Repetitive, Scheduled Non-Emergent Ambulance Transport (RSNAT) Prior authorization model prepayment paused due to COVID-19

The following is a message originally released by Novitas Solutions on March 31, 2020.

Novitas Solutions will pause certain operations for the RSNAT prior authorization model. During this time, Novitas will suspend all additional documentation requests (ADRs). For ADRs that have already been issued at the time of this notification, we will not deny claims from providers for failure to respond to ADR requests. In these cases, we will release the claims for payment and consider the provider for review when normal operations resume. We will continue to review all prior authorization requests that are submitted during the pause. The Centers for Medicare & Medicaid Services (CMS) will provide further instruction to remove the pause. Following the end of the pause, we will conduct post-payment review on all claims subject to the model that were submitted and paid during the pause. Those claims that are submitted with an affirmed Unique Tracking Number will not be reviewed under post-payment review. CMS will provide further instruction concerning the post-payment reviews at a later time.

CMS posted a Frequently Asked Questions section to their website regarding the COVID-19 Provider Burden Relief.

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