EMS Law Library Archive

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New Notice to Employees Required October 1st by the Affordable Care Act

Department of Labor Had Postponed Deadline to October 1, 2013

The United States Department of Labor has postponed until October 1, 2013, a requirement originally slated to go into effect on March 1, 2013, that employers subject to the Fair Labor Standards Act (FLSA) provide certain notices to their employees regarding health insurance exchanges established under the Affordable Care Act (ACA).
The ACA amended the FLSA by adding a section providing that no later than March 1, 2013, in accordance with regulations promulgated by...

All Medicare Contractors Must Soon Process Codes for Non-Covered Services

Starting January 1, 2012, Medicare contractors will have to accept and process claims for services such as wheelchair van transports, treatment without transport, and other ambulance services that are not covered by Medicare.  Please note that this does not require Medicare to pay for these non-covered services, it merely requires that they process claims with non-covered service codes to facilitate coordination of benefits or payments by secondary insurers.  Ambulance...

CMS Publishes New Fraud and Abuse Measures

Significant Impact on Ambulance Services

On February 2, 2011 the Centers for Medicare and Medicaid Services (CMS) published a Final Rule that drastically enhances the government’s ability to crack down on fraud and abuse in federal healthcare programs. For the ambulance industry, this means increased compliance obligations and more scrutiny from federal and state investigators. 
Below is an overview of the pertinent provisions of the Final Rule.
The Final Rule establishes new...

Important New OIG Advisory Opinion Issued

OIG Reaffirms Position on Discounting Ambulance Rates to SNFs

On December 28, 2010 the Office of the Inspector General issued a key Advisory Opinion for the ambulance industry, reaffirming its stance that offering discounted rates to skilled nursing facilities (SNFs) could violate the Federal anti-kickback statute (AKS). The OIG held that a prospective arrangement, where an ambulance service provider wanted to offer SNFs “below-cost” rates for Medicaid transport services, could be seen as illegally offering something of...

CMS Publishes Final Rule on Fractional Mileage

On November 29, 2010, the Centers for Medicare and Medicaid Services (CMS) published in the Federal Register the official Final Rule that will implement changes to many Medicare Part B payment policies, including the Ambulance Fee Schedule (AFS).   The published version of the Final Rule mirrors the advance copy obtained by PWW on November 2nd.  


Retroactive Payment for Ambulance Services

CMS Announces Plan for Retroactive Bonus Payments

Ambulance services should have received the long awaited retroactive “bonus” payments that were implemented by the Affordable Care Act (ACA) in March 2010.  The Centers for Medicare and Medicaid Services (CMS) announced that it will begin to reprocess affected claims from the first half of 2010.  ...

CMS Changes Stance Regarding Coverage of Transportation Services Under Certain State Medicaid Plans

Ambulance services have a reason to breathe a little easier today because CMS has backed off on a Final Rule that would have allowed states to amend their “benchmark” and “benchmark equivalent” Medicaid plans to exclude coverage of non-emergency transportation. A revised Final Rule, issued April 30, 2010, now expressly requires states to assure necessary transportation to and from providers for all beneficiaries enrolled in benchmark or benchmark-equivalent Medicaid plans.  ...