EMS agencies must be covered by a CLIA (Clinical Laboratory Improvement Amendments) Certificate of Waiver to perform blood glucose testing. Failure to meet this requirement could result in the forfeiture of EMS billing reimbursements and other penalties assessed by CMS (Centers for Medicare and Medicaid Services). The Greater Miami Valley EMS Council has obtained and will maintain a CLIA Certificate of Waiver for glucose testing, as a no cost benefit, which provides EMS member agencies with a group coverage opportunity. EMS member agencies may also opt to carry their own CLIA Certificate of Waiver, in lieu of participating in the GMVEMSC’s coverage.