. provide evidence supporting the certification as\n\nspecified by the Oklahoma Health Care Authority,\n\nc. submit data as specified by the Authority to determine\n\nthe appropriate amounts to claim as expenditures\n\nqualifying for federal financial participation, and\n\nd. keep, maintain, and have readily retrievable any\n\nrecords specified by the Authority to fully disclose\n\nreimbursement amounts to which the eligible provider\n\nis entitled, and any other records required by the\n\nCenters for Medicare and Medicaid Services; or\n\n2. Enter into and maintain an intergovernmental agreement with\n\nthe Authority, as specified by the Authority.\n\nF. 1. The Authority shall promptly seek any necessary federal\n\napprovals for the implementation of this section. The Authority may\n\nlimit the program to those costs that are allowable expenditures\n\nunder Title XIX of the Social Security Act, 42 U.S.C., Section 1396\n\net seq. If federal approval is not obtained for implementation of\n\nthis section, this section shall not be implemented.\n\n2. The Authority shall submit claims for federal financial\n\nparticipation for the expenditures for the services delineated in\n\nsubsection E of this section that are allowable expenditures under\n\nfederal law.\n\n3. The Authority shall submit any necessary materials to the\n\nfederal government to provide assurances that claims for federal\n\nfinancial participation will include only those expenditures that\n\nare allowable under federal law.","path":["OK Code","Title 63"],"source_url":"https://www.oklegislature.gov/OK_Statutes/CompleteTitles/os63.pdf","current_through":"2026-08-14","vintage":"open-us-law v2026.08, retrieved 2026-09-14","retrieved_at":"2026-09-14T18:32:36Z","sha256":"23a69d76ed1a1ae8e59b80d137325a9cfd9f97e719edfefe9211726b318a3c8e","source_id":"us-ok","stale":false,"prev":"us-ok/okla.-stat.-tit.-63-63-3241.6","next":"us-ok/okla.-stat.-tit.-63-63-3242.1"},"notice":"GroundRules: Original legal text. Not legal advice."}