In accordance with the public notice requirements of 42 CFR 447.205 and Section 1902(a)(13)(A) of the Social Security Act, the Indiana Family and Social Services Administration (FSSA), the Office of Medicaid Policy and Planning (the "office") publishes this notice of significant changes to the Medicaid reimbursement methodology for governmental ambulance services.

Beginning on January 1, 2011, the office shall change the payment methodology for instate governmental ambulance services providers to make supplemental payments for the difference between Medicaid reimbursement for services and the costs of providing such services. In order to receive the payments, instate governmental ambulance services providers will be required to certify their expenditures as eligible for federal financial participation through a cost-based methodology. The office estimates an annual increase in federal expenditures of $6,000,000, and no impact on state expenditures, due to the change in methodology.

The purpose of this change in methodology is to provide governmental ambulance providers with supplemental Medicaid payments to ensure access to ambulance services for Medicaid patients. The payment adjustment is subject to the approval of the Centers for Medicare and Medicaid Services, with a proposed effective date of January 1, 2011.

A copy of this notice is now on file at the Indiana Government Center South, 402 West Washington Street, Room W451, Indianapolis, Indiana and open for public inspection. Also, a copy of this notice is now available and may be inspected by contacting the local county division of family resources office, except in Marion County, where public inspection may be made at the Office of Medicaid Policy and Planning, 402 West Washington Street, Room W374, Indianapolis, IN.

Anyone who wishes to comment on the proposed changes may submit written comments to: IFSSA, Office of Medicaid Policy and Planning, Attention: David Garner, 402 West Washington Street, Room W374, P.O. Box 7083, Indianapolis, IN 46207-7083. Correspondence should be identified in the following manner: COMMENT RE: GOVERNMENTAL AMBULANCE SERVICES SUPPLEMENTAL PAYMENTS. Written comments received will be made available for public display at the address herein of the office.

Michael A. Gargano

Secretary

Office of the Secretary of Family and Social Services