Recent Victories and 2020 Priorities
The AAA continues to press the Congress and federal agencies for help to ensure ambulance service organizations and our paramedics and EMTs serving on the front lines of the COVID-19 pandemic have the necessary resources and financial assistance to serve their communities.
Help support the AAA’s efforts by contacting your members of Congress today asking them to support the ambulance industry in upcoming COVID-19 relief legislation:
Past accomplishments of the 115th Congress include:
- Ensuring inclusion and passage of a 5-year extension of the ambulance Medicare add-on payments through December 31, 2022 in the Bipartisan Budget Act (BBA) of 2018. Also included in the BBA of 2018 was the AAA preferred method for data cost collection using a survey which is the most likely to provide useful data as well as the least burdensome on the industry.
- Following passage of the extension of the Medicare ambulance add-on payments AAA has successfully worked with CMS and the RAND corporation in the development of the cost collection system in order to ensure that the end result is feasible for our industry. AAA has established itself and our members as a main stakeholder throughout the cost collection development process and look forward to remaining involved.
- Introduce legislation to restructure the offset included in the Bipartisan Budget Act of 2018 for the 5-year extension of Medicare add-on payments. This restructuring would allow for the additional 13% reduction included in the BBA 2018 to only be applied those ambulance service agencies in which 50% or more of their volume are repetitive BLS nonemergency transports to and from dialysis centers rather than the industry as a whole.
- Supporting the efforts of the IAFC and NAEMT in passage of language from the SIREN Act (2830, H.R. 5429) that reauthorizes the Rural EMS Grant program. These grants will now provide funds up to $200,000 for training, equipment, and personnel retention in rural areas. The grants also require a 10% contribution by the grant recipient. While the AAA had advocated that language be revised to ensure small rural for-profit providers would still be able to apply for grants, we are pleased to see this program reauthorized.
- Through AAA members, working with Senator Collins to include report language to accompany the FY2019 Senate VA Appropriations bill which directs the VA to use the prudent layperson standard for determining emergency ambulance services coverage.
While we are very pleased with our accomplishments during the 115th Congress, we are eager for the year ahead and will work hard to see all of these priorities come to fruition. The AAA’s priorities for 2020 include:
Ambulance Funding in Response to COVID-19
- Allocate a total of $2.89 billion under the Public Health and Social Services Emergency Fund (PHSSEF) for ground ambulance service organizations to account for increased costs, uncompensated care and lost revenue related to COVID-19.
- Ensure all EMS first responders including private for-profit, governmental, nongovernmental, nonprofit, and volunteer providers and personnel are covered in applicable provisions of the package by using the definition of “emergency response providers” from the Homeland Security Act of 2002.
Expansion of Treatment in Place Coverage
- Authorize CMS to reimburse ambulance service providers and suppliers for performing protocol-driven non-reimbursable medical services in responding to COVID-19 cases and transporting patients to facilities other than hospitals. This coverage will help limit the spread of COVID-19 by keeping patients with mild cases of COVID-19 at home and out of overcrowded hospitals or other facilities where they could expose others to the virus.
Priority PPE Access
- Give emergency response providers priority access along with other emergency medical professionals to Personal Protective Equipment (PPE). To ensure that emergency response providers are sufficiently equipped to handle the surge capacity and capability to respond to the spread of COVID-19, ambulance providers and suppliers need priority access to personal protective equipment (such as N95 masks, face shields, OSHA gowns and surgical masks).
Allow Private For-Profit EMS Providers to Apply Directly for FEMA Grants
- Allow private for-profit EMS agencies to apply directly to the Federal Emergency Management Agency (FEMA) for Public Assistance program grants during the Public Health Emergency and waive the matching requirement for emergency response providers. This will allow all EMS agencies to apply for financial assistance and for state and local governments to focus their limited resources on directly combating the pandemic.
Expand Public Safety Officer Benefits (PSOB)
- Add COVID-19 as an infectious disease under the Public Safety Officers’ Benefit (PSOB) and extend coverage during the pandemic to paramedics and EMTs employed by a private ambulance service (pursuant to H.R. 2887) who die from COVID-19.
We will keep you posted of new developments. Thank you for your continued support of the American Ambulance Association.
The American Ambulance Association invites you to become involved with our efforts on Capitol Hill. It is thanks to our member’s contributions, both time and resources, that we are able to have such a strong influence with federal legislators. The efforts of the AAA’s legislative team and our members have given our industry nearly $2 billion in desperately needed Medicare relief over the last 12 years. Become a member today and join this important work.
AAA Advocacy Priorities
Letter from AAA President Aarron Reinert August 5, 2020 At last night’s White House press conference with President Trump, a reporter asked the President about the need for ambulance services to be fully reimbursed for their work related to the COVID-19 public health emergency. President Trump responded that ambulance services are doing an incredible job which is a very tough and dangerous one. The President stated he would look into the issue. The fact that the President of the United States was engaged in a public dialogue about the need for our work to be fully reimbursed is a significant development. To view the YouTube clip of the ambulance dialogue during the press conference, please click here. The dialogue begins at 1:05:40. The AAA continues to elevate the profile of the need for ambulance service providers to receive additional funding under the Provider Relief Fund. While we are extremely grateful for the relief we have received thus far, it represents only a small portion of the total $2.89 billion we need to offset the impact of being front line health care responders during the COVID-19 public health emergency. We are directly requesting the Department of Health and Human Services (HHS)…
The American Ambulance Association is pleased to announce our new advocacy software to make contacting your Members of Congress even easier. With just a few clicks, you can contact your Senators and Representative without hassle. Follow the button below to send messages to Congress within minutes: As we reach the end of Congressional negotiations, it is critical now more than ever that you contact your Senators and Representative and ask them to support increased funding for ambulance service providers under the Public Health and Social Services Emergency Fund specifically for the increased costs, loss of revenue and uncompensated care facing ground ambulance service organizations due to COVID-19. In addition to advocating for Congress to include funding specifically for ground ambulance services in the next COVID-19 economic relief package, the AAA is pressing for the Department of Health and Human Services to allocate more funding to EMS under the $75 billion already appropriated to the PHSSEF through the Paycheck Protection Program and Health Care Assistance Act. The AAA will continue to fight for our members as your paramedics and EMTs are on the front lines of combating the Coronavirus.
From Tom Ridge’s op-ed in the NY Daily News By the time the EMTs reached my hotel room in Austin, Tex., I was already unconscious on the floor. Moments earlier I had dragged myself to the phone and called for help as chest pains began to overwhelm me. I later learned those first responders resuscitated me more than once as they used their medical training to keep me alive until we arrived at the hospital. That’s where doctors and nurses and a lot of machines took over. I had suffered a major heart attack. The care I received at that medical center was extraordinary. But not for the immediate care I received from that small team of EMTs, I never would have made it. That was back in 2017. I’ve since recovered and feel great, often thinking about those heroic first responders, whom I was lucky enough to meet and personally thank a year later. I especially think of them and their colleagues today as COVID-19 creates huge budget problems for local governments that threaten their jobs and our nation’s ability to respond to this and future crises. Continue reading► Ridge was governor of Pennsylvania and first U.S. Secretary of (more…)
Contact Your Members of Congress Today on Ambulance Specific Funding! Congress returned this week from recess and has three weeks in which to get another COVID relief package passed before their August recess. Please contact your Senators and Representative today and ask that they advocate for a funding program under the Public Health and Social Services Emergency Fund specifically for the increased costs, loss of revenue and uncompensated care facing ground ambulance service organizations due to COVID-19. Please e-mail your Senators and Representative today! It will take you only a few minutes per Congressional office to email a letter. Just follow these steps. 1. USE LETTER TEMPLATE: CLICK HERE to access a draft letter. Please customize your letter including the cities and towns you serve, and any additional details as to services you are providing during the COVID-19 outbreak and the financial impact on your operation. 2. LOOK UP YOUR SENATORS AND THEIR WEBFORM ADDRESS: CLICK HERE to access a list of the webform addresses of your Senators. 3. LOOK UP YOUR REPRESENTATIVE AND THEIR WEBFORM ADDRESS: CLICK HERE and enter your zip code to find the online contact form of your Representative. 4. SEND LETTERS TO MEMBERS: Follow the (more…)
On July 13, the American Ambulance Association was joined by the Congressional Fire Services Institute, International Association of Fire Chiefs, International Association of Fire Fighters, National Association of Emergency Medical Technicians, National Fire Protection Association, and the National Volunteer Fire Council in sending a letter to President Donald Trump requesting that firefighters and emergency medical services (EMS) personnel are placed on the highest priority tier for receiving COVID-19 vaccinations when they are available….
On July 7, 2020, the Internal Revenue Service published a series of Frequently Asked Questions that address the taxation of payments to health care providers under the HHS Provider Relief Fund. As part of the Coronavirus Aid, Relief and Economic Security Act (CARES Act), Congress appropriated $100 billion to reimburse eligible health care providers for health care-related expenses and/or lost revenue attributable to the COVID-19 pandemic. The Paycheck Protection Program and Health Care Enhancement Act appropriated an additional $75 billion to the Provider Relief Fund. The first FAQ addressed the issue of taxation for for-profit health care providers. Specifically, the IRS was asked whether a for-profit health care provider is required to include HHS Provider Relief Fund payments in its calculation of “gross income” under Section 61 of the Internal Revenue Code (Code), or whether such payments were excluded from gross income as “qualified disaster relief payments” under Section 139 of the Code. The IRS indicated that payment from the Provider Relief Fund do not qualify as qualified disaster relief payments under Section 139 of the Code. As a result, these payments are includible in the gross income of the entity. The IRS further indicated that this holds true even…