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TO: Ambulance Providers
RE: Reminder of Resumption of Ambulance Provider Requirements after the
COVID-19 PHE
Per federal
guidance, the COVID-19 public health emergency (PHE) ended on May 11, 2023.
Therefore, some flexibilities the Alabama Medicaid Agency (Medicaid)
implemented due to the COVID-19 PHE ended, and the policy outlined in Chapter 8
of the Provider Billing Manual is now in effect.
Medicaid intends
to keep providers updated on changes during the return to normal operations.
Medicaid is working with the Centers for Medicare and Medicaid Services (CMS) as
some flexibilities implemented during the COVID-19 PHE are ended. Notice of
changes is provided through additional notices via State Plan notice,
Administrative Code notice, waiver notice, or provider ALERTs.
Below are some
changes related to ambulance providers.
- Effective May 11, 2023, Medicaid will discontinue the following allowance
for ambulance services:
1.
Resume location restrictions – recipients are to be taken to the nearest hospital
that has appropriate facilities, physicians, or physician specialists needed to
treat the recipient’s condition.
2.
Resume prior authorization requirements for air transports.
3.
Resume prior authorization and non-emergency ambulance services 100 miles or greater
one-way.
- Effective May 11, 2023, Medicaid will not allow ambulance transports requiring isolation precautions as advanced life support (ALS) to qualify as medically necessary.
- Providers are required to submit a prior authorization request for non-emergency transports.
For billing
questions, please call the provider assistance center at (800) 688-7989 (Toll
Free) or (334) 215-0111.
For policy
questions, please email, brandon.williams@medicaid.alabama.gov,
or angela.johnson-groves@medicaid.alabama.gov.
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