EMS Law Library Archive

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CMS Publishes New Fraud and Abuse Measures

Significant Impact on Ambulance Services

02/03/2011

On February 2, 2011 the Centers for Medicare and Medicaid Services (CMS) published a Final Rule that drastically enhances the government’s ability to crack down on fraud and abuse in federal healthcare programs. For the ambulance industry, this means increased compliance obligations and more scrutiny from federal and state investigators. 
 
Below is an overview of the pertinent provisions of the Final Rule.
 
The Final Rule establishes new...

Important New OIG Advisory Opinion Issued

OIG Reaffirms Position on Discounting Ambulance Rates to SNFs

01/04/2011

On December 28, 2010 the Office of the Inspector General issued a key Advisory Opinion for the ambulance industry, reaffirming its stance that offering discounted rates to skilled nursing facilities (SNFs) could violate the Federal anti-kickback statute (AKS). The OIG held that a prospective arrangement, where an ambulance service provider wanted to offer SNFs “below-cost” rates for Medicaid transport services, could be seen as illegally offering something of...

PWW Article - The Discounting Dilemma

05/01/2010

How much can you discount your services without getting in trouble with the law? A good question for which at this point, no one has a clear answer. This brief article attempts to put the issue in perspective and remove some of the “cloud of uncertainty” that goes with it.
 
Overview of the Problem
 
A key government weapon in the anti-fraud campaign is the federal Anti-Kickback Statute (AKS), 42 U.S.C. § 1320a - 7b(b). An...

Court Case Illustrates Importance of Following Patient Refusal Guidelines

11/01/2006

A federal appeals court ruled that an EMS agency whose personnel allegedly failed to follow the wishes of a competent patient could be liable under the Americans With Disabilities Act (ADA) as well as under state tort law for transporting the patient against his will.

In Green v. City of New York (read the entire court case by ...

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