Sec. 515. National expansion of prior authorization model for repetitive scheduled non-emergent ambulance transport
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In implementing the model described in paragraph
(2)proposed to be tested under subsection
(b)of section 1115A of the Social Security Act ( 42 U.S.C. 1315a ), the Secretary of Health and Human Services shall revise the testing under subsection
(b)of such section to cover, effective not later than January 1, 2016, States located in medicare administrative contractor
(MAC)regions L and 11 (consisting of Delaware, the District of Columbia, Maryland, New Jersey, Pennsylvania, North Carolina, South Carolina, West Virginia, and Virginia). The model described in this paragraph is the testing of a model of prior authorization for repetitive scheduled non-emergent ambulance transport proposed to be carried out in New Jersey, Pennsylvania, and South Carolina. The Secretary shall allocate funds made available under section 1115A(f)(1)(B) of the Social Security Act ( 42 U.S.C. 1315a(f)(1)(B) ) to carry out this subsection. Section 1834(l) of the Social Security Act ( 42 U.S.C. 1395m(l) ) is amended by adding at the end the following new paragraph: Beginning January 1, 2017, if the expansion to all States of the model of prior authorization described in paragraph
(2)of section 515(a) of the Medicare Access and CHIP Reauthorization Act of 2015 meets the requirements described in paragraphs
(1)through
(3)of section 1115A(c), then the Secretary shall expand such model to all States. The Secretary shall use funds made available under section 1893(h)(10) to carry out this paragraph. Nothing in this paragraph may be construed to limit or modify the application of section 1115A(b)(3)(B) to models described in such section, including with respect to the model described in subparagraph
(A)and expanded beginning on January 1, 2017, under such subparagraph. .
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Sec. 515
National expansion of prior authorization model for repetitive scheduled non-emergent ambulance transport
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