Recent Victories and 2019 Priorities
The American Ambulance Association has worked diligently to achieve many legislative and regulatory wins for the industry in the 115th Congress. Thanks to AAA board, volunteer leaders, and members alike, we were able to accomplish many of our goals to improve payment and overall regulations that will benefit AAA members and the industry as a whole. The 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 2019 include:
- Cost Collection
The 116th Congress will be an important year in the development and implementation of the cost collection system within CMS and its work with the RAND corporation. AAA intends to remain very involved in this process in working with CMS, HHS, and Congress in order to ensure that the cost collection system end result is something with which our industry is able to comply. The AAA is also working to create comprehensive education resources on the new cost collection system. This information can be found at ambulancereports.org.
- 2019 Medicare Priorities Bill
AAA is eager to introduce a larger piece of legislation that will contribute to the long-term sustainability of the industry. This legislation will address issues such as inadequate reimbursement, the need for innovative payment models, a lack of equitable polices and more.
- Public Safety Officers Benefit
AAA will pursue efforts to include paramedics, EMTs and other first responders who work for a private for-profit EMS organization and who die in the line of duty as part of the Public Safety Offers Benefit program so that their family members will receive death benefits.
We will continue to pursue the Veterans Reimbursement for Emergency Ambulance Services Act (VREASA) which would provide veterans with reimbursement for emergency ambulance services when a prudent layperson would have a reasonable expectation that a delay in seeking immediate medical attention will jeopardize the life or health of the veteran.
- NEATSA Bill – Restructure of Medicare Payment for Non-Emergency ESRD transport
AAA will continue to push for policies that will help our industry target bad actors rather than harshly penalizing the entire ambulance industry for the fraudulent behavior of a few. We will continue to push to restructure the offset of additional cuts on ESRD transports to specifically target this additional cut to only those with 50% or more of their volume as repetitive BLS nonemergency transports to and from dialysis centers.
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
Earlier today, the Department of Health and Human Services (HHS) posted a revised set of frequently asked questions (FAQs) regarding the terms and details of payments distributed under the Public Health and Social Services Emergency Fund to Medicare providers including ground ambulance service providers and suppliers. The updated FAQs cover a range of topics regarding the acceptance of funds, revenue data submission and eligibility criteria….
CMS has issued a blanket waiver modifying the data collection period for the ground ambulance services that were selected to report in Year 1. Under the current law, these organizations would have been required to collect data beginning January 1, 2020, and through December 31, 2020. The waiver allows these organizations to select a new continuous 12-month data collection period that begins between January 1, 2021 and ends December 31, 2021. This modification means that such organizations will collect and report data during the same time period as the ground organizations that CMS will select for Year 2 of the cost collection program. From the summary of the waiver, it appears that organizations will have the choice of submitting data in Year 1 or Year 2. CMS has not moved the timeline for any other data collection year, so there is the potential for a substantial number of organizations to report in Year 2, which would increase the amount of data available. The AAA has supported the data collection system to make sure that CMS and the Congress have valid and reliable data to support maintaining the geographic add-ons to the Medicare Ambulance Fee Schedule and to support efforts to…
The U.S. House of Representatives is scheduled to vote later today on the Health and Economic Recovery Omnibus Emergency Solutions Act “HEROES Act” (H.R. 6800). The HEROES Act is the House Democratic proposal for the latest legislative effort on economic relief related to COVID-19. The House is expected to pass the HEROES Act along party lines with the Senate developing its own legislative proposal with consideration in the coming weeks. The HEROES Act contains numerous provisions of interest to ground ambulance service providers and suppliers. For a comprehensive summary of those provisions, please click HERE. Here are a few of the highlights: $100 Billion for Health Care Fund $100 billion in additional funding for the Public Health and Social Services Emergency Fund. This is the Fund under which ground ambulance service providers and suppliers have received direct payments to partially offset lost revenue as well as eligibility for grant funds to cover the cost of treating uninsured presumptive and actual COVID-19 patients. The bill would also set forth a methodology for the distribution of the new funds and all previously unallocated funds, based on the lost revenue and expenses of a provider or supplier. The AAA continues to advocate for…
On April 28, the American Ambulance Association sent a letter to President Donald Trump with four requests as to how his Administration can best help ground ambulance service providers mitigate the COVID-19 pandemic. The AAA requested the following: Increase Financial Assistance Related to COVID-19 for Ground Ambulance Services Increase the percentage of the general allocation of funds under the Public Health and Social Services Emergency Fund (PHSSEF) for ground ambulance services providers and suppliers to equal a total of $2.89 billion in funds for our industry. The $2.89 billion reflects $48,000 per ambulance with an estimated 60,000 registered vehicles. We greatly appreciate the recent payments under the Fund which will help with our current situation. However, the ground ambulance services industry is only 0.90% of Medicare fee-for-service annual outlays which resulted in $270 million for our industry in round one of PHSSEF payments. This figure is disproportional to the large role of ground ambulance service providers and suppliers in responding to COVID-19 and our increased costs and reduced revenues during the PHE. Priority Access for Paramedics and EMTs to PPE, COVID-19 Testing and Tax Relief Protect paramedics and EMTs by directing federal agencies to provide them with higher priority access…
On April 27, the CDC issued an update to its Guidance on “Evaluating and Testing Persons for Coronavirus Disease 2019” in which “first responders with symptoms” are now in the category of “highest priority” as to the prioritization of groups who should be tested for COVID-19. The AAA has been advocating to federal agencies and the Congress to move first responders to the highest level of priority for COVID-19 testing. The update can be viewed at HERE….
AAA Sends Letter to Requesting Priority Testing for First Responders Earlier today, the AAA sent a letter to the U.S. Public Health Service (USPHS) requesting that first responders with COVID-19 symptoms be given priority one status in the order of groups to be tested for COVID-19. The USPHS had issued guidance that assigned first responders a level two status. The AAA stated paramedics and EMTs should be included in the top level with other health care professionals who are on the front lines of caring for patients with COVID-19. Read the Letter HERE. …