Current Federal Legislative Issues/Reports
Title I: Medicare Ambulance Relief
Permanently incorporates into the Medicare ambulance fee schedule rates the current temporary 2 percent urban, 3 percent rural, and super rural bonus payments.
The Secretary and CMS are required to submit a report to Congress detailing the features of a reformed payment system for ambulance services under the Medicare program no later than July 1, 2019.
Title II: Dialysis Transport Reform
Requires the Secretary to establish a process for providing prior authorization for ambulance transport of Medicare beneficiaries. After the submission of appropriate documentation, Medicare contractors are required to respond in a timely manner with a 60-day minimum prior authorization that deems transport a medical necessity. Requires the Secretary to describe the process publicly no later than June 30, 2015.
Defines all who provide ambulance services as “providers” under Medicare.
Title III: Medicare Ambulance Payment Reform
Directs CMS to establish a data collection system no later than July 1, 2015, for ambulance providers which would define national prototype ambulance entities, establish specific allocation methods and data elements for each type, and be implemented through a purposive survey of representative organizations. Beginning July 1, 2016, providers selected to provide cost information and who do not comply with the request to submit the required data will receive a 5% reduction to their payments for 1 year. CMS must consult with stakeholders.