Today, the Centers for Medicare & Medicaid Services (CMS) published Notice in the Federal Register announcing a six-month extension of the moratoria on the enrollment of Medicare Part B non-emergency ground ambulance suppliers in New Jersey and Pennsylvania.
This is not an expansion, only a continuation of the existing moratoria. The moratoriium does not apply to provider-based Medicare ambulances, which are owned and/or operated by a Medicare provider (or furnished under arrangement with a provider) such as a hospital, critical access hospital, skilled nursing facility, comprehensive outpatient rehabilitation facility, home health agency, or hospice program, and are not required to enroll separately as a supplier in Medicare Part B.
Under the Affordable Care Act, CMS can impose temporary moratoria on the enrollment of new Medicare providers and suppliers if the agency believes that a moratorium is necessary to combat fraud, waste or abuse.
Ambulance Moratoria Timeline
- February 4, 2013 through August 2, 2016:
- Moratoria in effect for ALL Medicare Part B (emergency and non-emergency) ground ambulance suppliers in Houston, TX and Philadelphia, PA, including the surrounding counties of those cities.
- August 3, 2016:
- CMS lifted the moratoria for ALL emergency ambulance suppliers.
- But, CMS expanded the enrollment moratoria on Part B non-emergency ambulance suppliers statewide in New Jersey, Pennsylvania, and Texas.
- September 1, 2017:
- CMS lifted the moratorium on the enrollment of new Part B non-emergency ambulance suppliers in Texas only, in response to a need created by Hurricane Harvey. The moratoria in New Jersey and Pennsylvania remained in effect, and was extended several times.
Where Are We Today?
Currently, there are moratoria in effect for newly enrolling Part B non-emergency ground ambulance suppliers statewide in New Jersey and Pennsylvania. These moratoria will remain in place at least until January 29, 2019, unless CMS takes action.
Will This Change, and is Your Area Next?
CMS could reinstate the statewide non-emergency moratorium in Texas and even expand the moratoria to other areas if it determines that action is necessary to combat fraud and abuse. Find out if you’re in a fraud “hotbed” at abc360 where we'll be covering the latest news in Medicare compliance. Registration is now open for all four 2018 - 2019 locations.