Ambulance supplier's payment proposal could violate anti-kickback statute

Share this article:

One ambulance supplier's proposal to receive payments from skilled nursing facilities that use Medicaid transport services could overstep the bounds of an anti-kickback statute, according to an advisory opinion from the Department of Health and Human Services' Office of Inspector General.

The supplier had previously been paid for driving services under the state Medicaid program, which used a set fee schedule, the Bureau of National Affairs reported. But a change to state law rendered transport services as ancillary support costs, which states pay SNFs on a per-resident-per-day basis. Now, SNFs will compensate ambulance suppliers directly with negotiated rates.

The ambulance supplier proposed two payment plans for OIG consideration. Under the first plan, the ambulance supplier would offer SNFs a capitated rate per resident for Medicaid transport services based on resident days, rather than whether a patient requires the services, BNA said. Under the second payment plan, the ambulance supplier would offer a SNF a contract under which the facility would pay for transport services for Medicaid patients on a fee-for-service basis.
Share this article:

More in News

'Minor' issues at the nursing home can cause disastrous care transitions, expert warns

'Minor' issues at the nursing home can cause ...

What may appear to be minor administrative problems in a nursing home - a fax machine locked away at night or no one designated to copy paperwork - can cause ...

Long-term care facilities approach 80% worker flu vaccination rate after handing power ...

Fourteen long-term care facilities in Pennsylvania dramatically increased their staff flu vaccination rate by having a regional pharmacy take over the process, according to a report issued Thursday by the Agency for Healthcare Quality and Research (AHQR).

RACs were 'most improved' healthcare auditors for getting back money in 2013, ...

Medicare Recovery Audit Contractors dramatically stepped up their overpayment recoveries last year, returning nearly $487 million more to the government than they did in 2012, according to a new report from a federal watchdog agency.