Repetitive, Scheduled Non-Emergent Ambulance Transport (RSNAT) Prior Authorization Model Process and Requirements (CMS-10708)

The Centers for Medicare & Medicaid Services (CMS) is currently testing the Repetitive, Scheduled Non-Emergent Ambulance Transport (RSNAT) Prior Authorization Model, in limited states, under the authority of section 1115A of the Social Security Act (the Act). Section 515(b) of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) added paragraph (16) to section 1834(l) of the Act, which requires that, beginning January 1, 2017, the Secretary expand the model to all states if the model expansion meets certain statutory requirements for expanding models that are tested by the Center for Medicare and Medicaid Innovation (Innovation Center) under the authority of section 1115A of the Act. The expansion criteria, described in paragraphs (1) through (3) of section 1115A(c) of the Act, require that; (1) the Secretary determines that such expansion is expected to—(A) reduce spending under applicable title without reducing the quality of care; or (B) improve the quality of patient care without increasing spending; and (2) the Chief Actuary of the Centers for Medicare & Medicaid Services certifies that such expansion would reduce (or would not result in any increase in) net program spending under applicable titles; and (3) the Secretary determines that such expansion would not deny or limit the coverage or provision of benefits under the applicable title for applicable individuals. Because section 1834(l)(16) of the Act requires the Secretary to expand the RSNAT Prior Authorization Model to all States if it meets the statutory expansion criterial in 1115A(c)(1 through 3) of the Act, the exemption from Paperwork Reduction Act (PRA) process in 1115A(d)(3) is not applicable for the purposes of the nationwide expansion of this model. Therefore, in order to move forward with potential nationwide expansion, contingent on the Secretary’s determination that the expansion criteria are met, CMS must complete the PRA approval process, as required by chapter 35 of title 44, United States Code. As part of the process for working towards potential expansion of the RSNAT Prior Authorization Model under section 1834(1)(16) of the Act, CMS is seeking approval for the collection of information under PRA.

The latest form for Repetitive, Scheduled Non-Emergent Ambulance Transport (RSNAT) Prior Authorization Model Process and Requirements (CMS-10708) expires 2023-08-31 and can be found here.