Ambulance Billing News

News from Enhanced

CMS Issues Final Rule on Medicare Incentive Program and Provider Enrollment Standards

December 5, 2014
On December 4, 2014, CMS issued a final rule that makes significant changes to the Medicare provider enrollment process…

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Understanding NFPA's new ambulance rule

November 18, 2014
With NFPA taking over the new ambulance standard process, here's a look at what it means and how we got here…

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Tips to avoid a turkey-frying catastrophe

November 20, 2014
Deep frying a turkey, while a tasty alternative to the traditional oven-roasted main course, can lead to fire and serious injury…

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Maryland County Unveils $50M EMS Center

November 10, 2014
The center replaces a 50-year-old building and places volunteer and county EMS under one roof…

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Widespread Review of Ambulance Services: Fourth Quarter of FY 2014

November 5, 2014
Palmetto GBA (Railroad Medicare) has completed a widespread review of specific ambulance service claims submitted between July and September 2014…

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CMS Revises Ambulance Inflation Update for 2015

October 28, 2014
CMS re-forecasts AIF for 2015…adds 0.1% additional increase…

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OIG Issues Advisory Opinion on Waiver of Out-of-Pocket Expenses by Volunteer Ambulance Squad

October 14, 2014
HHS Office of the Inspector General posted Advisory Opinion 14-09, which permits a Township to pay the out-of-pocket expenses due from its residents when they are transported by a local volunteer ambulance squad…

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Prepayment Review of Emergency BLS Transport HCPCS Code A0429

October 7, 2014
Railroad Medicare’s Medical Review unit will begin a service-specific review of Emergency BLS Transport…

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FASNY Applauds Governor Cuomo for Signing Volunteer Firefighter/EMT Excused Leave Bill

October 6, 2014
The Firemen’s Association of the State of New York (FASNY) today issued the following statement after Governor Cuomo signed a bill that protects the jobs of volunteer firefighters and EMS personnel…

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OIG Proposing New Ambulance Safe Harbor

October 3, 2014
The Office of the Inspector General (OIG) is poised to publish a Proposed Rule that would establish a new safe harbor to the Anti-Kickback Statute…

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New law allows Naloxone to be given by PA firefighters

October 2, 2014
Pennsylvania Governor Corbett Signs Life-Saving Legislation, Approves Recommendations to Combat Pennsylvania's Heroin and Opioid Crisis…

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Permanent Medicare Ambulance Relief Bill Introduced in House

Spetember 12, 2014
I am extremely happy to report that yesterday, Congressmen Greg Walden (R-OR), Peter Welch (D-VT), Devin Nunes (R-CA) and Richard Neal (D-MA) introduced in the U.S. House of Representatives the Medicare Ambulance Access, Fraud Prevention, and Reform Act of 2014 (H.R. 5460)…

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2015 Medicare Ambulance Inflation Update

September 5, 2014
The Centers for Medicare and Medicaid Services (CMS) has released the official Medicare ambulance inflation factor for 2015. The inflation update will be 1.4%…

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Large employers see health costs rising 5% next year

August 14, 2014
Large employers expect their healthcare costs to jump 5% next year, and nearly a third of businesses will offer only higher-deductible plans to workers, a new survey shows…

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Area fire companies use Facebook to inform, recruit

August 6, 2014
Pages on the Internet, posted through social media, are keeping the public engaged in emergency services in greater Hazleton…

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Congress Passes VA Prompt Payment Language

August 1, 2014
Last night, the United States Senate passed by a vote of 91 to 3, legislation to improve the access of veterans to medical services from the Department of Veterans Affairs (VA)…

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Philadephia and Houston Area Moratoria Extended

July 31, 2104
The Centers for Medicare and Medicaid Services (CMS) is poised to publish a 6-month extension of the ambulance enrollment moratoria…

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Beneficiary Signature Requirement - Positive Change

July 17, 2014
When the patient is unable to sign the form requesting payment and authorizing the release of records due to a physical or mental condition, the request may be executed on their behalf…

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Govenor looks to raid EMS fund to balance budget

Pa. Legislature approves $29.1B budget; Corbett withholds signature

June 30, 2014
Republican Gov. Tom Corbett said late Monday he is withholding his signature from a state budget sent to him by the General Assembly…

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Pennsylvania EMS training bill heads to the governor's desk

June 11, 2014
The state House unanimously approved legislation allowing volunteer firefighters' relief association funds to be used to pay for the costs related to training…

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Apple will redefine Healthcare & make Billions - here is how...

June 4, 2014
The Health App - why is it key to Apple's long term growth?

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Bipartisan bill to recruit and retain volunteer first responders receives committee approval

June 4, 2014
Members of the Pennsylvania Senate Veterans Affairs and Emergency Preparedness Committee today unanimously approved legislation aimed to help municipalities recruit volunteer first responders…

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Ambulance Services: Incomplete Documentation

June 3, 2014
This article highlights current Comprehensive Error Rate Testing (CERT) denials for Ambulance Services. In all of these instances, the reason for denial was incomplete documentation…

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First Call Ambulance Service Settles False Claims Act Allegations

May 29, 2014
First Call Ambulance Service will pay $500,000 to settle allegations that it violated the False Claims Act…

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CMS Announces Prior Authorization Demonstration Program for Repetitive Ambulance Transports

May 22, 2014
CMS announced a limited prior authorization demonstration program for repetitive scheduled non-emergent ambulance transports in New Jersey, Pennsylvania and South Carolina…

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HHS Announces Proposed Rule to Enhance Fraud Fighting

May 9, 2014
The Department of Health and Human Services (HHS) issued a Proposed Rule amending the regulations relating to the Office of Inspector General’s (OIG) exclusion authorities…

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Baker and Wiley Introduce a Bill to Reward and Recruit Volunteer Firefighters/SB1342

April 14, 2014
Senators join forces to introduce bill giving municipalities the power to waive local earned income taxes for volunteer first responders…

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House Passes Medicare Ambulance Relief Extension

March 27, 2014
Earlier today, the U.S. House of Representatives passed by voice vote the Protecting Access to Medicare Act of 2014 (H.R. 4302)…

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ICD-10 Readiness Lags

March 6, 2014
With the Oct. 1, 2014, ICD-10 transition date approaching, many in the health care industry have not yet adequately prepared for the new coding system…

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CMS Finalizes Delay of ACA Employer Mandate

February 28, 2014
Earlier this month, CMS issued the final rule under the ACA that would provide an additional year for employers with 50 to 99 full-time workers…

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Administrative Law Judge Hearings - Major Delay

February 21, 2014
The Department of HHS Office of Medicare Hearings and Appeals (OMHA) issued a Memorandum (undated) and then published a Notice in the Federal Register on January 3, 2014…

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PPACA Final Regs Issued by Treasury

February 11, 2014
The final regulations for the employer shared responsibility provision of the PPACA were issued yesterday…

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Field EMS Quality, Innovation and Cost-Effectiveness Improvement Act

February 10, 2014
On January 27, 2013, the NAEMT Board of Directors unanimously voted for our association to take the lead in supporting passage of H.R. 809, the Field EMS Quality, Innovation and Cost-Effectiveness Improvement Act…

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CMS Bans New Suppliers in Greater Philadelphia Region

February 4, 2014
The Centers for Medicare and Medicaid Services (CMS) announced today that it is barring new ambulance suppliers in the Greater Philadelphia region from enrolling in Medicare for 6 months…

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CMS Imposes Moratoria on New Ambulance Providers

January 31, 2014
CMS is scheduled to publish in the February 4 issue of the Federal Register a notice which will impose a 6-month moratorium on new ambulance suppliers…

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Obamacare: Volunteers will not be Treated as Employees

January 11, 2014
On January 10, Assistant Secretary for Tax Policy Mark Mazur posted a notice on the U.S. Department of Treasury's blog that the IRS, "…will not require volunteer hours of bona fide volunteer firefighters and volunteer emergency medical personnel…

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Ohio Medicaid Reverses Rule

January 10, 2014
Ohio Department of Job and Family Services (Ohio Medicaid) Reverses Rule Prohibiting Fee-for-Service Payment for Ambulance and Wheelchair Van Transport Services of a Nursing Facility…

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Congress Passes 3-Month Ambulance Relief Extension

Moments ago, the U.S. Senate passed a two-year federal budget agreement…

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How the Affordable Care Act Could Impact Your Volunteer Agency

If your agency has volunteers, then you need to be aware of an issue that is getting some much warranted attention lately…

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Major Ambulance Service Shuts Down Without Notice in Six States

A private ambulance service that transported more than a half-million patients a year in six states abruptly shut down without explanation…

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CMS Issues Explanation on CR8404

When a patient is in a Part A Skilled Nursing Facility (SNF) stay and he/she is discharged from one SNF and transported by ambulance to a different SNF, the discharging SNF is responsible to pay for the transport…

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Five-Year Medicare Ambulance Relief Extension Included in Senate Proposal

Yesterday morning, the U.S. Senate Finance Committee released a proposal to repeal the sustainable growth rate (SGR) formula for Medicare payments to physicians…

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Erroneous Payments for BLS Non-Emergencies (A0428) with “GW” Modifier

In prior Member Advisories, we have notified you of the problem involving Part B claims being incorrectly reduced 10% when the “GW” modifier was used, with origin/destination modifiers other than for dialysis…

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Provider Enrollment Application Fee Amount

On November 29, CMS issued a notice (CMS-6051-N) announcing a $542.00 CY 2014 application fee for institutional providers…

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OIG Releases Important New Advisory Opinion

The Office of Inspector General (OIG) released Advisory Opinion 13-17, and for the first time ruled that a municipal, County-run EMS agency could extend their policy on using tax revenues to cover copayments and deductibles to non-residents as well as residents…

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Wrong Rates Paid by First Coast for some BLS Non-Emergencies

First Coast Service Options, the Medicare Administrative Contractor for Florida (and Puerto Rico and the Virgin Islands) started reducing the allowable by 10% for some non-dialysis BLS non-emergency claims…

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Wrong Rates Being Paid for Some BLS Non-Emergencies

Effective October 1, 2013, Medicare Administrative Contractors began to reduce the allowable for BLS non-emergency base rates and mileage, for transports to and from dialysis…

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Dressing Down for Donations

On October 17, 2013, our employees presented a check to the Ronald McDonald House of Danville, Inc…

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Required Notice to Employees Regarding New Health Care Exchanges

Section 1512 of the Affordable Care Act amended the Fair Labor Standards Act (FLSA), which requires all employers who are otherwise subject to the FLSA to prove a one-time written notice to their employees about potential coverage options through the new health care exchange marketplaces…

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Welcome to Government Shut-down!

A government shutdown starting Tuesday, Oct. 1, is now upon us…

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CMS Releases Ambulance Inflation Factor for 2014

The Centers for Medicare & Medicaid Services has released the Ambulance Inflation Factor for Calendar Year 2014…

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OIG Releases Critical Ambulance Report

The Department of Health and Human Services Office of Inspector General (OIG) released a crucial Report that foreshadows more fraud enforcement…

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N538 Denials in AL, GA and TN

What I am going to describe below only applies to ambulance service suppliers/providers who have Cahaba as their Medicare Administrative Contractor (MAC), i.e. those in Alabama, Georgia and Tennessee…

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AAA Estimates 2014 Ambulance Inflation Factor

Each year, the Medicare Ambulance Fee Schedule is updated to reflect inflation. The inflation adjustment factor is called the “Ambulance Inflation Factor” or “AIF”…

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Comparative Billing Report

You may have recently received a letter from SafeGuard Services, LLC with the results of a Comparative Billing Report. If not, you probably will very soon…

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Member Advisory: CMS Imposes Moratorium on New Ambulance Providers in Houston, Texas

Late Friday afternoon, CMS published a notice in the federal register that it would impose a 6-month moratorium on new ambulance suppliers in Houston, Texas…

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Rural/Metro Facing Financial Troubles

According to market reports and industry insiders, Rural/Metro Corp has reported millions of dollars of losses and is struggling to pay its bills…

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8 Tips to Reduce Stress for Emergency Responders

Emergency responders tend to be incessant multi-taskers with many involved in a number of full-time, volunteer and education rolls. Add all of these commitments together and you have a huge possibility of stress…

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Government Delays Key Provision of Healthcare Reform Law

The Treasury Department announced that the government is delaying a key component of the Affordable Care Act (ACA), the so-called "employer mandate," until 2015…

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Nearly 1/2 of All Working-Age U.S. Adults Uninsured or Underinsured in 2012

A recent report from the Commonwealth Fund finds that in 2012 an estimated 84 million people did not have health insurance for the full year or were underinsured…

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AAA Statement Regarding Medicare Fraud

As the primary association representing ambulance suppliers and providers in the United States, the American Ambulance Association (AAA) condemns Medicare fraud in any form…

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AAA Position Statement on Stretcher Van Transportation

The American Ambulance Association opposes the use of stretcher vans to transport patients. Accordingly, the AAA opposes Medicare reimbursement for stretcher van transportation…

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EMS Services Face Extinction In Illinois — Possible Bellweather For Obamacare Impact

Hospitals are finding it harder and harder to find ambulance services willing to transport medicaid patients in Illinois, according to a report in the Deadbeat Illinois series by Gatehouse News Service…

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OIG Issues Advisory Opinion on Reimbursement for Dispatch Costs

On June 21, 2013, the Office of the Inspector General (IG) posted Advisory Opinion 13-05, which permitted an exclusive contract between a municipality and a private ambulance service pursuant…

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Provider Enrollment Changes

Submit Comment Letter to CMS on Proposed Rule

On April 29, 2013, the Centers for Medicare and Medicaid Services (CMS) published a proposed rule intended to strengthen the Medicare Incentive Reward Program and to make certain changes to the provider enrollment process…

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Take Action!

Tell Congress to Eliminate Taxation of Minor Volunteer Benefits...

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Atrus to develop AED registry for State of Maryland

Atrus, Inc., creators of the National AED Registry™, announced that it has contracted with the Maryland Institute for Emergency Medical Services Systems (MIEMSS) to provide a customized version of its automated external defibrillator (AED) registry for the State of Maryland...

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Our iPad Mini Winner is . . .

As part of the enhanced billing and service promise, we developed the ambulance industry's first mobile reporting solution. To celebrate, we gave an iPad Mini to one lucky winner...

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A Message from PFESI

How to Lead Without Being a Jerk

Following disciplinary protocols in a fair way does not make you a jerk; it makes you a credible leader. I recently wrote a column about working with older, less motivated crews. In this column, I said that officers must insist on accountability with their crews, but "you don't have to be a jerk about it."

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PA Ambulance Operator Sentenced to 92 Months in Prison for Medicare Scam

Northeast Philadelphia ambulance operator, William Hlushmanuk, was sentenced to 92 months in prison after 5 years of fraudulent medicare billing and spending nearly $5.4 million on personal luxuries like motorcycles, drugs, a house, a Hummer, and vacations to Las Vegas and Florida.

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CMS Posts Transmittal 2703 Advising MAC's to Reduce Payments to BLS Non-Emergency ESRD Transports

On October 1, 2013, a 10% reduction in payments for BLS Non-Emergency ambulance transports of ESRD patients to and from dialysis facilities has now been posted to the CMS website.

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Enhanced Management Services Announces the Ambulance Industry's First Mobile Reporting Solution

Enhanced Management Services, a leader in the ambulance billing industry, has developed the ambulance industry’s first mobile reporting solution. Enhanced PulsePoint™ Mobile securely delivers billing reports to client’s mobile devices.

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AAA Member Advisory - Congress Extends Medicare Ambulance Relief

Congress Extends Medicare Ambulance Relief

I am happy to report that thanks to the AAA and many of you, Congress has extended the temporary Medicare ambulance relief for another year as part of the package to avert the fiscal cliff. This includes the 2% urban, 3% rural and super rural increases. In addition, Congress delayed the 2% cut to Medicare providers as part of sequestration. Congress did, however, also target nonemergency basic life support transports of ESRD patients with a 10% cut in response to concerns cited by MedPAC, the GAO and OIG. The President has stated he will sign the bill as soon as it reaches his desk. A detailed summary of the ambulance provisions contained in the package, the American Taxpayer Relief Act (H.R. 8), is listed below.

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Breaking News from Page, Wolfberg, & Wirth

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.

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Enhanced Unaffected by Sandy

The events of the past two days have most likely pushed many Fire/EMS departments to the limit. Hurricane turned “Superstorm Sandy” swept over the east coast of the United States with unprecedented impact leaving scars that will last long after Sandy has disappeared to our north. Thankfully, Enhanced Management Services didn’t miss a beat . . .

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Hurricane Sandy: Stay safe EMS friends and clients

As Hurricane Sandy assaults the east coast of the US, we thank EMS clients and friends for all they do and ask you to stay safe!

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Medicare Fraud Strike Force Charges 91 Individuals Approximately $430 Million in False Billing

Medicare Fraud Strike Force operations in seven cities have led to charges against 91 individuals – including doctors, nurses and other licensed medical professionals – for their alleged participation in Medicare fraud schemes involving approximately $429.2 million in false billing, Attorney General Eric Holder and Health and Human Services (HHS) Secretary Kathleen Sebelius announced today.

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OIG Issues its 2013 Work Plan

On October 3, 2012, the U.S. Department of Health and Human Services Office of the Inspector General (OIG) released its Work Plan for Fiscal Year 2013. The OIG’s Work Plan is important, as it sets forth a road map of the OIG’s priorities for the coming year.

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United States Government Accountability Office (GAO) Releases National Ambulance Provider Payments Report

Recently, the United States Government Accountability Office (GAO) released its most recent report that takes a look at payments to ambulance providers nationwide. The report is entitled “AMBULANCE PROVIDERS. Costs and Medicare Margins Varied Widely; Transports of Beneficiaries Have Increased.”

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Contact your Senator on HB1344 (Direct Pay Bill)

For nearly a decade, this bill has been strongly opposed by the insurance lobby. We are asking you to contact Senator Don White and the Committee to move this bill onto the floor for a vote.

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American Ambulance Association (AAA) Issues Advisory

ALS Ambulance companies have long enjoyed the ability to bill for ALS Assessments and collect additional revenue for those scenarios. Fewer dollars may be flowing to ALS Ambulance services in the days ahead, as CMS and the Inspector General’s office are currently studying this issue.

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PCS to Carry No Conclusive Weight with CMS Proposed Rule Change

Reacting to a recent Federal District Court decision, CMS has proposed a Rule Change in reference to the weight of a doctor’s signed Physician Certification Statement (PCS) when considering Medical Necessity of patients requiring repetitive non-emergency ambulance transports.

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President Obama Signs Act Extending Ambulance Bonus Payments

President Obama has signed the Middle Class Tax Relief and Job Creation Act of 2012 into law. In addition to insuring that thousands of Americans will not be assessed higher payroll deduction taxes for the balance of 2012, most importantly to the ambulance industry it means the 2% urban, 3% rural and 22.6% super rural bonus payments remain in place through December 31, 2012.

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Bill to Extend Ambulance Relief Payments for Remainder of 2012 Passes

The much anticipated “tax cut” bill has been passed by Congress! Ambulance companies across the United States were holding their collective breath as the temporary Medicare bonus payments of 2% urban, 3% rural and 22.6% super rural were set to once again expire at the end of February.

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Enhanced Achieves 5010 Version X12 Compliance for HIPAA Transactions

Enhanced Management Services, Inc, an emergency medical services and ambulance billing company announces its compliance with the Version 5010 X12 standards of readiness for HIPAA transactions.

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GPCI Decrease Offsets Positive Medicare Increase in Some Geographic Areas

Talk about a “yo-yo” effect of ups and downs surrounding the anticipated new Medicare Ambulance Fee Schedule amounts! You’ll recall we Blogged several times about the Congressional battle that stood to interfere with the extension of the bonus payments. We learned that the Ambulance Inflation Factor (AIF) would finally be a positive 2.4%. At the time that seemed like very good news! Then our hopes were dashed for any increase when it appeared that Congress would allow the Ambulance bonus payments to expire.

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Enhanced Management Services "CAC Wall of Pride"

Enhanced continues to require CAC Certification of new employees as part of its extensive training program. The diplomas of the company's CAC graduates are proudly displayed on the "CAC Wall of Pride" for visitors and staff to see when entering the company's corporate headquarters in Danville.

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Ambulance Inflation Factor to increase by 2.4% in 2012

The Centers for Medicare & Medicaid Services (CMS) has announced that the Ambulance Inflation Factor (AIF) for 2012 will be set at +2.4% beginning on January 1, 2012.

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Recovery Audit Program Extended to Medicaid

Last week the Department of Health and Human Services (HHS) released its final rule establishing the Medicaid Recovery Audit program. The Centers for Medicare and Medicaid Services (CMS) touted the program as a key part of the Obama Administration’s initiatives to curb waste, fraud and abuse within the Medicaid system, and extending the Recovery Audit initiatives beyond Medicare for the first time.

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New HIPAA-Mandated Format to Affect EMS Billing

Electronic medical claims submitted by healthcare providers and suppliers in the U.S.A. will take on a new look in 2012, thanks to the HIPAA mandated conversion to Version 5010 electronic transaction format.

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AAA Encourages EMS Community to Action

The American Ambulance Association is calling for the EMS Community to reach out to members of Congress to show their support in sponsorship of the Medicare Ambulance Access Preservation Act of 2011 (MAAPA).

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Re-Calculation May Delay Ambulance Fee Schedule Increase Extensions

Centers for Medicare and Medicaid Services (CMS) representatives announced during yesterday's Ambulance Open Door Forum nationwide conference call that extended increases in the Medicare Ambulance Fee Schedule, mandated by the newly-passed Health Care Reform Legislations, could be delayed until mid- to late-May due to mandated re-calculations in the Geographic Practice Cost Index (GPCI).

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How Will the Health Care Reform Law Affect Billing for Ambulance Services?

As you know, President Obama signed brand new Health Care Reform Legislation into law. Already health care providers, including ambulance services and EMS administrators, across the nation are beginning to ask questions about what these sweeping changes will mean for them, specifically. These answers will come over time, however, our friends at Page, Wolfberg and Wirth have put together a short statement pointing to the immediate items that will potentially have a direct impact on the ambulance industry for both the short and long terms.

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Our Maryland office is on the move...

New office is easier to find and easier to access.

Our Bel Air office is moving to a new location! We are now located at...

260 Gateway Drive
Suite 13B
Bel Air, MD 21014

Our new office is easier to find, easier to access, has more parking spots and has a fresh coat of paint, too!

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PA Governor Signs New EMS Bill

From: Office Of The Governor

GOVERNOR RENDELL SIGNS NEW EMS LAW

HARRISBURG – Governor Edward G. Rendell today signed into law SB240, a measure to update and enhance Pennsylvania's existing Emergency Medical Services Act. The law was first enacted in 1985.

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New On-Demand Reporting System

Get instant access to your billing records via a simple web interface from Enhanced Management Services. Enhanced has created an online reporting system that allows you to generate your own billing reports when you need them.

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Enhanced Billing Staff Becomes Certified Ambulance Coders

Enhanced Management Services, Inc. is the first ambulance billing service in the nation to certify 100% of its billing staff in Certified Ambulance Coder (CAC)™ program. The CAC certification demonstrates our continued commitment to compliance, collection, and efficiency.

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New Ambulance Billing Service blog is here to serve you!

Enhanced Management Services, Inc. is pleased to announce the Ambulance Billing Services blog at www.ambulancebillingservices.com. We created the blog as a way to share tips that will help you streamline your billing services and collect more money. We’ll also talk about industry news and trends as it relates to the administrative billing services for ambulance companies.

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Be Ready for the "Red Flag Rules"

Ambulance services need to take immediate steps to familiarize themselves with the Red Flag Rules and implement an Identity Theft Prevention Program. The FTC recently announced that it will begin enforcing the “Red Flag Rules” on May 1, 2009.

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New Medicare Signature Requirements!!

Signature requirements will change AGAIN on January 1, 2009. All Enhanced Clients have been provided the required information and forms prior to January 1st.

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Guaranteed cash flow during transition.