CMS to Expand Prior Authorization of Transportation Services to Six More States
The Centers for Medicare and Medicaid Services (CMS) will begin expanding a prior authorization model for non-emergency ambulance transportation for dialysis patients into six states: Maryland, Delaware, the District of Columbia, North Carolina, Virginia and West Virginia. The program expansion will begin on January 1, 2016 and requires ambulance providers in those states to obtain documentation from physicians prior to beginning service. CMS plans to reach out to ambulance providers and Medicare beneficiaries about the program through educational materials. This model was originally implemented in New Jersey, Pennsylvania and South Carolina. It came in response to fraud cases found in those states, [...]