According to InsideHealthPolicy, lawmakers and beneficiary advocates are urging the U.S. Department of Health and Human Services (HHS) to pause the expansion of a Medicare model that relies on prior authorization to reduce improper ambulance payments. Faegre Drinker Consulting Principal Mike Adelberg discussed the implications for beneficiaries.
In “HHS Pressed To Add NEMT To Medicare Ambulance Prior Auth Demo,” the publication explained that Medicare currently only covers repetitive scheduled non-emergency ambulance transport (RSNAT) for patients who are too sick or frail to travel to appointments by other methods. Thus, limiting those services could result in access problems for some of the most vulnerable beneficiaries.
“Strictly as a program integrity measure, RSNAT makes a lot of sense. But there are very sick people who depend on these rides, and turning out these people without considering their unmet transportation needs is deeply concerning,” said Adelberg.
The full article is available for InsideHealthPolicy subscribers.