Ok, this gem appeared in my mailbox today.
I will have a couple of comments after jump as well, but the problem with this policy bulletin is that it does not take into account what routinely happens in cardiac arrest scenarios, especially in progressive EMS systems. Specifically, what happens when an ALS provider arrives on scene with a patient in cardiac arrest and the resuscitation is not successful in the field? Well, I was an EMS Supervisor for the Houston Fire Department for almost 6 years before I retired and a Paramedic my entire career. For the ENTIRE time I was a supervisor, we would work many cardiac arrest calls and NOT transport if the resuscitation was not successful in the field. This is a generally accepted practice.
But reading this Bulletin, it appears that Novartis only believes that this should be paid at the provider’s BLS rate! I know that CMS defines the ambulance benefit as a “transport” benefit, but this is monumentally foolish with regards to a modern EMS system. And they don’t even address this issue in the bulletin as neither example provided reflects the reality of a significant number of the cases actually occurring in the field.
The FULL text of the Bulletin after the jump: