In Reply We do not agree with Drennan et al that the 20% claim sample we used has a sampling bias. It is a sample randomly assembled by the final digit of Social Security numbers.
Wang and Kupas rightly note that Medicare will only reimburse for a single transport, but this will be at the higher service level, that is ALS, as long as a written agreement exists between the responding emergency medical services (EMS) agencies.1 We excluded the relatively few areas identified in interviews with state EMS offices where such agreements may not exist. However, since billing is determined by the existence of an agreement and is unrelated to case characteristics, such random error in classification would attenuate the estimated effects.
Sanghavi P, Jena AB, Zaslavsky AM. Basic vs Advanced Life Support for Out-of-Hospital Cardiac Arrest—Reply. JAMA Intern Med. 2015;175(8):1423. doi:10.1001/jamainternmed.2015.2112
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