As previously reported, CMS announced in November 2014 that it would test a Medicare prior authorization process for repetitive scheduled nonemergent ambulance transport services in New Jersey, Pennsylvania, and South Carolina. The three-year model began on December 1, 2014. As mandated by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), CMS is now extending this prior authorization model to six additional states beginning January 1, 2016: Delaware, the District of Columbia, Maryland, North Carolina, Virginia, and West Virginia. The model will end in all states on December 1, 2017.