5. Eliminate Fraud & Abuse a. Local EMS agencies / authorities should:
b. State EMS authorities / associations should: i. Create technical assistance centers. ii.Conduct educational seminars and disseminate best practices. iii. Partner with higher education to develop new curriculums focused on management of EMS systems. c. National EMS associations should: i. Provide guidance and expertise to assist local EMS leaders and agencies to develop these skills. ii.Develop a standardized set of key performance indicators within the industry. iii. Establish benchmarks for good financial health. 4.Make Use of Available Grant Opportunities a. Local EMS agencies should: i. Be aware of the various grant mechanisms available to them. ii.Consider collaborating with other EMS or non-EMS partners including academic institutions to pursue these grants. b. State EMS authorities / associations should: i. Provide technical assistance to local EMS agencies seeking grant support. c. National EMS associations should: i. Advocate or create additional funding opportunities for EMS agencies. ii. Provide technical assistance to local EMS agencies seeking grant support.
i. Ensure that their billing and accounting practices are compliant with state and federal regulations. ii.Voluntarily participate in audits of innovative service provision to assure regulatory compliance and program integrity. b. State EMS authorities should: i. Clearly define expectations for EMS service billing. ii.Provide expert guidance, when needed, regarding billing for innovative services. c. National EMS associations should: i. Advocate for clear, freely available national guidance on compliance with federal regulations regarding Medicare and other federal EMS-related finance rules. ii.Partner with CMS, and other federal authorities, and payer groups to form a task force to design and implement anti-fraud and abuse initiatives.
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CHAPTER 3
MOUNT SINAI HEALTH SYSTEM | UNIVERSITY OF CALIFORNIA, SAN DIEGO
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