HHS Announces New EMS Reimbursement Model

Fire departments across the United States have long struggled with outdated federal reimbursement policies which fail to reimburse fire departments for the cost of providing EMS treatment without transportation and prohibit transporting patients to alternative destinations like urgent care clinics. However, the Center for Medicare and Medicaid Innovation (CMMI) announced today that they will begin testing a model policy in which CMMI reimburses fire departments for the cost of providing Medicare beneficiaries with treatment-without-transportation and transporting patients to alternative destinations.

HHS Secretary Alex Azar announced this new model policy this afternoon and was joined by Seema Verma, Administrator of the Centers for Medicare and Medicaid Services (CMS), Adam Boehler, CMMI Director, IAFC President Dan Eggleston, and other leading members of the fire and emergency medical services. Under this policy, fire departments soon will be able to apply for inclusion in this model policy and may even be reimbursed for EMS services provided to Medicare beneficiaries by EMS personnel working from non-transport vehicles including fire apparatus and quick response vehicles. Participation in this model policy is completely voluntary and is limited to transport agencies only. Fire and EMS agencies will need to contact a nurse practitioner, physician assistant, physician, or advanced practice provider to approve the treatment-without-transportation of each patient. According to CMS, this new model payment policy will be funded separately from CMS’ current Ambulance Fee Schedule.

CMMI is expected to release additional details soon on how participating fire departments will need to provide this care, how the application process will function, and how much fire departments can anticipate being reimbursed. CMMI plans to open the application process this Spring.

The IAFC is pleased to have worked with Dr. David Prezant, Chief Medical Officer for the Fire Department of New York, as well as the International Association of Fire Fighters and members of the Metropolitan Fire Chiefs Association in developing and advocating for this proposed model policy. Make sure to keep watching for additional details on this proposed model from CMMI.

Evan Davis is the IAFC's government relations strategic manager and liaison to the EMS Section.

IAFC PHOTO: From left U.S. Health and Human Services Sec. Alex M. Azar II, D.C. Fire Department Chief Greg Dean, and FDNY Chief medical officer Dr. David J. Prezant.

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