Medicare Pilot Of Prior Authorization For Repetitive Scheduled Non-Emergent Ambulance Transport, Frequently Asked Questions

On May 22, 2014, the Centers for Medicare & Medicaid Services (CMS) announced plans to launch a pilot program in New Jersey, Pennsylvania, and South Carolina that will require prior authorization for repetitive scheduled non-emergent ambulance transport for Medicare beneficiaries. The prior authorization decision, justified by the beneficiary's condition, may affirm up to 40 round trips per prior authorization request in a 60-day period. CMS seeks to determine if prior authorization helps reduce expenditures, while maintaining or improving quality of care . . .