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Audit your facility's ambulance rates to prevent inappropriate discounts

Health Care Auditing Strategies, April 1, 2007

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Auditing a healthcare facility is no easy task, and it's embarrassing when something falls through the cracks. But what is even worse is when situations arise about which you would otherwise have no clue, such as inappropriate, unwritten contracts with ambulance services.

Swapping-when a hospital or nursing home takes a discounted rate from ambulance companies for transports (e.g., Part A patient transports) in exchange for referring all of the other nonfacility responsible transports (e.g., Part B patient transports)-is one of the newest enforcement risks facing hospitals and other health facilities. It may not sound like a big deal, but a 1999 OIG advisory opinion found otherwise (see "OIG guidance on ambulance discounts" below).

Carrying on, as normal

The practice of swapping was common prior to the 1999 advisory opinion, according to R. Michael Scarano Jr., a partner at Foley & Lardner, LLP, in San Diego. Until the advisory opinion, ambulance companies and hospitals did not know this practice was potentially problematic, he says.

This is an excerpt from a member only article. To read the article in its entirety, please login.

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