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Prior authorization for non-emergency ambulance rides expands
Modern Healthcare

The CMS will soon require prior authorization for regular non-emergency ambulance transportation in order for it to be covered under Medicare.

The changes, which start next year, affect seniors living in Delaware, Maryland, North Carolina, Virginia, West Virginia and the District of Columbia. The six areas have large numbers of Medicare enrollees frequently taking non-emergency ambulance trips, according to the CMS. Those seniors often need transportation three or more times a week to get to dialysis, cancer or wound treatment appointments.

In 2012, Medicare Part B paid $5.8 billion for ambulance transports, almost double the amount it paid in 2003, according to an Office of Inspector General report released in September.

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