tci Medicare Compliance & Reimbursement - 2003 Issue 13

Ambulances: MEDICAL NECESSITY KEY IN AMBULANCE COMPLIANCE GUIDANCE

As health care fraud enforcement heats up for ambulance suppliers - especially at the state level - making sure you play by the rules is more important than ever. And the HHS Office of Inspector General made the game book a little clearer March 24, with the release of its compliance program guidance for ambulance suppliers. The ambulance CPG gives a high profile to medical necessity, noting that "medically unnecessary transports have formed the basis for a number of Medicare and Medicaid fraud cases." Within the overall rubric of medical necessity, the OIG says ambulance suppliers should take...

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