Medicare Update, Part I8:45 – 10:30 a.m.

The Medicare regulatory landscape continues to evolve, creating new challenges and opportunities for ambulance providers. In this two-part session, AAA Medicare Consultant Brian S. Werfel, Esq. will provide a practical update on significant reimbursement, regulatory and enforcement developments impacting Medicare’s coverage of ambulance services.

In the first session, participants will gain insight into current Medicare payment trends, the findings from CMS’s Ground Ambulance Data Collection System (GADCS) and the ongoing gap between Medicare reimbursement and the actual cost of providing ambulance services. The session will examine the financial pressures facing EMS organizations, including the effects of inflation, sequestration, Medicare Advantage growth and broader concerns regarding the long-term sustainability of the Medicare program.

Medicare Update, Part II10:45 a.m. – 12:00 p.m.

The second session will focus on compliance matters. Brian will provide an overview of current audit activity, including the recent uptick in Targeted Probe and Educate (TPE) audits. He will also discuss how CMS intends to leverage artificial intelligence and advanced data analytics to cut down on fraud, waste and abuse in the Medicare program. Finally, he will examine several recent OIG and DOJ enforcement actions, with the intent of providing attendees with practical steps they can take to reduce the compliance risks to their organization.