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The Centers for Medicare and Medicaid Services (CMS) published a proposed rule in the Feb. 22„Federal Register that could further cut ambulance-service revenues by allowing states to enroll Medicaid patients in plans that would not pay for non-emergency medical transportation.

The State Flexibility for Medicaid Benefit Packages proposal would give states the right to enroll most Medicaid recipients in "benchmark" private-managed-care or preferred-provider plans. Noting that current law (42 CFR 431.53) requires states to provide Medicaid beneficiaries with "transportation to medically necessary services," CMS wrote: "Generally, private health insurance plans do not offer non-emergency medical transportation as a benefit to enrollees. It would be a strong disincentive for States to offer benchmark coverage through private health plans if States had to supplement benchmark benefit plans with additional transportation benefits. We are therefore proposing to exempt States that elect benchmark coverage from the transportation assurance requirement." CMS will accept comments until March 24.

Watch upcoming issues of the EMS Insider for more as this story evolves.

Download the proposed rule, which includes information on how to submit comments.

For more information,„contact Tristan North at the American Ambulance Association.


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