The Conference Committee on House Bill 1012 voted 6-0 to adopt the Senate position to increase Medicaid rebasing for ambulance services by a total of $2,000,000 — $1,000,000 from the general fund and $1,000,000 in federal funds.

Senator Davidson moved the Senate position, which Representative O'Brien seconded. Chairman Nelson called the roll; the secretary recorded the vote, and the committee announced the motion passed 6-0.

Lawmakers debated whether rebasing ambulance Medicaid rates was the right priority. Senator Cleary argued North Dakota Medicaid rates are comparatively strong and questioned prioritizing this rebasing when other services lag. "If you look at the North Dakota rates on Medicaid, across the board, you'll find that we're in a very strong position compared to other states," Cleary said.

Sarah Acre, executive director of the Division of Medical Services at the North Dakota Department of Health and Human Services, explained the proposal would move Medicaid reimbursement toward the highest rural Medicare quartile; she noted that the bill addressing out-of-network ambulance insurer payments (House Bill 1322) does not apply to Medicaid. "1322 does not apply to Medicaid. That's why there's not a fiscal note for Medicaid in it," Acre said, adding Medicaid already reimburses higher than urban Medicare rates in some cases.

Supporters emphasized pressures on rural ambulance services and the difficulty recruiting and retaining personnel. "We're losing rural ambulance services, across the board," one rural member said; committee members cited workforce shortages and the public-safety implications for dispersed communities.

Recorded votes: Chairman Nelson — yes; Representative O'Brien — yes; Representative Mitscog — yes; Chairman Deaver — yes; Senator Cleary — yes; Senator Davidson — aye. The secretary announced, "That motion passes 6 0."