Ambulance services are an essential piece of our local and national health care and emergency response systems. The majority of ambulance services are small businesses that provide jobs and support to their local communities.  Unfortunately, services throughout the country are facing serious financial crisis due to below-cost Medicare Reimbursement.  In 2012, the Government Accountability Office (GAO) released a report which clearly showed that, in the absence of temporary Medicare relief, Medicare reimburses ambulance service providers below cost.

Currently, as part of temporary Medicare relief, ambulance services receive a 2% urban, 3% rural or super rural add-on payment for each transport. The 2012 GAO report found that ambulance service providers are reimbursed 1% below cost when temporary Medicare relief is not taken into account.  The GAO report likely underestimates the financial difficulties facing ambulance service providers as the report did not take into account many other factors such as the expiration of a temporary GPCI add-on, productivity adjustments, a new fractional mileage policy, or increased fuel costs.

For these reasons, the American Ambulance Association is working tirelessly to win permanent Medicare relief for ambulance service providers.  Even with the current 33-month extension of ambulance Medicare relief, it is extremely difficult for ambulance services to budget and prepare for the uncertainties of the future.

Permanent Medicare Relief Bill

Early last year, the American Ambulance Association was successful in getting the Medicare Ambulance Access, Fraud Prevention and Reform Act of 2015 (S. 377, H.R. 745) introduced in both the Senate and the House of Representatives.  This critical legislation would help the ambulance industry move into the future by doing the following:

– Provides Medicare ambulance relief by permanently incorporating the current temporary 2% urban, 3% rural, and super rural bonus payments into the Medicare ambulance fee schedule rates.

– Requires the Centers for Medicare and Medicaid Services (CMS) to submit a report to Congress detailing the features of a reformed payment system for ambulance services under the Medicare program.

– Modifies the process for the transport of dialysis patients by requiring the Department of Health and Human Services to establish a process for the prior authorization of coverage for patients.

– Defines all who provide ambulance services as “providers” under Medicare.

– Specifies CMS to work with stakeholders in the development of a data collection system for ambulance providers that defines the various types of ambulance entities as well as the relevant cost and data elements required for submission.

What You Can Do to Help

As is customary, Congress is scheduled to take an extended recess at the beginning of August through Labor Day in September.  That means that most Members of Congress will be spending a large portion of time in their states and districts.  This presents a great opportunity for members of the AAA and all ambulance service providers to meet with their legislators.

The AAA asks that you invite your members of Congress to participate in an Ambulance Ride-Along during the months of July, August and September.  Conducting a ride-along with legislators is one of the most effective ways to showcase all that you do for the community and what your legislator can do for you.  The American Ambulance Association recently released the 2015 version of the Ambulance Ride-Along toolkit to guide you through the process.

Permanent Medicare relief and the Medicare Ambulance Access, Fraud Prevention and Reform Act of 2015 will be critical for ambulance services moving into the future.  We invite you to join our push for permanent Medicare relief.