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Ambulance Rate Increases <br />April 9, 1992 <br />Page 3 <br /> <br /> Ail of the above recommended rate changes fall within <br />approved payment guidelines of medicare/medicaid except the <br />$3.00 per loaded mile charge. Medicare/medicaid will approve <br />this charge on January 1, 1993. All increases for medicare/ <br />medicaid require twelve months of history in order to <br />establish standard rate charges for the County. At the end <br />of the twelve month period, an increase in the County <br />supplement may be applied for and approved. <br /> <br /> While increasing the rate for Cabarrus County Emergency <br />Medical Services, we also need to consider several other <br />changes in rate charges. <br /> <br /> 1. Non-emergency medical necessity transports which <br /> are being done under franchise agreement with <br /> Char-Meck of Cabarrus should be increased to <br /> $125.00. <br /> <br />A County ordinance should be established to allow <br />the County to bill direct any facility (i.e., <br />nursing homes, hospitals) that transports a <br />patient out of their facility and the patient does <br />not fall under either medicare/medicaid guidelines <br />or COBRA 86 guidelines for patient transfers. <br />Examples of this are as follows: <br /> <br />b) <br /> <br />A patient being transported from a hospital <br />or emergency room to a helipad for transport <br />to another facility. <br /> <br />Emergency transports to a facility (Duke) <br />which do not fall under the classification of <br />closest appropriate medical facility to <br />handle patients condition and/or <br />doctor/patient preference and does not follow <br />medicare/medicaid guidelines. <br /> <br />An example of this ordinance is attached. This ordinance was <br />modeled after ones already approved in Union and Rowan <br />Counties. <br /> <br /> In conclusion, I recommend rate changes be considered on <br />an annual or semi-annual basis so that the impact of any <br />increase would be reduced. Our last increase was over five <br />(5) years ago. Considering rate changes more often helps <br />alleviate the impact on collectable amounts from both <br />medicare and medicaid due to the twelve month history <br />requirement and on the elderly citizens of Cabarrus County <br />who live on fixed incomes. <br /> <br />ALA:jys <br /> <br />Attachments <br /> <br /> <br />