Download Notice of Ambulance Restocking Program

Ambulance Restocking Policy
A.
PURPOSE: To serve a significant public interest by allowing ambulances to
depart the hospital stocked for the next emergency call.
B.
POLICY: Hospital will replenish medications, linens, and medical/surgical
supplies to all non-charging ambulance providers at no cost to such
ambulance providers. For charging ambulance providers, Hospital will
provide a trade out for clean linens to such ambulance providers at no cost.
The Ambulance Restocking Program adheres to the requirements of the safe
harbor for ambulance restocking programs issued by the Office of the
Inspector General for the Department of Health and Human Services.
C.
PROCEDURE:
1. A transfer of drugs and/or medical supplies, including linens, to a
non-charging ambulance provider, will be only for the purpose of
replenishing comparable drugs or medical supplies used by the
ambulance provider in connection with the transport of a patient by
ambulance to Hospital. A trade out of clean linens to a charging
ambulance provider will be only for the purposes of replacing linens
that were soiled during the transport of a patient by the ambulance
provider to Hospital.
2. The ambulance that is replenished must be used to provide
emergency ambulance services.
3. Federal health care programs must be appropriately billed. Hospital
cannot bill for items provided through the restocking program.
4. Documentation will be maintained by the Hospital as follows:
a. Records of the replenished drugs and medical supplies and the
patient transport to which the replenished drugs and medical
supplies relate will be maintained by the Hospital for 5 years.
Ambulance providers will document requested drugs and/or
supplies on the Supply Request Sheet and attach it to the
goldenrod copy of the Ambulance Run Sheet.
b. Records will be made available to the ambulance provider upon
request.
c. Records will be made available to the Department of Health and
Human Services upon request.
5. The replenishing arrangement will not be tied to referrals.
6. Hospital and the ambulance provider will comply with all federal, state
and local laws regulating ambulance services, including, but not
limited to, laws relating to controlled substances.
7. Hospital will restock supplies on an equal basis for all non-charging
ambulance providers. Hospital will trade out clean linens for all
charging ambulance providers on an equal basis.
8. Hospital will post a written disclosure of the replenishing program in
the Emergency Department. Copies of the disclosure shall be made
available upon request to ambulance provides, government
representatives and members of the public. A copy of this disclosure
is attached.
ATTACHMENTS: Notice of Ambulance Restocking Program
Notice of Ambulance Restocking Program
Hospital offers the following ambulance restocking program:
1. We will restock ambulance providers of emergency services that bring
patients to Hospital in the following categories: (a) ambulance
providers that do not charge patients or insurers for their services will
be offered restocking of supplies and drugs utilized during transport
and (b) ambulance providers that charge patients or insurers for their
services will be offered a trade out for clean linens to replace soiled
linens utilized during transport.
2. We only offer restocking of emergency transports to Hospital.
3. The restocking will include drugs and medical supplies, and linens,
used for patient prior to delivery of the patient to Hospital. Drugs and
medical supplies not stocked by Hospital will not be replenished. Only
drugs and medical supplies of equivalent quantity or volume will be
replenished.
4. The ambulance providers will not be required to pay for the restocked
drugs and medical supplies, and linens.
5. The restocked drugs and medical supplies, and linens, must be
documented as follows: Record information on the Supply Request
Sheet and attach it to the goldenrod copy of the Ambulance Run Sheet.
Information will include, but is not limited to: patient name, date of
transport, relevant drugs and/or supplies.
6. This restocking program does not apply to the restocking of
ambulances that only provide non-emergency services or to the general
stocking of an ambulance provider’s inventory.
7. Hospital does not bill any Federal health care program for restocked
drugs or supplies. Ambulance providers must notify Hospital if they
intend to submit claims for restocked drugs or supplies to any Federal
health care program.
8. It is the responsibility of any participant in the ambulance restocking
arrangement that bills Federal health care programs for restocked drugs
or supplies to comply with all applicable Federal program billing and
claims filing rules and regulations.
9. For further information about our restocking program or to obtain a
copy of this notice, please contact the Corporate Compliance
Department at ###-###-####.
Dated:
Signed: