Administrative Relief in Response to the 2019-Novel Coronavirus (COVID-19) Pandemic: Pausing Repetitive, Scheduled Non-Emergent Ambulance Transport (RSNAT) Prior Authorization Model

Pursuant to the Robert T. Stafford Disaster Relief and Emergency Assistance Act, President Trump declared that, as a result of the effects of COVID-19, a national emergency exists nationwide.

Effective March 29, 2020, Palmetto GBA, specifically Jurisdiction M MAC paused certain operations for the RSNAT Prior Authorization Model. During this time, all Additional Documentation Requests (ADRs) will be suspended.

  • ADRs issued prior to March 29, 2020, will be released and processed as normal
  • Providers may continue to submit prior authorization requests during the pause
  • Claims that have received a provisional affirmative prior authorization decision and are submitted with an affirmed unique tracking number (UTN) will continue to be excluded from future medical review. Following the end of the PHE for the COVID-19 pandemic, the MACs will conduct postpayment review on claims otherwise subject to the model that were submitted and paid during the pause.

CMS has also issued FAQs related to this topic. Providers can access this information by clicking here (PDF 54 KB). Providers are strongly encouraged to stay informed by reading the Palmetto GBA email updates. Sign up here.

Note: Providers/suppliers must resume compliance with normal Medicare fee-for-service rules and regulations as soon as they are able to do so and, in any event, the waivers or modifications a provider/supplier was operating under are no longer available after the termination of the emergency period.

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Provider Contact Center: 855-696-0705

TDD: 866-830-3188

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