Sources: 42 C.F.R. §  1001.952(v)

9. Ambulance Replenishing

Arrangements whereby hospitals replenish ambulance providers with drugs and/or supplies used during transport of a patient to the hospital, provided all of the following four conditions (plus additional conditions applicable to three specific categories of replenishing arrangements—i.e., general replenishing, fair market value replenishing, and government-mandated replenishing) are met:

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  1. appropriate billing of federal health programs (i.e., no double billing);

  2. either the hospital or ambulance provider must generate patient care report that identifies the drugs and supplies used and subsequently restocked, and the non-generating party must receive and keep a copy of the report;

  3. the restocking arrangement must not be conditioned on or otherwise take into account the volume or value of referrals or other business generated between the parties for which payment may be made by a federal health program; and

  4. hospital and ambulance provider must comply with all laws regulating ambulance services.

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