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What's New for 2008
Patient Transport Verification Signature Requirements
New rules governing obtaining patient signatures for ambulance transports will go into effect January 2008. The new rule will require a service to make every effort to obtain a patient signature or signature from a family member to verify the transport was done. Specific requirements regarding documentation that will need to be obtained by the provider in the event of not being able to obtain a patient or family member signature have been specifically outlined.
The following is a summary of the new requirements for documentation. Each provider should check with their billing agency and legal representative regarding any changes that they may need to make. For details on these and other current Colorado EMS issues visit the Colorado Department of Health web site.
New Exception for Emergency Transports
The exception would permit an ambulance service, in an emergency, to answer "Yes" for the signature question on electronic claims and submit the claim to Medicare for payment, provided each of the following conditions was met:
The patient was physically or mentally incapable of signing the claim at the time of service.
There is no one else legally entitled to sign on the patient's behalf at the time the service was provided and
the ambulance service obtains/maintains the following documentation for 4 years:
Note: To qualify for the new exception, you must obtain 3 pieces of documentation:
1. Statement from crew member (i) that the patient was unable to sign and (ii) that no legally authorized person was available or willing to sign on the patient's behalf. NOTE: this documentation must be obtained at the time of transport.
2. Documentation of (i) the date and time of the transportation and (ii) the name and location of the facility that received the patient
3. Documentation from the receiving facility of (i) the name of the patient and (ii) the date and time the patient was received in the form of either:
A contemporaneous statement from a representative of the receiving facility, OR
A secondary form of verification from the receiving facility, which can include a patient medical record, hospital admission record, hospital log, etc.
The new exception makes no allowances for the inevitable situations where the ambulance service makes a good faith effort to comply, but is ultimately unable to obtain the required documentation from the receiving facility. When this happens, you will still be required to get the signature of the patient or an authorized representative.
2007 EMS Rule Changes
New rules governing EMT certification went into effect January 1st, 2007. These rules include changes in requirements for motor vehicle driving records and state practical skills tests. In addition new Continuing Education requirements are slated to take effect July 1st, 2008. These changes will affect all levels of EMS certification. For details on these and other current Colorado EMS issues visit the Colorado Department of Health web site.
Legislation and Colorado EMS in 2006
Legislative and other changes in 2006 affected many aspects of Colorado EMS in 2006. The EMT formulary, state accreditation of EMS Continuing Education providers, and EMS education and certification rule changes are just some of the areas that were affected. In addition, the State of Colorado looked at guidelines for a Critical Care Paramedic course curriculum. For details on these and other current Colorado EMS issues visit the Colorado Department of Health web site.
Federal Register Publishes Final Rule for Medicare Fee Schedule
The final rule for the new Medicare Ambulance Fee schedule was published in the Federal Register (02/27/02, Vol. 67, No. 69).
Privacy Rule
HHS Secretary Tommy G. Thompson issued the first-ever comprehensive federal regulation that gives patients sweeping protections over the privacy of their medical records. The final regulation, which takes effect April 14, 2003, will ensure strong privacy protections without interfering with Americans' access to quality health care.
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