By Lisa Gillespie

Kaiser Health News

PHILADELPHIA — Seniors living in three states will need prior approval from Medicare before they can get an ambulance to take them to cancer or dialysis treatments.

The change, which begins today, is part of a 3-year pilot to combat extraordinarily high rates of fraudulent billing by ambulance companies in Pennsylvania, New Jersey, and South Carolina.

Expert Analysis Ambulance may not be best resource for non-emergency transports When I started in the business in the mid-1980s, I worked for a private ambulance service in the suburbs north of Boston. We handled 911 and interfacility transports; it was fairly normal to run emergency calls through the night, and end the shift by transporting a scheduled transfer at 6 a.m. One of these runs was a quiet, older woman who would walk slowly out of her home, cane in one hand and lunch bag in another. We would help her into the passenger seat of the ambulance, and the EMT would ride in the back on the way to her dialysis appointment. As a young gun, I was frustrated by these runs. It seemed pretty straightforward that she should use a taxi and not one of the town’s 911 ambulances for her “convenience.” Why was it that I had to be the cab driver? Related articles Pa. woman gets 8 years in jail for Medicare fraud

Pa. ambulance co. founder jailed for Medicare fraud Related feature Feds crack down on Philly Medicare fraud Medicare officials temporarily blocked any new Philadelphia-area ambulance companies from becoming eligible for Medicare payments

The good news is that Medicare beneficiaries in those states will now know beforehand whether the program will cover their non-emergency transportation to treatments. The bad news, say advocates, is that many fragile people will be left with no way to get to appointments that might mean the difference between life and death.

Read full story: Medicare Tightens Non-Emergency Ambulance Use