Back to REMSCO Policy Statements

SCOPE:

In accordance with the Federal Anti-Kickback Statue “Safe Harbor” the following Emergency Ambulance Restocking Policy shall be in effect within the Westchester EMS Region.  The program has been developed following the opinion of the United States Office of the Inspector General (OIG)¹.  This program pertains to all New York State certified emergency ambulances² and the approved 911 receiving hospitals operating in the Westchester Region / County (see Appendix A).  It does not apply to intra-facility or contracted non-emergency ambulance transports.  The Anti-kickback Statute³ makes it a criminal offense to knowingly and willingly offer to pay, solicit or receive any remuneration to induce referrals of items or services reimbursable by the Federal Health Care Program.

PURPOSE:

To provide a means of maintaining essential emergency medical supplies on emergency ambulances through a one-for-one exchange system with area hospital emergency departments and hospital pharmacies.

POLICY ELEMENTS:

1.      Hospitals will exchange, on a one-for-one basis, certain supplies and pharmaceuticals used by participating EMS agencies on patients transported to the hospital.

a.      Basic supplies are shown on the attached Appendix B.  Hospitals will exchange designated supplies with all EMS agency ambulances on a one for-one (one item used, one replacement item provided) basis.

b.      The Westchester Regional Medical Advisory Committee “ALS Treatment Protocol Formulary” designates pharmaceuticals and related ALS supplies.  Hospitals will exchange designated medications with all ALS EMS agency ambulances on a one-for-one (used item exchanged for sealed, prepared box) basis. The only exception to this will be those substances under the jurisdiction of the NYS DOH Bureau of Controlled Substances (BCS). Those controlled substances will be replaced as per each agency’s Part 80 Plan.

c.      This exchange policy also applies where an agency might expend exchangeable supplies and/or pharmaceuticals on emergency calls not resulting in patient transport by that agency (e.g., helicopter transport after initial treatment by ground ambulance crew). In such cases, participating hospitals will exchange in the same manner as when a patient is delivered by the agency.

2.      For the purposes of documenting exchanged equipment, ambulance personnel may utilize either:

a.      The Westchester Regional Emergency Medical Services Council’s Ambulance Restock Inventory Form (see attached) ; or

b.      A NYS DOH Patient Care Report (PCR) Continuation Form; or

c.      An agency generated acceptable alternative exchange documentation form

3.      The exchange documentation shall be kept by the EMS Agency with the Agency’s copy of the  NYS DOH PCR and/or approved alternative patient care record.  A copy of the exchange documentation shall be given to the Emergency Department to be included with the PCR in the hospital record.

4.      The Westchester Regional Medical Advisory Committee (REMAC) will conduct program evaluation, revisions and updates on an annual basis.

5.      All 911 receiving hospitals shall post conspicuous documentation that they participate in the Westchester Regional EMS Emergency Ambulance Restock Program.

Notes:

The restocking arrangement must not take the volume or value of patient referrals into account, or other business generated between the partner;

Under no circumstances may both the hospital and the ambulance provider bill for the replenished items;

All parties must otherwise comply with all applicable Federal health care program payment and coverage requirements;

1.        Antikickback Statute – Safe Harbor – Department of Health and Human Services – Office of Inspector General 42 CFR Part 1001.952  42 U.S.C. 1320a – 7b (b), 1128 B (b).

2.        Emergency Ambulance – ambulance that responds to emergencies on the average of three times per week. (This excludes designated transport ambulances). 

3.        Anti-kickback Statute – Department of Health and Human Services – Office of Inspector General 952 42 U.S.C. 1320a – 7b (b), 1128 B(b).

Notes:

·            This list does not suggest specific brands or manufacturers. Selection of brands and manufacturers will be the prerogative of the hospitals.

·            Pharmaceuticals and related supplies are listed on the Westchester Regional Medical Advisory Committee “ALS Treatment Protocols” formulary.

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