[CCM-L] trauma-list Digest, Vol 63, Issue 38

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There is precedent for Medicare to examine the cost vs. benefit of medical 
helicopter services. Project Hope (Center for Health Affairs, Chevy Case, MD No. 
99-c-99168/3-02, 1991) was a study commissioned by the Health Care Financing 
Administration (HCFA) in response to Sec. 6136 of the Omnibus Reconciliation 
Act of 1989 (PL 101-239). The goal of the study was to establish the cost vs. 
benefit relationship between BLS and ALS ambulance services under Medicare, in 
view of the fact that reimbursement for ambulance services had risen at an 
average annual rate of more than 20% since 1974, or more than twice the rate of 
medical inflation for the same period.

Because the study reported "disagreement in the literature about the medical 
effectiveness of ALS services when compared to BLS services," Medicare applied 
this finding to all future reimbursement policies by requiring ambulance 
suppliers to prove medical necessity according to increasingly strict Medicare 
guidelines. Such should be the case for medical helicopter services.

Bob Kellow


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