Article - Rural Air Ambulance Service Protocols (A52917)

CMS National Coverage PolicyN/AArticle TextNote: 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 100-08Program Integrity Manualstates: "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.ArizonaNoridian Healthcare SolutionsPO Box 6730Fargo ND 58108-6730AlaskaNoridian Healthcare SolutionsPO Box 6726Fargo ND 58108-6726MontanaNoridian Healthcare SolutionsPO Box 6732Fargo ND 58108-6732WashingtonNoridian Healthcare SolutionsPO Box 6720Fargo ND 58108-6720North DakotaNoridian Healthcare SolutionsPO Box 6709Fargo ND 58108-6709OregonNoridian Healthcare SolutionsPO Box 6726Fargo ND 58108-6726South DakotaNoridian Healthcare SolutionsPO Box 6733Fargo ND 58108-6733IdahoNoridian Healthcare SolutionsPO Box 6726Fargo ND 58108-6726UtahNoridian Healthcare SolutionsPO Box 6724Fargo ND 58108-6724MinnesotaNoridian Healthcare SolutionsPO Box 6714Fargo ND 58108-6714WyomingNoridian Healthcare SolutionsPO Box 6734Fargo ND 58108-6734Providers 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