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Prior Approval for Non-Emergency Ambulance Use: Medicare Pilot Launched
The 3-year pilot is expected to reel-in significant cost savings for Medicare, which has seen a lot of fraudulent charges with services and equipment.
Seniors living in three states will need prior approval from Medicare before they can get an ambulance to take them to cancer or dialysis treatments.
The change, which begins today, is part of a 3-year pilot to combat extraordinarily high rates of fraudulent billing by ambulance companies in Pennsylvania, New Jersey, and South Carolina.
The good news is that Medicare beneficiaries in those states will now know beforehand whether the program will cover their non-emergency transportation to treatments. The bad news, say advocates, is that many fragile people will be left with no way to get to appointments that might mean the difference between life and death.
"Often people have to go long distances, they feel lousy when treatment is over, and in some cases, it's to the point of being dangerous in providing their own transportation," said Jon Burkhardt, a consultant who has studied transportation for dialysis patients.
Link to the complete article on Medpage Today: http://bit.ly/1HVhJyB
Laundromats as a New Frontier in Community Health, Medicaid Outreach
May 29th 2025Lindsey Leininger, PhD, and Allister Chang, MPA, highlight the potential of laundromats as accessible, community-based settings to support Medicaid outreach, foster trust, and connect families with essential health and social services.
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New Research Challenges Assumptions About Hospital-Physician Integration, Medicare Patient Mix
April 22nd 2025On this episode of Managed Care Cast, Brady Post, PhD, lead author of a study published in the April 2025 issue of The American Journal of Managed Care®, challenges the claim that hospital-employed physicians serve a more complex patient mix.
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