Public Health Emergency - Leading a Nation Prepared
A condition of NDMS coverage is that the patient is transported via Federal assets, processed through a Federal Coordinating Center (FCC), and referred to facilities or practitioners for definitive medical care. The NDMS tracks all NDMS federal patients who are transported via Federal assets and thus, are eligible for coverage under this program.Authorized emergency response and disaster relief personnel responding to the public health emergency who suffer injuries or illnesses are also eligible for NDMS Definitive Care coverage.
Generally, any medically necessary service which is authorized under Medicare Part A, Medicare Part B or a State’s Medicaid program is eligible for reimbursement as long as the NDMS federal patient sustained one of the following:
The NDMS Definitive Care Reimbursement Program coverage ends when one or more of the following conditions is met:
The NDMS Reimbursement Program will pay primary under the following circumstances:
Note: the NDMS Definitive Care Reimbursement Program does not supersede contracts that providers have with other payers which require the payer’s reimbursement be accepted as payment in full (also referred to as “Assignment”). In these cases where the provider has agreed to accept Assignment from another payer, the NDMS Definitive Care Reimbursement Program will not make any secondary payments.
The NDMS Definitive Care Reimbursement Program will make no primary or secondary payments for patients with:
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