Rural Air Ambulance Service Protocols **Note** : This is a reprint of an
article published in " _Medicare A News_ ," Issue 2064 dated November 1, 2007.
This article is being reprinted to update mailing and submission information
for facilities/providers that provide rural air ambulance service; this is not
a new regulation.  
  
The Center for Medicare and Medicaid Services (CMS) has issued instructions
for contractors to post instructions for submission of the state or regional
protocol that has been recognized or approved by the Secretary of the
Department of Health and Human Services. This instruction has been published
in the IOM Publication 100-08 Program Integrity Manual Chapter 6; section 6.4.  
  
IOM Publication 100-08 _Program Integrity Manual_ states: "Per Section 415 of
the Medicare Modernization act of 2003, the reasonable and necessary
requirement for rural air transport may be "deemed" to be met when the service
is provided pursuant to an established State or regional emergency medical
services (EMS) agency protocol. CMS defines "established" to mean those
protocols, which have been reviewed and approved by State EMS agencies or have
been developed according to State EMS umbrella guidelines. Additionally, the
protocol must be recognized or approved by the Secretary."  
  
Rural air ambulance providers who are anticipating transports based upon the
contents of such a protocol (either State or regional) must submit that
protocol in advance to the fiscal intermediaries for review and approval.
Providers will also need to submit documentation that their protocol is or is
based on a protocol that has been approved or recognized by the Secretary of
Health and Human Services. This information should be sent to the following
address for your state if Noridian is your fiscal intermediary or A/B Medicare
Administrative Contractor.  
  
**Arizona**  
Noridian Healthcare Solutions  
PO Box 6730  
Fargo ND 58108-6730  
  
**Alaska**  
Noridian Healthcare Solutions  
PO Box 6726  
Fargo ND 58108-6726  
  
**Montana**  
Noridian Healthcare Solutions  
PO Box 6732  
Fargo ND 58108-6732  
  
**Washington**  
Noridian Healthcare Solutions  
PO Box 6720  
Fargo ND 58108-6720  
  
**North Dakota**  
Noridian Healthcare Solutions  
PO Box 6709  
Fargo ND 58108-6709  
  
**Oregon**  
Noridian Healthcare Solutions  
PO Box 6726  
Fargo ND 58108-6726  
  
**South Dakota**  
Noridian Healthcare Solutions  
PO Box 6733  
Fargo ND 58108-6733  
  
**Idaho**  
Noridian Healthcare Solutions  
PO Box 6726  
Fargo ND 58108-6726  
  
**Utah**  
Noridian Healthcare Solutions  
PO Box 6724  
Fargo ND 58108-6724  
  
**Minnesota**  
Noridian Healthcare Solutions  
PO Box 6714  
Fargo ND 58108-6714  
  
**Wyoming**  
Noridian Healthcare Solutions  
PO Box 6734  
Fargo ND 58108-6734  
  
Providers may also submit the information by email if more convenient.  
Email address: _fiambprotocol@noridian.com_.  
  
Noridian will review the protocol and or any subsequent revisions and notify
the rural air ambulance provider, via letter, of the determination within 30
days of receipt of the protocol. Approval of a protocol does not exempt the
provider from the remaining Medicare requirements for rural air ambulance
services. Regardless of protocol instructions regarding transport locations
Medicare payment can be made only to the closet facility capable of providing
the care needed by the beneficiary.  
  
**Sources: Internet Only Manual (IOM) Publication 100-08, _Medicare Program
Integrity Manual_ , Chapter 6**