SF 3011

Introduction - 94th Legislature (2025 - 2026)

Posted on 03/28/2025 09:41 a.m.

A bill for an act
relating to human services; establishing an ambulance provider assessment program;
providing supplemental medical assistance payments for ambulance services;
exempting certain ambulance services from the MinnesotaCare provider tax;
requiring report; appropriating money; amending Minnesota Statutes 2024, sections
295.50, subdivision 4; 295.52, by adding a subdivision; proposing coding for new
law in Minnesota Statutes, chapter 256B; repealing Minnesota Statutes 2024,
section 295.52, subdivision 5.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

new text begin [256B.1951] AMBULANCE ASSESSMENT AND PAYMENT PROGRAM.
new text end

new text begin Subdivision 1. new text end

new text begin Definitions. new text end

new text begin (a) For purposes of this section, the following definitions
apply.
new text end

new text begin (b) "Ambulance provider" means an ambulance service licensed under chapter 144E,
with the exception of:
new text end

new text begin (1) ambulance services operated by a public or governmental entity, including but not
limited to a municipal fire department or police department; and
new text end

new text begin (2) ambulance services that exclusively provide air ambulance services.
new text end

new text begin (c) "Emergency ambulance services" means any services delivered by an ambulance
provider other than air ambulance services.
new text end

new text begin (d) "Fee" means the ambulance service assessment fee authorized by this section.
new text end

new text begin (e) "Gross revenues" has the meaning provided in section 295.50, subdivision 3.
new text end

new text begin Subd. 2. new text end

new text begin Ambulance provider assessment fee. new text end

new text begin (a) The commissioner, on a quarterly
basis, shall charge every ambulance provider an ambulance service assessment fee. The
commissioner shall implement the fee as a health care related tax as defined under United
States Code, title 42, section 1396b(w)(3)(A), and the commissioner shall collect the fee
only to the extent and for the periods that the commissioner determines that revenues
generated by the fee qualify as the state share of medical assistance expenditures eligible
for federal financial participation. The commissioner shall assess the fee on each ambulance
provider's gross revenues at a rate determined annually by the commissioner. The
commissioner shall calculate the rate such that the assessment generates the state share
necessary to fund the expenditures described in subdivision 4, provided that the fee must
not exceed the maximum percentage specified under Code of Federal Regulations, title 42,
section 433.68(f)(3)(i)(A). The commissioner shall establish each provider's fee amount
using the best data available, as determined by the commissioner in consultation with the
Minnesota Ambulance Association, and shall update each ambulance provider's fee at least
annually.
new text end

new text begin (b) All gross revenues received for emergency ambulance services, regardless of payer,
are subject to the fee, including but not limited to gross revenues received for emergency
ambulance services from commercial insurance and public health care programs under
fee-for-service and managed care arrangements. In the case of a transfer of ownership, an
ambulance provider's liability for the fee must be assumed by the successor in interest to
the ambulance provider.
new text end

new text begin (c) The commissioner of human services shall consult with the commissioner of revenue
when administering this subdivision.
new text end

new text begin Subd. 3. new text end

new text begin Ambulance fee fund. new text end

new text begin (a) The ambulance fee fund is established in the state
treasury. The commissioner of management and budget shall deposit the following revenues
into the fund:
new text end

new text begin (1) all revenues generated from the fee collected under subdivision 2;
new text end

new text begin (2) an amount equal to any federal financial participation revenues received by the state
for eligible expenditures made from the fund;
new text end

new text begin (3) any other appropriations to the fund authorized by law; and
new text end

new text begin (4) interest earned on any money in the fund.
new text end

new text begin (b) Money in the fund is annually appropriated to the commissioner of human services
for the purposes specified in subdivision 4.
new text end

new text begin Subd. 4. new text end

new text begin Expenditures from the ambulance fee fund. new text end

new text begin (a) The commissioner shall use
money in the ambulance fee fund only to provide supplemental payments to ambulance
providers, in order to increase medical assistance payments to ambulance providers to a
level that does not exceed the average commercial insurance rate. The commissioner may
expend money in the fund for this purpose without further legislative authorization. The
commissioner shall not use money in the fund to supplant or replace existing general fund
appropriations and payment commitments.
new text end

new text begin (b) The commissioner shall make expenditures from the fund in a manner consistent
with the requirements and conditions of federal financial participation under United States
Code, title 42, section 1396b(w), and Code of Federal Regulations, title 42, section 433.68,
and consistent with federal payment requirements and payment limits as determined by the
secretary of the United States Department of Health and Human Services. The commissioner
shall expend money in the fund in a manner that maximizes federal financial participation.
new text end

new text begin (c) The commissioner shall make supplemental payments to ambulance providers on a
quarterly basis. The commissioner shall consult with the Minnesota Ambulance Association
in the development and implementation of the payments.
new text end

new text begin (d) Beginning January 1, 2027, and each January 1 thereafter, the commissioner shall
report annually to the chairs and ranking minority members of the legislative committees
with jurisdiction over health care spending and policy on expenditures from the ambulance
fee fund.
new text end

new text begin Subd. 5. new text end

new text begin Rulemaking. new text end

new text begin The commissioner of human services may adopt rules necessary
to accomplish the purposes of this section.
new text end

new text begin Subd. 6. new text end

new text begin Federal approval required. new text end

new text begin (a) The implementation of subdivisions 1 to 5 is
contingent on federal approval. If the Centers for Medicare and Medicaid Services does not
approve of, or withdraws approval of, the payments made to ambulance providers under
this section, all money remaining in the fund must be returned to ambulance providers. If
the commissioner no longer collects the fee, the commissioner shall return all money
remaining in the fund to ambulance providers.
new text end

new text begin (b) The commissioner shall submit to the Centers for Medicare and Medicaid Services
all Medicaid state plan amendments, waiver requests, and other documents required to
implement this section.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin Subdivisions 1 to 5 are effective January 1, 2026, or upon federal
approval, whichever is later. The commissioner of human services shall notify the revisor
of statutes when federal approval is obtained. Subdivision 6 is effective the day following
final enactment.
new text end

Sec. 2.

Minnesota Statutes 2024, section 295.50, subdivision 4, is amended to read:

Subd. 4.

Health care provider.

(a) "Health care provider" means:

(1) a person whose health care occupation is regulated or required to be regulated by
the state of Minnesota furnishing any or all of the following goods or services directly to a
patient or consumer: medical, surgical, optical, visual, dental, hearing, nursing services,
drugs, laboratory, diagnostic or therapeutic services;

(2) a person who provides goods and services not listed in clause (1) that qualify for
reimbursement under the medical assistance program provided under chapter 256B;

(3) a staff model health plan company;

(4) an ambulance service deleted text begin required to be licensed deleted text end new text begin operated by a hospital new text end ;

(5) a person who sells or repairs hearing aids and related equipment or prescription
eyewear; or

(6) a person providing patient services, who does not otherwise meet the definition of
health care provider and is not specifically excluded in clause (b), who employs or contracts
with a health care provider as defined in clauses (1) to (5) to perform, supervise, otherwise
oversee, or consult with regarding patient services.

(b) Health care provider does not include:

(1) hospitals; medical supplies distributors, except as specified under paragraph (a),
clause (5); nursing homes licensed under chapter 144A or licensed in any other jurisdiction;
wholesale drug distributors; pharmacies; surgical centers; bus and taxicab transportation,
or any other providers of transportation services other than ambulance services deleted text begin required to
be licensed deleted text end new text begin operated by a hospital new text end ; supervised living facilities for persons with developmental
disabilities, licensed under Minnesota Rules, parts 4665.0100 to 4665.9900; housing with
services establishments required to be registered under chapter 144D; board and lodging
establishments providing only custodial services that are licensed under chapter 157 and
registered under section 157.17 to provide supportive services or health supervision services;
adult foster homes as defined in Minnesota Rules, part 9555.5105; day training and
habilitation services for adults with developmental disabilities as defined in section 252.41,
subdivision 3; boarding care homes, as defined in Minnesota Rules, part 4655.0100; and
adult day care centers as defined in Minnesota Rules, part 9555.9600;

(2) home health agencies as defined in Minnesota Rules, part 9505.0175, subpart 15; a
person providing personal care services and supervision of personal care services as defined
in Minnesota Rules, part 9505.0335; a person providing home care nursing services as
defined in Minnesota Rules, part 9505.0360; and home care providers required to be licensed
under chapter 144A for home care services provided under chapter 144A;

(3) a person who employs health care providers solely for the purpose of providing
patient services to its employees;

(4) an educational institution that employs health care providers solely for the purpose
of providing patient services to its students if the institution does not receive fee for service
payments or payments for extended coverage; and

(5) a person who receives all payments for patient services from health care providers,
surgical centers, or hospitals for goods and services that are taxable to the paying health
care providers, surgical centers, or hospitals, as provided under section 295.53, subdivision
1, paragraph (b), clause (3) or (4), or from a source of funds that is excluded or exempt from
tax under sections 295.50 to 295.59.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective for gross revenues received on or after
January 1, 2026.
new text end

Sec. 3.

Minnesota Statutes 2024, section 295.52, is amended by adding a subdivision to
read:

new text begin Subd. 5a. new text end

new text begin Ambulance services operated by a hospital. new text end

new text begin An ambulance service operated
by a hospital must pay the tax under this section directly to the commissioner as provided
under section 295.55. Gross revenues from an ambulance service operated by a hospital
must not be included in hospital gross revenues for purposes of payment of the tax.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective for gross revenues received on or after
January 1, 2026.
new text end

Sec. 4. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2024, section 295.52, subdivision 5, new text end new text begin is repealed.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective for gross revenues received on or after
January 1, 2026.
new text end

APPENDIX

Repealed Minnesota Statutes: 25-00868

295.52 TAXES IMPOSED.

Subd. 5.

Volunteer ambulance services.

Volunteer ambulance services are not subject to the tax under this section. For purposes of this requirement, "volunteer ambulance service" means an ambulance service in which all of the individuals whose primary responsibility is direct patient care meet the definition of volunteer under section 144E.001, subdivision 15. The ambulance service may employ administrative and support staff, and remain eligible for this exemption, if the primary responsibility of these staff is not direct patient care.