Authors: Rachel Ray and Sarah DiCicco
A Brief History of Medicare
In 1965, Medicare was signed into law under President Lyndon B. Johnson. In 1966, Medicare was officially implemented and around nineteen million individuals enrolled in the program during that first year. In the 1970s, Medicare eligibility was expanded to reach individuals under the age of 65 with long-term disabilities and individuals with end-stage renal disease. In the early 1980s, Medicare supplemental insurance, also known as Medigap, was brought under federal oversight. Then in the late 1980s, a new fee schedule for Medicare was created for physician and other professional services, including ground ambulance services. Since then, no changes have been made to the Medicare ground ambulance services.
It’s hard to believe that the Medicare ground ambulance fee schedule has not been analyzed or adjusted since the late 1980s. Many ground ambulance service departments benefit from the payments of the program; however, economic changes over the past 40 years make it difficult to tell how much these departments benefit today versus how much they benefitted from the program at its original release.
What is the Medicare Ground Ambulance Data Collection Survey?
As part of the Bipartisan Budget Act of 2018, the Centers for Medicare and Medicaid (CMS) is requiring departments that perform ground ambulance services to participate in the Medicare Ground Ambulance Data Collection Survey. All providers who performed at least one ground ambulance response in 2017 have been or will be selected to participate in this survey initiative, which is roughly 10,000 providers.
This survey will require departments to collect data for a period of 12 months followed by a 5-month reporting period. Departments will collect data related to revenue, utilization, and cost including: labor, facilities, vehicle, and equipment consumable and supply costs.
Data will be recorded and submitted to CMS through a secure, web-based portal developed by the Secretary of the Department of Health and Human Services (HHS). CMS will then analyze the data submitted, assess the burden on providers and suppliers of ground ambulance services, and provide a recommendation as to whether the program should be revised.
When are Departments Required to Begin Collecting Data?
Due to the Public Health Emergency (PHE) that transpired in early 2020, CMS decided to postpone the Medicare Ground Ambulance Data Collection Survey since there was a possibility that data would be skewed. Providers selected to report in Year 1 and Year 2 were then placed on hold, meaning roughly 5,000 ground ambulance service providers have been selected to participate in the survey so far.
In late 2021, CMS began sending out notifications to providers selected to report in Year 1 and Year 2— informing them that the program is no longer on hold and they will be required to begin collecting data in 2022. This means that those providers are now officially on the clock. The notification from CMS was sent out to providers both via email and postal mail to the individual registered with the Provider Enrollment Chain and Ownership System (PECOS). All departments are required to respond to the notification from CMS stating their department’s NPI number, main departmental point of contact for the initiative, and their choice of collection period (either the calendar year or their fiscal year).
- If your department is no longer performing ground ambulance services, you are still required to respond to the CMS letter informing them of your inability to participate.
- If your department was selected and has not yet responded to the CMS letter, click here to submit your response.
- If your department is selected and you do not submit a response to CMS, or your submission is deemed incomplete/insufficient, then you will be penalized with a ten percent (10%) reduction in Medicare Part B payments for one full calendar year.
What do we do if Our Department has Not Been Selected Yet?
If your ground ambulance service department has not yet been selected to participate in the survey initiative, you will be selected to participate in either Year 3 or Year 4, which means you will be required to begin collecting data in 2023 on either the calendar year or your fiscal year. CMS does not offer any exemptions to completing or postponing the survey during your selection period.
What do we do if Our Department does Not Have Adequate Staff to Complete this Survey?
This survey requires substantial information on your department from expenditures to staff hours. Accordingly, many departments have found that they do not have the personnel or bandwidth to complete the requirements of the survey on their own. If your department is looking for support on this initiative, please reach out to Public Consulting Group (PCG). We are providing introductory meetings for departments interested in learning more about the survey and hoping to gain support in the completion and submission of the Instrument.
Click here if you would like to schedule a free Medicare Ground Ambulance Data Collection consultation.