At issue is nonemergency ambulance transportation, patients who need to be driven from their home or long-term care facility to regular appointments for treatment such as dialysis, wound care or chemotherapy and radiation.
The patients typically are confined to their beds and can't be moved in a wheelchair, so they need the service that ambulances and emergency medical technicians can offer.
The Centers for Medicare and Medicaid Services is now seven months into a pilot program designed to weed out fraud in ambulance service for nonemergencies.
The agency -- and some transportation companies -- say tougher compliance is doing the trick and saving taxpayers money. But other operators say it is going overboard and putting patients' lives at risk.
What's all the fuss about? States with the biggest increase in nonemergency ambulance trips, 2002-2011:
1. California: +554 percent
2. Georgia: +301 percent
3. South Carolina: +218 percent
4. Indiana: +183 percent
5. Pennsylvania: +159 percent
6. New Jersey: +144 percent
U.S.: +94 percent
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