CMS believes there will be minimal disruption in claims payment

By BOB GARNER
American Ambulance Association Member Advisory

WASHINGTON, D.C. — On Friday, February 3, 2006, the AAA formally communicated with Mark B. McClellan, Centers for Medicare and Medicaid Services (CMS) Administrator.  The inquiry was regarding statements about an ambulance payment “freeze” made during the Ambulance Open Door Forum on Thursday, February 2.  The AAA received a quick response from CMS with a commitment to rapidly resolve the claims processing and payment issue.

I am pleased to report that earlier today the AAA held a conference call with CMS principals who provided details of the “Action Plan” to rectify the ambulance payment issue.  Most importantly, CMS confirmed that correct 2006 reimbursements rates have been delivered to Medicare Carriers and Fiscal Intermediaries.

CMS transmitted a Joint Signature Memo (rapid means of Carrier communication) with corrected 2006 rates to Carriers and Fiscal Intermediaries on Monday, February 6.  Carriers/Intermediaries were instructed to load and test the files and immediately resume processing and payment of claims.

CMS believes there will be minimal, if any, disruption in payment of claims including those which had been previously processed and held.  Claims held since issuance of the “suspend” order are expected to be processed at the corrected rates within the required “14-day floor” and therefore experience no delay.

CMS advised that ambulance service providers “SHOULD NOT HOLD CLAIMS”.  Submit claims to your Carrier/Fiscal Intermediary for processing on a regular schedule.

CMS will issue an additional transmittal advising Carriers/Intermediaries of the expected methodology for recovering claims overpayment.  It is anticipated by CMS that this will be accomplished with a single adjustment rather than by individual claim.  The AAA will disseminate this Change Request/Transmittal upon receipt.

Copyright © 2006 The Kentucky EMS Connection. All rights reserved. News stories may be copyrighted by another organization. Original material may be reproduced provided source is credited.