Congress just passed the "Medicare Access and CHIP Reauthorization Act of 2015," H.R. 2(link is external), extending the Medicare ground ambulance bonus payments until December 31, 2017.  The Bill also significantly expands Medicare's current prior authorization program for repetitive non-emergency transports.  The President is expected to sign the Bill into law today.  

Due to the extension of bonus payments, the Medicare fee schedule amount for ground ambulance services will continue to be increased by:

  • 3% for transports originating in rural areas;
  • 2% for transports originating in urban areas; and
  • 22.6% for transports originating in super-rural areas.

​The Act also expands the existing model prior authorization program for scheduled, repetitive non-emergency ambulance transports which currently only applies to ambulance suppliers in Pennsylvania, New Jersey and South Carolina.  The program will continue in these states, then expand to Delaware, DC, Maryland, North Carolina, West Virginia and Virginia starting January 1, 2016, followed by a nationwide expansion beginning January 1, 2017.

  • More States in 2016
    • ​No later than January 1, 2016, HHS must expand the model program to cover: .   
       
  • Nationwide in 2017
    • The Bill calls for the expansion of the prior authorization program to all states beginning  January 1, 2017, provided HHS determines that the initial model programs have met all appropriate criteria.     

Read more about the Medicare Access and CHIP Reauthorization Act of 2015 and how it impacts the ambulance industry on Page, Wolfberg & Wirth’​s website.