Sec. 2111. Ground ambulance services cost reporting requirement
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Section 1121 of the Social Security Act ( 42 U.S.C. 1320a ) is amended— in subsection (a)— by striking For the purposes of and inserting Subject to subsection (d), for the purposes of ; by inserting suppliers of ground ambulance services, after health maintenance organizations, ; and in the matter following paragraph (5), by adding the following new sentence: Not later than December 31, 2019, the Secretary shall modify the uniform reporting systems for providers of services with respect to ground ambulance services to ensure that such systems contain information similar (as determined by the Secretary) to information required under the uniform reporting system for suppliers of ground ambulance services. ; and by adding at the end the following new subsection:
In the case of a provider or supplier of ground ambulance services, the Secretary may modify the requirements for the inclusion of any data element specified in subsection
(a)in reports made in accordance with the uniform reporting system established under this section with respect to such services for such provider or supplier. . 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: With respect to ground ambulance services furnished by a supplier of such services during cost reporting periods (as defined in subparagraph (I)) beginning on or after January 1, 2020, such supplier shall make reports to the Secretary of information described in section 1121(a) in accordance with the uniform reporting system established under such section for such suppliers and, as may be required by the Secretary, of any of the information described in subparagraph (B). The Secretary may, with respect to a supplier of ground ambulance services, require the following information (to be reported to the extent practicable under the uniform reporting system established under section 1121(a) for such suppliers): Whether the supplier is part of an emergency services department, a governmental organization, or another type of entity (as described by the Secretary). The number of hours in a week during which the supplier is available for furnishing ground ambulance services. The average number of volunteer hours a week used by the supplier. Subject to subparagraph (E), in the case that the Secretary determines that a supplier of ground ambulance services has not made to the Secretary a timely report described in subparagraph
(A)with respect to a cost reporting period beginning on or after January 1, 2020, and before January 1, 2022, the Secretary may suspend payments made under this subsection, in whole or in part, to such supplier until the Secretary determines that such supplier has made such a report. Subject to subparagraphs
(E)and (F), in the case that the Secretary determines that a supplier of ground ambulance services has not made to the Secretary a complete, accurate, and timely report described in subparagraph
(A)with respect to a cost reporting period beginning on or after January 1, 2022, the Secretary may either— deem payments made under this subsection to such supplier for such period to be overpayments and recoup such overpayments; or suspend payments made under this subsection to such supplier for such period. The Secretary shall establish a process whereby a supplier of ground ambulance services may request a delay in making a report described in subparagraph
(A)with respect to a cost reporting period for reason of significant hardship (as determined by the Secretary). Not earlier than January 1, 2024, the Secretary may provide that subparagraph
(D)no longer applies to suppliers of ground ambulance services or a category of such suppliers after— taking into account the recommendation of the Medicare Payment Advisory Commission in the most recent report available to the Secretary submitted under section 2111(g) of the SUSTAIN Care Act of 2018 whether cost reports made by suppliers or a category of suppliers (as specified for purposes of the report submitted under such section) of ground ambulance services should be required or modified; and undertaking notice and comment rulemaking. The Secretary shall audit reports described in subparagraph
(A)made with respect to cost reporting periods beginning on or after January 1, 2021. The Secretary shall establish a process whereby a supplier of ground ambulance services may appeal a determination described in subparagraph
(C)or
(D)made with respect to a cost report required to be made by such supplier under subparagraph (A). In this paragraph, the term cost reporting period means, with respect to a year, the 12-month period beginning on January 1 of such year. . The Secretary of Health and Human Services shall implement the provisions of this section, including the amendments made by this section, through notice and comment rulemaking and seek input from stakeholders. Chapter 35 of title 44, United States Code, shall not apply with respect to— the development and implementation of the uniform reporting system required under section 1121(a) of the Social Security Act ( 42 U.S.C. 1320a(a) ) for suppliers of ground ambulance services and reports required to be made under section 1834(l)(17) of such Act ( 42 U.S.C. 1395m(l)(17) ); and the modification of the uniform reporting systems under such section 1121(a) of such Act for providers of such services and reports required to be made under section 1861(v)(1)(F) of such Act ( 42 U.S.C. 1395x(v)(1)(F) ). In addition to funds otherwise available, there are appropriated to the Centers for Medicare & Medicaid Services Program Management Account from the Federal Hospital Insurance Trust Fund under section 1817 of the Social Security Act ( 42 U.S.C. 1395i ) $8,000,000 and from the Federal Supplementary Medical Insurance Trust Fund under section 1841 of such Act ( 42 U.S.C. 1395t ) $137,000,000 (of which not less than $15,000,000 shall be used to fulfill the auditing requirement under section 1834(l)(17)(G) of such Act, as added by subsection
(b)of this section) to carry out the provisions of this section, including the amendments made by this section, to remain available through December 31, 2022. Of the amounts appropriated under the previous sentence, the Secretary shall use such sums as may be necessary to hire not less than 2 full-time employees for purposes of carrying out such provisions, including such amendments. Section 1834(l) of the Social Security Act (42. U.S.C. 1395m(l)) is amended— in paragraph (12)(A), by striking 2018 and inserting 2023 ; and in paragraph (13)(A), by striking 2018 each place it appears and inserting 2023 . It is the sense of Congress that— a cost report made by a supplier of ground ambulance services with respect to a cost reporting period beginning before January 1, 2022, may not contain complete and accurate information on ground ambulance services furnished during such a period by the supplier; and the Secretary should take into account only the timeliness of such a report made with respect to such a period when determining whether to suspend payments to a supplier under section 1834(l) of the Social Security Act ( 42 U.S.C. 1395m(l) ). Not later than March 15, 2023, and as determined necessary by the Medicare Payment Advisory Commission thereafter, such Commission shall assess and submit to Congress a report on cost reports of suppliers and providers of ground ambulance services carried out in accordance with sections 1121(a) and 1834(l) of the Social Security Act ( 42 U.S.C. 1320a(a) , 1395m(l)), the adequacy of payments for such services made under section 1834(l) of such Act, and geographic variations in the cost of providing such services. The report described in paragraph
(1)shall contain the following: An analysis of cost report data submitted in accordance with such sections. An analysis of any burden on providers and suppliers of such services associated with reporting such data. A recommendation on whether or not cost reports of ground ambulance services made by suppliers or a category of suppliers (as specified by the Secretary) of such services, or the ground ambulance portion of cost reports made by providers of such services, should be required or modified, taking into account the analyses described in subparagraphs
(A)and (B).
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Sec. 2111
Ground ambulance services cost reporting requirement
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