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Air Ambulance Rate Improvement Bill in Senate

The United States Senate is looking at ways to improve the ways air ambulance companies are paid. The effort is intended to help medical transport reliability in rural areas by ensuring the air ambulance company is paid a fair rate. The bill, introduced in the Senate by Rep. Greg Walden (R-Ore.) and five other members of Congress, is exciting for anyone in the air ambulance industry.

The bill, if passed, would provide more stability to air ambulance services. The Medicare Ambulance Access, Fraud Prevention, and Reform Act of 2015 (H.R. 745) would end uncertainty that some air ambulance providers face when being reimbursed for their services. According to Rep. Walden two studies conducted in 2007 and 2012 found Medicare is reimbursing some air ambulance companies below the cost of the service. This is especially true in rural areas, where the costs are higher for the services.

Under current law Congress has to pass temporary legislative fixes so companies can receive higher rates. Because the relief is temporary, availability of an air ambulance is threatened all over the country each time the rate adjustments are about to expire. Because so many people in remote areas depend on air ambulance services, the need for stability in the funding for the services is vital.

The Medicare Ambulance Access, Fraud Prevention, and Reform Act of 2015 would provide permanent fixes by giving providers a 2-percent payment increase in urban areas and a 3-percent payment increase in rural areas. Areas designated as “super rural” would receive a bonus payment.

The bill also implements anti-fraud measures that aim to curb abuse of air ambulance services. The bill, if passed, would build on the existing prior authorization programs that are in place in the states of New Jersey, Pennsylvania and South Carolina.

The new law would institute 60-day advanced authorizations for air ambulance transports throughout the country for end-stage renal disease to and from dialysis facilities. A study by the CMS Inspector General in 2013 found the increases in these transfers were a breeding ground for abuse and fraud. Preventing fraud ensures the proper funding for Medicare services and will help pay for the law.

The bill was introduced by Rep. Walden on February 4th. Currently the bill has bipartisan support. For more information about  The Medicare Ambulance Access, Fraud Prevention, and Reform Act of 2015, click here.

Stay up to date on the progress of H.R. 745 by clicking here.

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