CMS Releases Data Regarding Medicare Payment to Providers
APR 11 2014
The national news media is buzzing about new Medicare payment data just released by the Centers for Medicare & Medicaid Services (CMS). These data, which were released following the removal of a court injunction, provide extensive information on payments made to specific ambulance services, including the numbers of transports, the number of Medicare beneficiaries they serve, the amounts they were paid and other detailed data. CMS also released aggregate data regarding all ground and air ambulance claims and payment information nationally.
FAA Final Rule Creates Stricter Safety and Equipment Regulations for Helicopter Air Ambulance Operat
APR 10 2014
New rules from the Federal Aviation Administration (FAA) will have a significant impact on helicopter air ambulance services. These regulations implement new operational procedures and require additional equipment for helicopter air ambulances in response to an increase in fatal helicopter air ambulance accidents. The new rules identify four common factors in those accidents- inadvertent flight into Instrument Meteorological Conditions, loss of control, controlled flight into terrain, and night conditions.
Under Proposed ACA Regulations Volunteers Could be “Employees”
DEC 13 2013
The Affordable Care Act (ACA) is aimed at getting tens of millions of uninsured Americans into the health insurance marketplace, and there are a number of ways the law goes about doing that. One major initiative, the “employer mandate,” requires employers with at least 50 full-time employees (including full-time equivalent employees) to offer health insurance to all employees that work at least 30 hours per week and their dependents. Employees that work at least 30 hours per week are considered to be full-time employees under the ACA. When the ACA was signed into law back in 2010, many assumed that an “employee” was someone who was being paid for work, not a volunteer.
New OIG Advisory Opinion Allows No Bills for Municipal Residents, But Bills for Non-Residents
JUL 09 2013
On July 9, the OIG posted Advisory Opinion 13-08, concerning a Fire Protection District ("District") policy of only billing individuals that reside outside the fire protection district for emergency medical services. Here, the District does not bill any residents or their insurers (including federal health care programs) for emergency medical services. But it does bill all non-residents (including federal health care programs) for emergency medical service under a fee schedule established by referendum.
Proposed Rule to Eliminate Ambulance Backbilling and Enhance Fraud Prevention
MAY 13 2013
CMS issued a Proposed Rule that would limit ambulance providers' ability to "backbill" Medicare for certain services and enhance some the other "fraud-fighting" Medicare regulations. It's not too late to register for an abc3 conference this spring, where we'll tackle the proposed changes and discuss how CMS is taking a cue from the IRS by increasing fraud reporting incentives.