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BREAKING NEWS – Fiscal Cliff Deal



Fiscal Cliff Deal to Extend Ambulance Bonuses, Cut Reimbursement for Dialysis Trips 10% in 2013

Late last night, Congress reached a deal to avoid the so-called “fiscal cliff” and delay the 2% Medicare sequestration cuts for two months.

The bill, if signed into law, would temporarily avoid the automatic 2% Medicare “sequestration” cuts to ambulance fee schedule rates that were scheduled to go into effect on January 1st. The fiscal cliff bill also extends the temporary 2% urban, 3% rural and 22.6% super-rural bonus payments for ground ambulance services through December 31, 2013.  In addition, the legislation preserves some temporary relief for the air ambulance industry through June 30, 2013.  But, Congress also voted to reduce reimbursement by 10% for BLS non-emergency ambulance services furnished to renal dialysis patients beginning on October 1, 2013.

Having passed the Senate and the House, the bill is expected to be signed into law shortly.  We have excerpted the key sections of the 154-page bill, and you can click HERE to read those provisions.

The bill also directs HHS to conduct two studies on ambulance costs and issue recommendations to Congress.  Those studies are:

A study analyzing cost reports for ambulance services furnished by hospitals

A study of the feasibility of obtaining cost data from ambulance providers on a periodic basis about the “appropriateness” of the Medicare bonus payments

The one-year extension of the bonus payments is good news for the industry, especially since there is only a very small increase to the ambulance inflation factor for 2013.  The 2013 Ambulance Inflation Factor is 0.8%. But, the 10% cut for BLS non-emergency dialysis trips could be devastating for ambulance providers that transport beneficiaries with ESRD.