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CMS Issues Repayment Notice

During the initial stages of the response to the COVID pandemic, the Centers for Medicare and Medicaid Services (CMS) provided several payments to EMS agencies through the Provider Relief Fund (PRF). While CMS does not plan the recoup the bulk of these payments, CMS has issued guidance for the repayment of some funds which were dispensed from the PRF in the early stages of the pandemic response. 

Throughout the COVID-19 Public Health Emergency, ground ambulance services  faced an increasing number of patients refusing transport to a hospital due to fears of contracting COVID-19. Unfortunately, these declining numbers of patient transports directly  decreased reimbursements for most departments. As a result, CMS utilized the PRF to provide stabilizing payments to assist agencies in funding their COVID-19 response operations. Most  CMS payments to ground ambulance services came in two forms:

Direct Deposit Payments: All Medicare-enrolled ground ambulance suppliers and providers should have received a direct deposit payment in 2020 which was equal to 6.19% of their 2019 Medicare fee-for-service receipts. Agencies were not asked to repay CMS for these payments. 

Advanced and Accelerated Payments: Medicare-enrolled ground ambulance agencies, along with all other Medicare-enrolled suppliers and providers, were eligible to receive certain advanced payments if they anticipated experiencing delays in either submitting claims or receiving payments. Unlike the direct deposit payments, Medicare suppliers and providers had to affirmatively apply for these funds and agree to a repayment schedule.  

Earlier this month, CMS published a notice with additional details on the repayment process for the advanced and accelerated payments. It is important that any fire department that applied for and received these funds ensure they comply with CMS’ latest repayment process. Please take some time to review the instructions from CMS if your department applied for and received these funds. 

CMS has no plans to require repayment of the direct deposit funds sent to all Medicare-enrolled suppliers and providers. These automatic payments are not eligible for recoupment and are unimpacted by the CMS’ guidance for repayment of the advanced and accelerated payments. 


Evan Davis is a strategic government relations manager for the IAFC

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