OIG Advisory Opinion 00-11
Charitable Contribution by Hospital to EMS
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The PWW Executive Institute (“XI”) is a high-level and intensive all-day workshop for EMS leaders, chiefs, HR managers, privacy officers, compliance professionals and others who want to see the Big Picture to identify critical industry trends.
EEOC Issues Sweeping New Pregnancy Discrimination Enforcement Guidance
On July 14, 2014, the U.S. Equal Employment Opportunity Commission (EEOC) issued new and controversial Enforcement Guidance on the subject of pregnancy discrimination. The text of the EEOC’s Enforcement Guidance is available at: http://www.eeoc.gov/laws/guidance/pregnancy_guidance.cfm. This sweeping new Guidance, the first guidance for employers on the subject issued by the EEOC since...
2015 Ambulance Inflation Factor Updated
AIF Will be 1.5% in 2015
Medicare reimbursement rates for ambulance services will increase by 1.5% in calendar year 2015. On October 7, 2014, CMS issued Transmittal 3090, revising the Ambulance Inflation Factor for calendar year 2015. CMS previously said the Inflation Factor would be 1.4%.
Each year, CMS updates the Medicare ambulance reimbursement rates to reflect increases in inflation. CMS calls this...
OIG Proposes Safe Harbor for Cost-Sharing Waivers for Emergency Ambulance Services
On October 3, 2014 the Office of the Inspector General is set to publish a Proposed Rule that would establish a new safe harbor under the Anti-Kickback Statute (AKS) that would permit waivers of cost-sharing amounts for emergency ambulance services furnished by State or municipally-owned ambulance providers and suppliers. But, there are conditions that must be met in...
PWW Summary of Final 2015 Ambulance Fee Schedule Rule
Many ZIP Codes Going From Rural to Urban
On November 13, 2014, the Centers for Medicare and Medicaid Services (CMS) issued a Final Rule that updates regulations to account for the ambulance bonuses and changes many ZIP code designations for purposes of Medicare reimbursement. The Rule, “Medicare Program; Revisions to Payment...
CMS Issues Notice About Prior Authorization Model in PA, NJ and SC
Requests Can Start on December 1, 2014
On November 13, 2014, CMS issued a Notice in the Federal Register officially announcing a 3-year Medicare Prior Authorization model for repetitive scheduled non-emergent ambulance transports in the states of New Jersey, Pennsylvania, and South Carolina. The new model means that certain ambulance services in these three states must soon obtain prior authorization for repetitive, scheduled non-emergent transports by submitting a host of documentation to their Medicare Administrative...
CMS Finalizes New Fraud Safeguards Including Ambulance Backbilling
#000000;">The Centers for Medicare & Medicaid Services (CMS) just issued a #0000CD;">Final Rule#000000;"> intended to improve CMS’s ability to deny or revoke the enrollment of entities and individuals that pose an integrity risk to the Medicare program. This Rule would also significantly limit ambulance suppliers' ability to...
What is PWW XI?
PWW HIPAA Update
3 Things You Must Know for 2015
The new HIPAA regulations are here and providers are being hit with million dollar settlements as the government gears up for its biggest round of HIPAA audits in 2015. The big question is, are you ready? Recent HIPAA settlements reveal that simply updating your Notice of Privacy Practices (NPP) and business associate agreements (BAA) isn’t going to cut it.