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for private ground ambulance service providers as set forth in this section.

(b)Each private ground ambulance service provider that…#

(b) Each private ground ambulance service provider that pays assessments under this chapter and meets the eligibility standards set by subsection (c) of this section shall be eligible to receive quarterly adjustment payments as provided in this section. The department shall distribute quarterly adjustment payments in amounts up to but not to exceed the applicable upper payment limit gap. The department shall establish a uniform methodology by which to distribute payments in compliance with applicable federal and state Medicaid laws and regulations.

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Page 126

Official source

for private ground ambulance service providers as set forth in this section.

(b)Each private ground ambulance service provider that…#

(b) Each private ground ambulance service provider that pays assessments under this chapter and meets the eligibility standards set by subsection (c) of this section shall be eligible to receive quarterly adjustment payments as provided in this section. The department shall distribute quarterly adjustment payments in amounts up to but not to exceed the applicable upper payment limit gap. The department shall establish a uniform methodology by which to distribute payments in compliance with applicable federal and state Medicaid laws and regulations.

(c)Unless otherwise prohibited by federal law, only…#

(c) Unless otherwise prohibited by federal law, only private ground ambulance service providers who meet all of the following requirements shall be eligible to receive a quarterly adjustment payment authorized in subsection (b) of this section:

(i)Private ground ambulance service providers who provide…#

(i) Private ground ambulance service providers who provide ground ambulance services to Medicaid beneficiaries;

(ii)Private ground ambulance service providers who provide…#

(ii) Private ground ambulance service providers who provide ground ambulance services to Medicare beneficiaries;

(iii) Private ground ambulance service providers who accept as full payment for ground ambulance services any payments made under Wyoming's worker's compensation system; and

(iv) Private ground ambulance service providers who:

(A) Are network providers for all insurers offering private health benefit plans in this state who maintain not less than a twenty percent (20%) share of the state's individual or small group health insurance market; or

(B) Have made a bonafide and reasonable offer to become a network provider to all of the insurers identified in subparagraph (A) of this paragraph by offering to accept as network provider reimbursement not more than double the Medicaid reimbursement rate for relevant medical services. The offer required by this subparagraph may be higher to the extent the private ground ambulance service provider demonstrates to the department that the actual cost of providing relevant medical services plus six percent (6%) of the actual cost is an amount higher than double the Medicaid reimbursement rate for the relevant medical services.