Michael Brady October 28, 2019
The CMS wants to expand prior
authorization for non-emergency ambulance transportation nationwide and on
Friday requested ambulance services for information that could help achieve
that goal.
The agency has been testing prior
authorization for repetitive, scheduled, non-emergency ambulance transportation
for its Medicare beneficiaries in several states since 2014.
In a notice, the CMS said it will
collect information from ambulance providers on how many and what type of transportation
services are necessary. Prior authorization would require providers to hand
over all medical records associated with ambulance services.
The agency would freeze payments
for review and approval if the ambulance supplier doesn't submit a prior
authorization request after four round trips during a 30-day period.
The CMS has been testing whether
prior authorization cuts healthcare spending by curbing Medicare-covered
ambulance transportation. The program's early results show substantial declines
in utilization and spending during the first year of implementation.
The agency announced in September
that it's extending the trial for another year in Delaware, the District of
Columbia, Maryland, New Jersey, North Carolina, Pennsylvania, South Carolina,
Virginia and West Virginia.
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