HHS to Collect Data From the EMS System: Good Time to Examine Accounting, Cost, Billing, and Collection Systems

15 February 2018 Legal News: Government Enforcement Defense & Investigations Publication
Authors: Pamela L. Johnston Edmund T. Baxa Jr Thomas F. Carlucci Lawrence M. Kraus Lauren M. Loew Lisa M. Noller Judith A. Waltz J. Mark Waxman Heidi A. Sorensen Jeremy J. Bledsoe Kristina J. Matic Lori A. Rubin Olivia S. Singelmann Jennifer H. Wang

Legal News: Government Enforcement Defense & Investigations

While recent legislation impacting the Emergency Medical Services (EMS)/ambulance industry drew attention inside the industry for its reduction in Health and Human Services’ (HHS) spend on non-emergent dialysis transports and the five-year extension of the Medicare add-ons for the EMS industry, the legislation created a new forward-looking reporting obligation. Specifically, as part of the Continuing Resolution enacted into law on February 8, 2018, Congress authorized HHS to develop a “data collection system … to collect cost, revenue, utilization” and other information “determined appropriate by” HHS from EMS systems. Public Law 115-123, §50203 (b)(17)(A) (emphasis added). Congress provided HHS until December 31, 2019, to create the data collection system, the ambulance suppliers that will need to provide the data, and the type of representative samples that they will need to supply to HHS. If selected, a company will need to provide HHS with the requested data – including data about, for example, revenue, costs, vehicles, and ambulance utilization rates – once a year, with the suppliers that need to report to HHS rotating on a regular basis.

What Does this Legislation Mean to Ambulance Suppliers

This legislation means that some ambulance suppliers, including private companies, will need to provide revenue figures, ambulance utilization data, cost data, vehicle usage, and likely other data to HHS so that HHS can mine this data to see trends, spot hot spots in the country where costs are higher, and generally seek to reduce the money spent on particular segments of the EMS industry.

Preparing for the Change in Reporting Obligations – Examine Your Systems

To prepare for this coming change in the reporting obligations, EMS suppliers should consider reviewing in 2018 their accounting, transport, and billings systems (including third party vendor systems) and conducting audits of these systems, including audits of third party vendors, to square away any issues or problems ahead of the 2019 roll-out date. Some companies may want to work with counsel to do this in order to obtain legal advice for issues that arise; use of an attorney in the audit process can protect the audit from production later in an investigation or litigation because of the attorney client privilege if it is done at the request of an attorney who is providing legal advice to the company in conjunction with the audit.

HHS will be collecting data through the year 2024 pursuant to this new legislation. It will be interesting to understand what HHS observes once the agency is able to mine it for trends and perceived abuses.

For more information on legislation impacting the EMS industry, including the team, publications, and other materials, visit Foley’s Government Enforcement Defense and Investigations Group.

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