On April 1, 2019, CMS implemented a new series of Common Working File (CWF) edits that it stated would better identify ground ambulance transports that were furnished in connection with […]

The post New SNF Consolidated Billing Edits: FAQs appeared first on American Ambulance Association.

On April 1, 2019, CMS implemented a new series of Common Working File (CWF) edits that are intended to better identify ground ambulance transports that are furnished in connection with […]

The post New SNF PPS Edits Highlight the Importance of Facility Agreements appeared first on American Ambulance Association.

HHS OIG Issues Advisory Opinion Permitting Community Paramedicine Program Designed to Limit Hospital Readmissions On March 6, 2019, the HHS Office of the Inspector General (OIG) posted OIG Advisory Opinion […]

The post HHS OIG Issues Advisory Opinion on Community Paramedicine appeared first on American Ambulance Association.

The AAA is pleased to release its 2019 State Medicaid Rate Survey. This survey sets forth the fee-for-service Medicaid rates for all 50 states. For each state, the Survey lists […]

The post AAA Releases 2019 State Medicaid Ambulance Rate Survey appeared first on American Ambulance Association.

The post Talking Medicare: CMS Implements Further Dialysis Cuts appeared first on American Ambulance Association.

Talking Medicare: Recent DOJ Settlement Highlights Importance of Exclusion Testing On July 17, 2018, the U.S. Attorney for the District of Maine issued a press release on a settlement that […]

The post Talking Medicare: DOJ Settlement Highlights Importance of Exclusion Testing appeared first on American Ambulance Association.

Talking Medicare: GAO urges CMS to continue prior authorization efforts On May 21, 2018, the Government Accountability Office (GAO) issued a report to the U.S. Senate Finance Committee on the […]

The post Talking Medicare: GAO urges CMS to continue prior authorization appeared first on American Ambulance Association.

The post Talking Medicare: A Good Thing Poorly Explained appeared first on American Ambulance Association.

The post First Interim Evaluation Report on Medicare Prior Authorization appeared first on American Ambulance Association.

The post Talking Medicare: Low Volume Settlement Option appeared first on American Ambulance Association.

Talking Medicare: Navigating a Post-Prior Authorization World Novitas Solutions, Inc. recently announced that it will no longer issue prior authorizations for scheduled, repetitive non-emergency transports, effective December 1, 2017. This […]

The post Navigating a Post-Prior Authorization World appeared first on American Ambulance Association.

A Preliminary Estimate of 2018 Medicare Rates In this blog, I will provide a preliminary estimate of the Ambulance Inflation Factor (AIF) for calendar year 2018.  The AIF is main […]

The post Preliminary Estimate of 2018 Medicare Rates appeared first on American Ambulance Association.

Prior Authorization Data Shows Continued Reduction in Overall Spending on Dialysis Transports; Pendulum Swings Back Slightly in New Jersey and Pennsylvania In May 2014, CMS announced the implementation of a […]

The post Talking Medicare: Prior Authorization Spending Update appeared first on American Ambulance Association.

On June 16, 2017, the Centers for Medicare & Medicaid Services (CMS) released Transmittal 236. This Transmittal makes some minor changes to Chapter 10 of the Medicare Benefit Policy Manual. […]

The post Talking Medicare: CMS Transmittal 236 appeared first on American Ambulance Association.

Over the past few weeks, we have been contacted by a number of ambulance suppliers that have received letters from the HHS Office of the Inspector General (OIG). These letters […]

The post OIG Looking into SNF Consolidated Billing Claims appeared first on American Ambulance Association.

Talking Medicare with Brian S. Werfel, AAA Medicare Consultant Over the past few weeks, we have received emails from ambulance providers across the country reporting that UnitedHealthCare (UHC) has started […]

The post UnitedHealthCare Denials for ALS-2 Claims appeared first on American Ambulance Association.

Talking Medicare: Understanding CERT Every year around this time, our firm receives a steady stream of questions from AAA members about the CERT Program. Typically, the provider has received a […]

The post Understanding CERT appeared first on American Ambulance Association.

2015 Medicare Payment Data Offers Evidence of Nationwide Crackdown on Non-Emergency Ground Ambulance Transportation; Impact Varies Dramatically by Medicare Administrative Contractor Every year, CMS releases data on aggregate Medicare payments […]

The post 2015 Medicare Data Shows Evident of Crackdown on Non-Emergency Transport appeared first on American Ambulance Association.

On August 16, 2016, the HHS Departmental Appeals Board (DAB) issued a decision related to CMS’ authority to revoke a Medicare supplier’s billing privileges.  The DAB is the fourth and […]

The post Findings Patterns Where None Exist appeared first on American Ambulance Association.

In May 2014, CMS announced the implementation of a three-year prior authorization demonstration project for repetitive scheduled non-emergency ambulance transports.  CMS initially elected to limit this demonstration to three states: […]

The post Prior Authorization Data Shows Dramatic Reductions in Spending on Dialysis Transports appeared first on American Ambulance Association.

Question We operate a mid-sized ambulance services in the Midwest. Recently, one of our local hospitals entered into an agreement to become part of a large health system. We are […]

The post When a Capitated Payment Arrangement Makes Sense appeared first on American Ambulance Association.

 On July 15, 2016, the Bureau of Labor Statistics released its monthly report on inflation.  This release includes the change in the Consumer Price Index for all urban consumers (CPI-U) […]

The post A Preliminary Estimate of 2017 Medicare Rates appeared first on American Ambulance Association.

Normally this blog focuses on an area of Medicare reimbursement or compliance.  However, this month I want to talk about Medicare’s companion program, Medicaid. When you talk to ambulance providers […]

The post AAA 2016 State Medicaid Ambulance Rate Survey Results Released appeared first on American Ambulance Association.

The post Understanding the GAO’s Recent Report on Medicare Prepayment and Postpayment Reviews appeared first on American Ambulance Association.

On March 21, 2016, the Indian Health Service (IHS), an agency with the Department of Health and Human Services, issued a final rule with comment period titled “Payment for Physician […]

The post Indian Health Service Issues Final Rule on Payments to Non-Contracted Providers appeared first on American Ambulance Association.

On Friday, May 13, the Government Accountability Office (GAO) publicly released a new Medicare report entitled, “Claim Review Programs Could Be Improved with Additional Prepayment Reviews and Better Data,” which […]

The post The GAO Releases New Report on Claims Review Programs, Recommending Additional Prepayment Review Authority and Written Guidance on Calculating Savings from Prepayment Review appeared first on American Ambulance Association.

On May 5, 2016, CMS publicly released the “Medicare Provider Utilization and Payment Data: Physician and Other Supplier Public Use File,” which provides information on the services and procedures provided […]

The post CMS Releases Medicare Provider Utilization and Payment Data for CY 2014 for Ambulance Suppliers, Physicians and Other Part B Organizations appeared first on American Ambulance Association.

The post HHS Office of Civil Rights Announces Phase 2 HIPAA Audit Review Program appeared first on American Ambulance Association.

The post Calculating Excess Mileage appeared first on American Ambulance Association.

The post Musings on 2014 Medicare Payment Data (Part 1) appeared first on American Ambulance Association.

The post Question of a “Lifetime” appeared first on American Ambulance Association.

The post 2016 AIF: A Step Backward appeared first on American Ambulance Association.