Musings on 2014 Medicare Payment Data…Part 2

Brian S. Werfel, AAA Medicare Consultant Every year, the Centers for Medicare and Medicaid Services (CMS) releases data on Medicare payments for the preceding year. The 2015 Physician/Supplier Procedure Master File (PSP Master File) was released in late November 2015. This report contains information on all Part B and DME claims processed through the Medicare Common Working File with 2014 dates of service. In last month’s post, I focused on total Medicare spending. This month, I want to shine the spotlight on Medicare’s payment for ambulance transports to and from dialysis. It is no secret that the federal government has long viewed dialysis transports with suspicion. In 1994, the HHS Office of the Inspector General (OIG) issued a report citing dialysis transports as an area of concern. In a 2013 report, the OIG cited the dramatic increase in the volume of dialysis transports since the implementation of the Medicare Ambulance Fee Schedule as evidence that the Medicare ambulance benefit is vulnerable to fraud and abuse. Dialysis transports were also featured heavily in the OIG’s 2015 report on questionable billing practices.  A 2013 report by the Medicare Payment Advisory Commission (MedPAC) noted that the utilization of BLS non-emergency transports, dialysis in...

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Spotlight: Kim Godden

Kim Godden Vice President of Legal and Government Relations Superior Air-Ground Ambulance Service (Michigan, Indiana, Illinois) Region 3 Alternate, American Ambulance Association Board Elmhurst, IL Tell us a little about yourself. I grew up in Barlett, Illinois, a Chicago suburb. I received my BA in History and Political Science from Purdue University and my law degree from DePaul University College of Law. After graduating from Purdue, I worked for the Illinois Attorney General’s Office while attending law school in the evening. While with the Attorney General’s office, I was an policy analyst/attorney for criminal justice and victims’ rights initiatives. During this time, I reviewed, drafted, and testified on various legislative and regulatory initiatives. In 2007, I was able to bring this experience to the ambulance industry when I joined Superior. In addition to sitting on the AAA board, I also sit on the boards of the Illinois State Ambulance Association and the Indiana EMS Association. I also participate on the government affairs committee for the Michigan Association of Ambulance Services. In addition to overseeing government relations and regulatory and compliance matters for Superior, I oversee the legal department which manages litigation, contracts, real estate and employment matters. I have been (more…)

Spotlight: Patrick Hatch

Patrick Hatch Paramedic Life EMS Grand Rapids, Michigan, USA Can you please tell us a little about yourself? Grand Rapids has always been my home. This city has transformed itself in the last 30 years, I love it here! I have a strong passion for music, specifically classic rock era, and I play guitar and perform in a cover band. How did you come to work in the industry? How long have you been involved? I became a paramedic in 1984 with the intention of becoming certified in criminal justice. What do you enjoy most about your job? I still like the high priority patients. I like to mentor and practice with particular attention to detail! What is your biggest professional challenge? I would like to see a structured tier of paramedics where the medic provider can obtain higher training in areas such as RSI; non-urgent cases such minor suture repair and pain management; and greater responsibility. What is your typical day like? It can vary from multiple back to back high acuity patients to relatively easy transports and encounters!...

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CMS Extends Ambulance Enrollment Moratoria

On July 25, 2015, CMS issued a notice extending the temporary moratorium for enrollment of new ambulance suppliers in the Texas counties of Brazoria, Chambers, Fort Bend, Galveston, Harris, Liberty, Montgomery and Waller, as well as in Philadelphia and the surrounding counties of Bucks, Delaware, Montgomery (Pennsylvania), Burlington, Camden and Gloucester (New Jersey). This notice will appear in the Federal Register on July 28, 2015. Read the PDF announcement (available now). Read the Federal Register post (available tomorrow, July 28, 2015).