Arkansas Stars of Life to be Honored on May 15
Ceremonies and Activities Planned At State Capitol  

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NPI UPDATE

Getting an NPI is free - not having one can be costly.

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ARKANSAS BCBS INCREASES PAYMENT FLOOR FOR AMBULANCE SERVICE
FROM $300 PER YEAR TO $1,000 PER YEAR FOR MOST PLANS

FROM AR-BCBS:   Effective 04/04/06 the Ambulance benefit limitation will be changed to a $1000.00 benefit for services 04/01/06 and after.  Transportation and mileage will be allowed at billed charges.  All other charges for Ambulance will be subject to the fee schedule allowance.  This will increase the members coverage for Ambulance services.  If the member has already met the $300.00 benefit limitation for 2006, they will receive an additional $700.00. 

The above message was transmitted to insurance agents on April 10, 2006. This is in response to ongoing negotiations with Arkansas BCBS to increase payments under many of its policies to better reflect the costs of ambulance services to its insured. This change represents a significant committment by BCBS to the ambulance industry. Many thanks to Bruce Hawkins, Ken Kelley, Jon Swanson and others for their diligence in this process.

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GAO Publishes Report on Medicare Ambulance Reimbursement
Costs and Expected Medicare Margins Vary Greatly

Costs of ground ambulance services were highly variable across providers that did not share costs with nonambulance services in 2004, reflecting differences in certain provider and community characteristics. Costs per transport among these providers varied from $99 per transport to $1,218. Providers without shared costs that had higher costs per transport typically had fewer transports per year, a greater percentage of transports in which more than a basic medical intervention occurred, more transports in super-rural areas (rural counties with lowest population density), lower productivity—measured as number of transports furnished per staffed hour, and a greater percentage of revenues from local tax support. Average payments under the national fee schedule in 2010 are expected to be higher than historical payments, but providers’ Medicare margins will vary greatly. GAO could not assess whether, on average, providers without shared costs would break even, lose, or profit under the national fee schedule, because the average Medicare margin for providers without shared costs was estimated to fall from negative 14 percent to positive 2 percent. However, GAO estimated that approximately 39 to 56 percent of providers without shared costs would have average Medicare payments above their average cost per transport under the national fee schedule in 2010. From 2001 to 2004, utilization of ambulance transports per beneficiary increased 16 percent overall. However, use declined by 8 percent in super-rural areas. Declining utilization coupled with potentially negative Medicare margins in super-rural areas, which could be exacerbated when the MMA temporary payment provisions expire, raise questions as to whether Medicare payments will be adequate to support beneficiary access in super-rural areas.