Agenda - Council - 02/08/2021 - Laserfiche WebLink

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Response: Include in Minn. Stat. § 471.59 (the joint powers statute) language substantially similar to Minn. Stat. § 626.93 that clarifies that Indian tribes entering into joint powers relationships agree to: a) Be subject to liability for its torts and those of its officers, employees, and agents acting within the scope of their employment or duties arising out of the joint powers agreement to the same extent as a municipality under Minn. Stat. ch. 466; and b) Notwithstanding Minn. Stat. § 16C.05, subd. 7, waive its sovereign immunity with respect to claims arising from liability under the joint powers. SD-14. Ambulance Service Costs and Liability Issue: The cost of providing ambulance care has increased steadily over the last several years due in part to changes in Medicare and Medicaid reimbursement. The federal Balanced Budget Act (BBA) of 1997 made two significant changes to ambulance billing. First, the act mandated that all ambulance services accept Medicare and Medicaid assignments as payment in full; that is, ambulance services cannot bill the Medicare or Medicaid patient for any unpaid balance beyond the Medicare or Medicaid assignment. Second, the act mandated a uniform fee schedule that was implemented in April 2002. The new fee schedule significantly reduced reimbursement levels for many ambulance services. The BBA mandates are impacting the ability of some Minnesota ambulance service providers to adequately fund their operations. The loss of revenue due to Medicare and Medicaid reimbursement changes, coupled with higher insurance rates, is affecting the 22 ability of many non -government -based ambulance service providers to deliver emergency care, particularly in rural Minnesota. All ambulance services and personnel are regulated by Minn. Stat. ch. 144E and must comply with the same licensing, training, and equipment -related requirements, regardless of ownership. In addition, the liability exposure of medical directors associated with ambulance service is a concern. While medical directors of government -based ambulance services may arguably be covered by public official immunity, the law is unclear and should be clarified. Response: The League of Minnesota Cities supports federal legislation that would: a) Require Medicare to set ambulance payment rates at the "regional cost" of providing service; b) Require adequate reimbursement for ambulance providers; c) Establish a "prudent layperson" standard for the payment of emergency ambulance claims such that if a reasonable person believed an emergency medical problem existed when the ambulance was requested, Medicare would pay the claim; d) Make it easier for providers to file claims with Medicare by eliminating a processing system that often leads to the rejection of legitimate reimbursement claims. The League also urges the Legislature to extend the protection of the state and municipal Tort Claims Act to licensed third parties that contract with a municipality to provide ambulance services. The League also supports extending the applicability of public