The Center for Health Information and Analysis (CHIA) is now collecting the fiscal year (FY) 2022 Ambulance Revenue Report and the FY2022 Ambulance and Wheelchair Van Cost Report from ambulance and wheelchair van providers. CHIA collects these reports pursuant to regulation 957 CMR 6.00. The reports are used by CHIA and other public entities for monitoring costs and for health care payment policy development.
Please note that this year, there are now two separate Ambulance reports with separate requirements. Please read carefully below.
All non-municipal ground ambulance providers providing services in Massachusetts in FY2022 are required to submit the FY2022 Ambulance Revenue Report. The new FY2022 Ambulance Revenue Report only collects information on your organization and Massachusetts ground ambulance revenue. Please closely read the instructions for how to complete and submit the new report.
Providers are required to submit the FY2022 Revenue Report via email to firstname.lastname@example.org.
Non-municipal ambulance and wheelchair van providers that received more than $100,000 in MassHealth revenue in FY2022 are also required to submit the FY2022 Ambulance and Wheelchair Van Cost Report. A complete submission includes the following:
CHIA will only accept the Ambulance and Wheelchair Van Cost Report via CHIA Submissions. Financial statements should be emailed directly to CHIA in PDF format at email@example.com. Links to instruction documents are posted on this webpage. Please read all instructions carefully.
Access CHIA’s online submission platform at https://chiasubmissions.chia.state.ma.us. Please see the CHIA Submissions User Guide for how to register if you are a new user.
A provider may request an exemption from the Ambulance and Wheelchair Van Cost Report if they received less than $100,000 in MassHealth revenue in FY2022 by using the FY2022 Ambulance Cost Report Exemption Request Form, available as a Word document. Email the completed form to firstname.lastname@example.org.
Both reports and financial statements, if applicable, are due no later than August 31, 2023.
Links to instruction documents are posted on this webpage. Please read all instructions carefully.
If you have questions, please email the Pricing Cost Reports Helpdesk at CostReports.Pricing@chiamass.gov with the following information in the subject line of your email:
Subject Line Example: Question on FY2022 Ambulance Revenue Report – ABC agency, ID# 123456789A