The Health Care Financing Administration (HCFA) has published a proposal for a new, more streamlined reimbursement fee schedule for ambulance service covered by Medicare. Issued on Sept. 12, the proposed rule responds to a congressional directive, included in the Balanced Budget Act of 1997, that calls for a new, simplified system of billing codes for Medicare reimbursement of ambulance services.

The publication of the proposed rule represents the culmination of the work of the official Negotiated Rulemaking Committee that was appointed to come up with a fair and reasonable reimbursement plan. NACo served on the committee and was able to offer the unique perspective of counties in this process. Because many counties are responsible for the organization, delivery, oversight, and funding of ambulance services, NACo convinced HCFA officials that it was crucial that this committee include the input of elected county officials.

The proposed rule is set to take effect Jan. 1, 2001 and would immediately replace existing billing codes. A Program Memorandum (PM) was sent to all Medicare carriers and fiscal intermediaries on Sept. 18, with instructions on the implementation of the fee schedule. The PM can be accessed on the Internet at: www.hcfa.gov/pubforms/transmit/memos/comm_date_dsc.htm.

There is a 60-day comment period on the proposed rule. All comments must be received by 5 p.m., Nov. 13, 2000. As a member of the Negotiated Rulemaking Committee, NACo is precluded from further comment on the proposal. Copies of the proposed rule can be found in the Sept.12 issue of the Federal Register (Vol. 65, No. 177, pp. 55077-55100) or online at http://frwebgate .access.gpo.gov/cgi-bin/getdoc.cgi?dbname=2000 _register&docid=00-23195-filed.

Mail written copies – one original and three copies – to the following address: Health Care Financing Administration, Department of Health and Human Services, Attn: HCFA-1002-P. O. Box 8013, Baltimore, MD, 21244-8013. Fax transmissions will NOT be accepted.

(There will be more information about the proposed regulations in the next issue of County News.)