Medicare program; ambulance service--HCFA. Final rule.

Abstract

These regulations revise current Medicare policy on coverage of ambulance services. They provide for round trip transportation to the nearest appropriate treatment facility to obtain medically necessary diagnostic or therapeutic services not available in the hospital or skilled nursing facility in which the beneficiary is an inpatient. The regulations also specify that, in the case of a beneficiary who is being transported to a hospital, the availability of a physician or physician specialist capable of providing the necessary treatment required by the beneficiary's condition is a factor in determining whether the hospital has appropriate facilities to care for the beneficiary. These changes are designed to make the ambulance service benefit consistent with changes in the health care delivery system, and are expected to reduce Medicare program expenditures and facilitate the sharing of services.