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Author: Meghan Winesett

2024 AAA Board of Directors Election Results

The winners of the 2024 AAA Board of Directors election are listed below. Each board member’s term will begin on January 1, 2025. Please join us in thanking all candidates for volunteering their time and talent to serve the American Ambulance Association.

 

President-Elect

Wayne Jurecki
Vice President/ COO
Bell Ambulance, Inc.

 

 

 


Treasurer

Tom Fennell
Regulatory Officer
Mayo Clinic Ambulance

 

 

 


Secretary

Allyson Pharr
Chief Legal Officer and EVP Governmental Affairs
Acadian Ambulance

 

 

 


 

Region 1 Director (3 year term)

Richard Raymond
President & CEO
Armstrong Ambulance Service

 

 

 


 

Region 2 Director (3 year term)

Terence Ramotar
Director of Government Affairs
Global Medical Response

 

 

 


Region 3 Director (3 year term)

Chris Anderson
Director of Operations
Bell Ambulance, Inc.

 

 

 


 

Region 4 Director (3 year term)

Michelle Anderson
Director of Administration
Lakes Region EMS

 

 

Region 4 Director (2 year term serving the remainder of the seat vacated to serve on the executive committee) 

Angie McLain-Johnson
VP of Revenue Integrity
Pafford Medical Services

 

Region 4 Director (1 year term serving the remainder of the seat vacated to serve on the executive committee) 

*To be determined by a run-off due to a tie between the following candidates*

Ken Kelley 
President & CEO
ProMed Ambulance

Ron Quaranto
VP of Revenue Integrity
Pafford Medical Services

 


Region 5 Director (3 year term)

Brenda Staffan
Chief Government Affairs & Public Policy Officer
Priority OnDemand, LLC

 

 

 

 


Ethics Committee Members

  • Gibson McCullagh (Region 1) 
  • Christopher Dell (Region 2)
  • Mike Pieroni (Region 3)
  • Dennis Rowe (Region 3) 
  • Johna Easley (Region 4)
  • Ailyn Risch (Region 5)
  • Krista Cuthbert (Region 5) 

 

2024 AAA Legislative Awards

The American Ambulance Association is proud to announce the winners of the 2024 AAA Legislative Awards. Each Member of Congress is being recognized for their strong advocacy for emergency medical services and their ongoing dedication to ambulance services across the United States. In addition to our two Legislator of the Year Awards and 25 Legislative Recognition Awards, the American Ambulance Association has named their first-ever EMS Legacy Award Winner. This award is reserved for a Members of Congress who made a substantial impact on the EMS industry during their tenure in the U.S. Congress.

2024 EMS Legacy Award

Senator Debbie Stabenow (MI)

2024 AAA Legislators of the Year

Congresswoman Marie Gluesenkamp Perez (WA-3)
Congressman Brad Finstad (MN-1)

2024 AAA Legislative Recognition Award Recipients

Senators

  • Senator Jon Tester (MT)
  • Senator Katherine Cortez Masto (NV)
  • Senator Susan Collins (ME)
  • Senator Bill Cassidy (LA)
  • Senator Patty Murray (WA)
  • Senator Jerry Moran (KS)
  • Senator John Boozman (AR)
  • Senator Shelley Moore Capito (WV)
  • Senator Peter Welch (VT)

Representatives

  • Congresswoman Terri Sewell (AL-7)
  • Congressman Brad Wenstrup (OH-2)
  • Congressman Buddy Carter (GA-1)
  • Congressman Paul Tonko (NY-20)
  • Congressman Andy Kim (NJ-3)
  • Congressman Ryan Zinke (MT-1)
  • Congressman Michael Guest (MS-3)
  • Congressman Michael Bost (IL-12)
  • Congresswoman Carol Miller (WV-1)
  • Congresswoman Nikki Budzinski (IL-13)
  • Congressman Darin LaHood (IL-16)
  • Congressman Kelly Armstrong (ND- At Large)
  • Congressman Emanuel Cleaver (MO-5)
  • Congressman Lloyd Doggett (TX-37)
  • Congressman Mike Carey (OH-15)
  • Congresswoman Becca Balint (VT- At Large)

 

Senator Stabenow Receives Inaugural EMS Legacy Award

FOR IMMEDIATE RELEASE

Contact:
Tristan North
tnorth@ambulance.org
October 10, 2024

 

Senator Debbie Stabenow Receives Inaugural EMS Legacy Award from the American Ambulance Association

 

Washington, D.C. — Senator Debbie Stabenow has been honored with the first-ever annual EMS Legacy Award by the American Ambulance Association (AAA) for her exemplary leadership and unwavering commitment to emergency medical services (EMS) during her distinguished tenure in the United States Senate.

The award recognizes Senator Stabenow’s significant contributions to the EMS community, particularly her role in introducing and championing critical legislation. Notably, she was instrumental in the creation of the Ground Ambulance Cost Data Collection System, which enhances transparency and supports the sustainability of ground ambulance services across the nation. Additionally, Senator Stabenow’s efforts led to the successful extension of Medicare Ambulance Add-On payments for five years, a vital support mechanism that helps ensure reliable emergency medical care for Medicare beneficiaries.

The EMS Legacy Award underscores the critical importance of legislative support for emergency medical services, highlighting Senator Stabenow’s role in elevating these issues on the national stage. Her advocacy ensures that EMS providers have the resources and support needed to deliver high-quality care.

About the American Ambulance Association:
The American Ambulance Association is a nonprofit organization that advocates for the interests of ambulance service providers and the patients they serve. With a mission to advance the profession and improve patient care, the AAA provides resources, education, and support to its members and the EMS community.

Press Release: Congressman Brad Finstad Honored as Legislator of the Year

Press Contact
Tristan North
Senior Vice President
American Ambulance Association
tnorth@ambulance.org

FOR IMMEDIATE RELEASE

Congressman Brad Finstad Honored as 2024 Legislator of the Year by the American Ambulance Association

Washington, D.C. — September 23, 2024 — Congressman Brad Finstad, representing Minnesota’s 1st District, has been named the 2024 Legislator of the Year by the American Ambulance Association (AAA) in recognition of his exceptional leadership in tackling the pressing workforce challenges faced by the emergency medical services (EMS) industry.

As the EMS community confronts a serious shortage of qualified personnel, Congressman Finstad has emerged as a crucial champion for effective solutions. His leadership on H.R. 6433, the PARA-EMT Act, marks a significant advancement in efforts to attract and retain EMS professionals nationwide.

The PARA-EMT Act seeks to establish an EMS Workforce Grant aimed at recruiting, training, and retaining EMS professionals. It also includes a provision to assist combat medics with first response experience in their transition to the civilian workforce and directs the Department of Labor and the Department of Health and Human Services to conduct a study on the EMS workforce shortage and the necessary training and education to meet the evolving demands of the pre-hospital industry over the next decade.

Congressman Finstad’s leadership and commitment exemplify his dedication to sustaining a robust future for emergency medical services and to serving our nation’s veterans.

“Congressman Finstad’s devotion to the EMS workforce is vital to not only our industry, but to all of America’s communities,” stated AAA President Randy Strozyk. “His leadership has established a foundation for policies that will help mitigate the workforce crisis, ensuring our communities receive the critical care they require.”

The American Ambulance Association is proud to present the Legislator of the Year Award to Congressman Brad Finstad for his efforts on behalf of the EMS industry.

The award will be presented at the AAA Stars of Life event in Washington, D.C., on November 12th.

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About AAA

The American Ambulance Association represents ambulance services across the United States that participate in serving more than 75% of the U.S. population with emergency and non-emergency care and medical transportation. The AAA was formed in response to the need for improvements in medical transportation and emergency medical services. AAA views pre-hospital care not only as a public service, but also as an essential part of the total public health care system.

Press Release: Congresswoman Gluesenkamp Perez Honored as Legislator of the Year

Press Contact
Tristan North
Senior Vice President
American Ambulance Association
tnorth@ambulance.org

 

FOR IMMEDIATE RELEASE

Congresswoman Gluesenkamp Perez Awarded 2024 Legislator of the Year by the American Ambulance Association

Washington, D.C. — September 23, 2024 — Congresswoman Marie Gluesenkamp Perez has been recognized as the 2024 Legislator of the Year by the American Ambulance Association (AAA) for her outstanding leadership in addressing the critical workforce shortage facing the Emergency Medical Services (EMS) industry.

In a time when the EMS sector grapples with a significant shortage of qualified personnel, Congresswoman Gluesenkamp Perez has emerged as a vital advocate for meaningful change. Her introduction of the H.R. 6433, the PARA-EMT Act, has been a pivotal step in advancing solutions to recruit and retain EMS professionals across the nation.

“Congresswoman Gluesenkamp Perez’s commitment to the EMS workforce is not just commendable; it is essential,” said AAA President Randy Strozyk. “Her leadership has laid the groundwork for policies that will help alleviate the workforce crisis, ensuring that our communities receive the emergency care they deserve.”

The PARA-EMT Act aims to create an EMS Workforce Grant to help recruit, train, and retain EMS professionals and tasks the Department of Labor and Department of Health and Human Services with creating a study of the EMS workforce shortage and the training and education needed to meet the demands of the pre-hospital industry over the next decade. Additionally, the legislation includes a provision to assist combat medics with first response experience in transitioning into the civilian workforce.

Introduction of this legislation reflects the Congresswoman’s dedication not only to securing a strong future for emergency medical services to meet the needs of  our communities, but also her dedication to serving our nation’s veterans.

The American Ambulance Association is honored to award our Legislator of the Year Award to Congresswoman Marie Gluesenkamp Perez, a true advocate of emergency medical services.

The award will be presented at the AAA Stars of Life event in Washington, D.C. on November 12th.

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About AAA

The American Ambulance Association represents ambulance services across the United States that participate in serving more than 75% of the U.S. population with emergency and non-emergency care and medical transportation. The AAA was formed in response to the need for improvements in medical transportation and emergency medical services. AAA views pre-hospital care not only as a public service, but also as an essential part of the total public health care system.

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VA Final Rule Delayed One Year

Hot off the press! The Department of Veteran’s Affairs has announced a one year delay of the VA Final Rule. This delay pushes implementation of the final rule to February of 2025.

We want to thank all of our AAA members, partner organizations, and legislative champions for their collaborative efforts and commitment to securing this critical delay.

Please see the following press release from the Office of Senator Tester. 


Following Tester Efforts, VA Takes Action to Avoid Potential Reduction in Air and Ground Transportation Services

VA delays rule that could have resulted in severe reductions in access to emergency ground and air transportation services in Montana

(Big Sandy, Mont.) – Following sustained efforts from U.S. Senator Jon Tester to protect rural veterans’ access to lifesaving emergency medical transportation services, the Department of Veterans Affairs is delaying a rule to change reimbursement rates for special mode transportation, including air and ground ambulances. This delay will give VA more time to work with stakeholders and Congress to implement the rule in a way that would ensure access and availability of emergency transportation to veterans and civilians, especially in rural America.

“The availability of emergency air and ground transportation services in Montana and rural America can be the difference between life and death,” said Tester, Chairman of the Senate Veterans’ Affairs Committee. “VA’s hasty implementation of its rate change for these services could have been the final straw for providers in rural America, and I’m glad to see VA answering my call and taking steps to fix this reimbursement issue. VA still has a lot more work to do, and I’ll continue pushing my VA Emergency Transportation Access Act to ensure VA gets this rule right for veterans and anyone who calls rural America home.”

VA’s rule was set to go into effect in February 2024, despite significant opposition from Tester, transportation providers, and Veteran Service Organizations. Now, VA is committing to delaying the rule’s effective date until February 2025, which would give the Department more time to work with providers to ensure the rule will not negatively impact their services and ability to serve veterans, especially those in rural and hard-to-reach areas. The previous implementation timeline of rate reductions could have resulted in emergency transportation providers severely reducing services, closing bases, or even billing veterans for the remainder of their costs in order to shoulder the financial impacts of this change. 

Tester has led the bipartisan charge to push back on the Biden Administration’s proposed rule change and protect Montana veterans’ access to emergency medical transportation services since day one. In September 2022, he wrote to VA Secretary Denis McDonough to express his concerns with VA’s rule, and in February of this year, he called on the Secretary again to delay this rule. This September, he introduced the bipartisan VA Emergency Transportation Access Act to bar VA from reducing rates of pay and reimbursement for special mode transportation providers, including ground and air ambulances, unless the Department meets certain requirements that ensure rate changes will not reduce veterans’ access to this essential service.

The Senator also recently secured a bipartisan amendment to prohibit VA from implementing this rule in fiscal year 2024 to a key Senate bill that passed earlier this month.

Tester’s efforts have been applauded by emergency medical service leaders in Montana and across the nation. Earlier this month, the Senator was awarded Legislator of the Year by the American Ambulance Association for his work to push back on VA’s rule.

2023 AAA Board of Directors Election Results

The winners of the 2023 AAA Board of Directors election are listed below. Each Director will serve a 3-year term beginning January 1, 2024.  Please join us in thanking all candidates for their service to the American Ambulance Association.

Region 1 Director (3 year term)

Mike Addario
Vice President, Operations
Global Medical Response

 

 

 


 

Region 2 Director (3 year term)

Mike Thomas
Director of Government Relations & Safety
Jan-Care Ambulance

 

 

 


Region 3 Director (3 year term)

Kyle Wolber

Director of Logistics
Superior Air-Ground Ambulance Service, Inc.

 

 

 


 

Region 4 Director (3 year term)

Tom Fennell
Regulatory Officer
Mayo Clinic Ambulance

 

 

 


Region 5 Director (3 year term)

Jimmy Pierson
President
Medic Ambulance Service

 

 

 

 


Ethics Committee Members (2 year term)

  • Christopher Dell (Region 2)
  • Mike Pieroni (Region 3)
  • Johna Easley (Region 4)
  • Ailyn Risch (Region 5)

 

2023 AAA Legislative Awards

The American Ambulance Association is proud to announce the winners of the 2023 AAA Legislative Awards. Each Member of Congress is being recognized for their strong advocacy for emergency medical services and their ongoing dedication to ambulance services across the United States.

2023 AAA Legislators of the Year

Senator Bill Cassidy, M.D (LA)
Senator Jon Tester (MT)

2023 AAA Legislative Recognition Award Recipients

Senators

  • Senator Cortez Masto (NV)
  • Senator Collins (ME)
  • Senator Stabenow (MI)
  • Senator Schumer (NY)
  • Senator Lujan (NM)
  • Senator Kaine (VA)
  • Senator Murkowski (AK)
  • Senator Tuberville (AL)
  • Senator Murray (WA)
  • Senator Moran (KS)
  • Senator Boozman (AR)

Representatives

  • Congressman Blumenauer (OR-3)
  • Congresswoman Kelly (IL-2)
  • Congresswoman Sewell (AL-7)
  • Congressman Wenstrup (OH-2)
  • Congressman Carter (GA-1)
  • Congressman Tonko (NY-20)
  • Congressman Davis (IL-7)
  • Congresswoman Perez (WA-3)
  • Congressman Finstad (MN-1)
  • Congressman Pence (IN-6)
  • Congressman Kim (NJ-3)
  • Congresswoman Clark (MA-5)
  • Congressman Zinke (MT-1)
  • Congressman Guest (MS-3)
  • Congresswoman Hoyle (OR-4)
  • Congressman Bost (IL-12)
  • Congressman Alford (MO-4)

 

CMMI Notice of Termination of the Emergency Triage, Treat, and Transport Model

The Centers for Medicare & Medicaid Innovation (CMMI) has announced the agency will end the ET3 Model pilot program early, on December 31, 2023, which is two years prior to the ET3 Model Participation Agreement’s original Performance Period end date. CMS has been reaching out to ambulance services participating in the program notifying them of the early termination. Please find the notice being sent to participants linked below. 

Notice of Early Termination of the ET3 Model

 

Binder Lift responds to emergency care provider shortage by becoming PHASE; expands resources to help providers have longer and healthier careers. 

Bigfork, Montana, May 17 – Binder Lift, a supplier of patient handling equipment and training for emergency care providers, recently became PHASE (Patient Handling and Safety Experts) in response to the ongoing workforce shortage in the emergency care industry. “Patient handling causes far more injuries to emergency care providers than any other job function,” said PHASE CEO Rick Binder. “Though we can’t help agencies find new personnel, we can help them retain employees by providing them with the equipment and training necessary to avoid injuries where they happen most.”

Recognizing a problem they could help solve, the company expanded its resources to protect emergency care providers from the most common cause of injury. It added new solutions to its product line and helped produce an accredited training program on patient handling safety that will be available without cost. “Suddenly, we weren’t only helping providers avoid lifting injuries by supplying a single product; we were helping customers safely move patients from the bathtub in the patient’s home all the way to the hospital bed,” Binder said. “Becoming PHASE was a natural progression.”

The company’s first product, Binder Lift, was born in 2012 out of a friendly argument between Binder’s mother and father. Julie Binder, an EMT-I at the time, told Dan Binder there was nothing available to help her and her partner safely lift a large patient from the floor to a standing position. Dan didn’t believe her. “After a long web search to prove her wrong, he found nothing,” Binder said. “So he got to work making his own solution.”

The result was the company’s flagship product. Since then, more than 3,000 emergency care departments have invested in the Binder Lift to keep their personnel safe when lifting patients. The device has also won multiple industry awards, including EMS Innovation of the Year.

Binder believes adding new products and resources to its offerings is the best way the company could serve the emergency care providers it works to protect. “These are remarkable people,” he said. “They work tough hours for modest pay in order to help others. They shouldn’t have to worry about being injured simply by doing their job.”

Continuing its commitment to their health and safety, PHASE is offering free product trials to first responders through its new website, www.phaseintl.com.

The new website also includes a comprehensive resource center where users can watch instructional videos, get product information, and read case studies. The site will also feature free access to an accredited training program created in partnership with other industry stakeholders in the coming months.

“We’ve grown a lot over the last decade since first bringing the Binder Lift to market,” Binder said. “But we’re still the same family-owned and operated business that values our relationships with our customers and industry partners.”

About PHASE (Patient Handling and Safety Experts)

We’re on a mission to empower emergency care providers to have longer and healthier careers by providing the equipment and training necessary to safely move patients of any size with ease. All our products and services are science-backed solutions that help emergency care providers avoid injuries where they happen most. PHASE is a family-owned business that brings our family values to the workplace. When you do business with us, you’re more than a customer. You’re family. So, let’s connect. We look forward to helping you.  To learn more, visit www.phaseintl.com

Preserving Access to Ground Ambulance Medical Services Act of 2023

Earlier today, Senators Catherine Cortez Masto (D-NV), Susan Collins (R-ME), Debbie Stabenow (D-MI) and Bill Cassidy, MD (R-LA) introduced the Preserving Access to Ground Ambulance Medical Services Act of 2023. The legislation would extend the temporary Medicare ambulance add-on payments for an additional three years.

“We thank Senators Cortez Masto, Collins, Stabenow, and Cassidy for introducing the Preserving Access to Ground Ambulance Medical Services Act and for their strong support for ground ambulance services and the communities and patients we serve,” said AAA President Randy Strozyk. “The disparity between Medicare reimbursement and the costs of providing services has grown significantly through reductions in reimbursement and skyrocketing expenses for labor, ambulances, and equipment. This bill would help reduce that gap and maintain access to vital ground ambulance services for communities around the country.”

The Senate version of the bill would go even further by increasing the add-on payment levels for urban from 2% to 3.4% urban, for rural from 3% to 4.3% rural and for super rural from 22.6% 26.2%. The last extension of the add-on payments was scheduled to end on December 31, 2022, but our champions on Capitol Hill were able to secure a two-year extension through December 31, 2024. The additional three-year extension is critical to keep the add-on payments in place through ambulance data collection and provide time to Congress to then use the data to reform the Medicare ambulance fee schedule.

Representatives Brad Wenstrup (R-OH), Terri Sewell (D-AL), Buddy Carter (R-GA) and Paul Tonko (D-NY) introduced the House version (H.R. 1666) of the bill on March 17. The House bill would be a three-year extension of the add-on payments at their present levels.

This progress is the result of tireless advocacy on the part of AAA volunteer leaders, staff, and consultants made possible by the sustained support of our members. It is critical that AAA members reach out to both their Senators and Representatives to cosponsor the respective versions of the Preserving Access to Ground Ambulance Services Act of 2023. It is vital that we generate a groundswell of support in the Congress for extending the add-on payments and will need that support to then also advocate for the higher add-on percentages when Congress negotiates on Medicare payment extensions.

Ninth Brain and PHASE Team Up to Give Away 100 Binder Lifts in Celebration of EMS Week!

      

FOR IMMEDIATE RELEASE
May 15, 2023
Contact: Holly Taylor, Chief Hat Holder
Phone: 888-364-9995 ext 320
Email: Holly@ninthbrain.com

EMS Week is about celebrating our practitioners and the unparalleled care they bring to our communities. In honor of the upcoming EMS Week celebration, Ninth Brain and PHASE (formerly known as Binder Lift) are teaming up! These two EMS centric companies, with a combined 30 years of experience, wish to inspire EMS Leaders to share their story.

This year’s theme, “EMS: Where Emergency Care Begins”, brings a sense of nostalgia with it. Why did your EMS career begin? Hearing stories of the ‘why’ behind the journey and reminiscing those first days in EMS is both important and inspirational. Mentors sharing their passion for what they do and providing impactful words of wisdom to future EMS leaders, is how we keep Emergency Care thriving. “We know sharing their story may not fix the problems they face, but it may provide a brief reprieve and to remember the ‘why’ when faced with the everyday pressures that weigh heavily on their responsible shoulders.” said Holly Taylor, Chief Hat Holder at Ninth Brain. “And for opening up and sharing, we want to give them an opportunity to help their EMS Agency win equipment that has a proven track record of safety.”

For participating in sharing their story, Ninth Brain and PHASE, will be giving away a total of 100 Binder Lifts to chosen participants’ Agencies. “One of the biggest challenges EMS leaders face is the nationwide shortage of emergency care workers. Though we can’t help agencies find new personnel, we can help them retain employees by keeping existing care providers happy and injury free.” stated by Rick Binder, Chief Executive Officer at PHASE. Take a few minutes to motivate others with your ‘why’, what you love about EMS, and advice for future leaders, for the opportunity to win Binder Lifts for your Agency! Visit https://www.ninthbrain.com/ems-week-2023/ to get started as the opportunity will close on May 31st at 5pm ET!

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About Ninth Brain: Launched in 2001, Ninth Brain is a Michigan based software solution that provides a centralized solution to help EMS organizations with maintaining their daily operations, such as tracking required credentials, providing a robust learning management system, creating forms/checklists, managing workforce scheduling, and much more! With one login, you can easily manage your company’s needs with the Ninth Brain software, AND enjoy superb client support including training, webinars, and (gasp) real people! To learn more, visit www.ninthbrain.com

About PHASE: We’re on a mission to empower emergency care providers to have longer and healthier careers by providing the equipment and training necessary to safely move patients of any size with ease. All our products and services are science-backed solutions that help emergency care providers avoid injuries where they happen most. PHASE is a family-owned business that brings our family values to the workplace. When you do business with us, you’re more than a customer. You’re family. So, let’s connect. We look forward to helping you. To learn more, visit www.phaseintl.com

OIG Announces Modernization of Compliance Program Guidance Documents

By Brian S. Werfel, Esq.

On April 25, 2023, the HHS Office of the Inspector General (OIG) posted a notice in the Federal Register that it would be updating its publicly available resources, including its compliance program guidance documents.  The OIG’s Compliance Program Guidances (CPGs) were developed as voluntary, non-binding guidance documents that can assist healthcare providers in developing their own internal controls to ensure adherence to federal laws, regulations, and program requirements.

Specifically, the OIG announced that it will no longer publish updated or new CPGs in the Federal Register.  Instead, updates or new CPGs will now be made available on the OIG’s website.  The OIG will also revise the format for CGS.  The new format will consist of: (1) a General CPG (GCPG) that applies to all healthcare providers and (2) industry-specific CPGs (ICPGs) tailored to the fraud and abuse areas specific to that industry.  The OIG indicated that it anticipates issuing the GCPG by the end of calendar year 2023, with ICPGs being issued starting in calendar year 2024.  The OIG further indicated that it anticipates the first two ICPGs will address Medicare Advantage plans and nursing facilities.

Note: the OIG is not updating its 2003 guidance on compliance programs for ambulance suppliers.  The OIG frequently cites this document in enforcement actions it takes against ambulance providers and suppliers.  Thus, this guidance document remains relevant to this day.  For that reason, A.A.A. members are strongly encouraged to review this document to ensure that their existing compliance program incorporates the elements cited by the OIG.

Previous Compliance Program Guidance for Ambulance Suppliers

In March 2003, the OIG issued its “Compliance Program Guidance for Ambulance Suppliers.”  This document sets forth the basic elements that it believes should be included in any effective compliance program, and then discusses various fraud and abuse and compliance risks associated with the provision of ambulance services under the Medicare Program.

The 7 basic elements identified by the OIG are:

  1. The development of compliance policies and procedures
  2. The designation of a compliance officer or compliance committee
  3. The implementation of education and training programs
  4. The use of internal monitoring and reviews
  5. Policies designed to respond appropriately to detected misconduct
  6. Ensuring open lines of communication
  7. The enforcement of disciplinary standards through well-publicized guidelines

The CPG then goes into greater detail on each of these elements, including specific recommendations on how to properly implement each of these elements.  For instance, the OIG suggests that the organization’s compliance office be a high-level individual who reports directly to the organization’s CEO or Board of Directors.

With respect to the specific fraud and abuse risks associated with ambulance, the OIG highlighted the issue of medical necessity.  The OIG also cited level of service issues (i.e., billing ALS vs. BLS), non-emergency transports, and coordination of benefit issues as particular areas of concern.

 

AAA Provides Comments to the Senate HELP Committee Related to Workforce Shortage

The American Ambulance Association has submitted comments to the Senate Committee on Health, Education, Labor, and Pensions (HELP) in response to their request for input on crafting legislation to address the health care workforce shortage.

Ground ambulance service organizations are facing a severe shortage of paramedics and EMTs which is placing a significant strain on an emergency medical system already in financial distress. We greatly appreciate the opportunity to provide our legislative solutions to the committee to help address the ongoing workforce crisis.

Please see the document linked below, which was sent to the HELP Committee Chairman, Senator Bernie Sanders, and the Ranking Member, Senator Bill Cassidy.

3-17-2023 HELP Workforce Comments

 

Department of Veterans Affairs Issues Final Rule on Reimbursement for Ambulance Services and Other Special Modes of Transportation

On February 16, 2023, the Department of Veterans published in the Federal Register the final rule to revise the payment methodology for beneficiary travel by ambulance and other so-called “special modes of transportation. The changes contained within the final rule were first included in a November 5, 2020 proposed rule.

The final rule will become effective on February 16, 2024.

Relevant Background

The VA currently pays for beneficiary travel under certain circumstances.  To be eligible for reimbursement, the veteran must meet certain eligibility criteria.  Specifically, the veteran must be traveling either: (i) for care at a VA health facility or (ii) for care at a non-VA facility that has been previously approved by the VA.  The veteran must also meet one of the following additional criteria:

  1. The veteran must have a VA disability rating of 30% or higher;
  2. The veteran must be traveling for treatment of a service-related condition (if their VA disability rating is less than 30%);
  3. The veteran receives a VA pension;
  4. The veteran has an income below the maximum annual VA pension rate;
  5. The veteran cannot otherwise afford to pay for their travel; or
  6. The veteran is traveling for one of the following reasons: (i) to obtain a VA compensation and pension exam, (ii) to obtain a VA service dog, or (iii) to obtain VA-approved transplant care.

Beneficiary travel covers all modes of transportation, including transportation by private vehicle, common carriers (e.g., taxi, livery, and public transportation), mass transit, etc.  Beneficiary travel also covers so-called “special modes of transportation,” which includes air and ground ambulance services, wheelchair vans services, and stretcher vans services.

The rules governing the payment for beneficiary travel services at set forth in 38 C.F.R. § 70.30.

Subpart (a)(4) sets forth the payment methodology for the reimbursement of special modes of transport, and simply provides that payment is based on “[t]he actual cost of a special mode of transportation.  In the context of ambulance services, this has historically been interpreted to mean the ambulance provider’s full billed charges.

Provisions of Final Rule 

Under the final rule, the VA would revise its existing payment methodology for beneficiary travel by ambulance and other special modes of transportation to no longer reimburse providers for their actual costs, and to instead base reimbursement on:

  1. For ground and air ambulance services, the lesser of: (i) the actual charge for ambulance transportation (i.e., the provider’s billed charges) or (ii) the amount determined under the Medicare Ambulance Fee Schedule.
  2. For other special modes of transportation (i.e., ambulette, wheelchair van, or stretcher van), the lesserof: (i) the provider’s actual charge, (ii) the applicable Medicaid rate in the state where the provider is domiciled (using the lowest Medicaid rate where the provider is domiciled in multiple states), or (iii) the applicable Medicaid rate in the state where the transport occurred (or the lowest Medicaid rate if the transport occurred in more than one state). Note: the revised regulations provide that if none of the states involved has a “posted rate,” the VA would continue to pay the provider’s full billed charges

The revised payment methodology for non-ambulance special modes of transport is intended to be temporary.  In its proposed rule, the VA indicated that it would use this payment methodology for a minimum of 90 calendar days after a final rule was posted in the Federal Register.  This period of time was intended to allow the VA to gather payment data.  If the VA believes that it gathered sufficient payment data during this initial 90-day period, it indicated that it would develop a new payment methodology “using the lowest possible rate.”  If the VA determined that it did not have sufficient payment data after the initial 90-day period, it would extend the proposed payment methodology for additional 90-day periods as needed until it believed it had sufficient data.  The VA indicated that it did not anticipate needing more than 18 months from the effective date of the final rule to gather sufficient payment data to implement a new payment method

2022 AAA Board of Directors Election Results

The winners of the 2022 AAA Board of Directors election are listed below. The term for each position will begin on January 1, 2023. For regions 1 and 3, two directors were chosen due to vacant positions. Please join us in thanking all candidates for their service to the American Ambulance Association.

President-Elect

Jamie Pafford-Gresham
Pafford EMS
Hope, AR

 


Treasurer

Julie Rose
Superior Air-Ground Ambulance Service, Inc.
Ashtabula, OH

 

 


Secretary

Wayne Jurecki
Bell Ambulance Service, Inc.
Milwaukee, WI

 

 


Region 1 Director – 3 Year Term

Dennis Cataldo
Cataldo Ambulance Service
Somerville, MA

 

 

 

Region 1 Director – 1 Year Term

Mike Addario
Global Medical Response
Baldwinsville, NY

 

 


Region 2 Director – 3 Year Term

Chuck Kearns
Mercy Ambulance Service, Inc
Savannah, GA

 

 


Region 3 Director – 3 Year Term

Tom Tornstrom
Gundersen Health System-Tri-State Ambulance
La Crosse, WI

 

 

Region 3 Director – 1 Year Term

Kyle Wolber
Superior Air-Ground Ambulance Service, Inc.
Winfield, IL

 

 


Region 4 Director – 3 Year Term

Allyson Pharr
Acadian Ambulance
Lafayette, LA

 

 


Region 5 Director – 3 Year Term

J.D. Fuiten
Metro West Ambulance
Hillsboro, OR

 

 

 

 


Ethics Committee

Hanan Cohen
Empress EMS
Region 1

 

 

 

Ron Quaranto
Acadian Ambulance
Region 4

CALL TO ACTION: Medicare Extenders Expiring

The temporary Medicare ambulance increases are scheduled to expire at the end of the year at a time when our industry is facing unprecedented financial challenges. In addition to extending the Medicare add-on payments for five years, the AAA is asking Congress to increase the 2% urban rate to 3.4%; the 3% rural rate to 4.3%; and the super rural 22.6% rate to 26.7% to help address the crisis.

The Protecting Access to Ground Ambulance Medical Services Act of 2021 (S. 2037, H.R. 2454) by Senators Catherine Cortez Masto (D-NV), Susan Collins (R-ME), Bill Cassidy (R-LA), Debbie Stabenow (D-MI) and Patrick Leahy (D-VT) and Congresswoman Terri Sewell (D-AL), Congressman Markwayne Mullin (R-OK) and Congressman Peter Welch (D-VT) would extend the temporary Medicare ground ambulance increases of 2% urban, 3% rural and the super rural bonus payment for five years and help ensure that rural zip codes remain rural under the Medicare fee schedule following the upcoming zip code reclassification based on 2020 Census data.

These bills are essential to ensuring access for all patients to vital emergency and non-emergency care, but they still do not bring payment rates up to a level that covers the increased cost of labor and other expenditures. We ask that you write to your members of Congress to cosponsor S. 2037 or H.R. 2454 and support increasing the percentages to 3.4% urban, 4.3% rural and 26.7% for the super rural bonus payment.

Contact Your Legislators

Senate Appropriators Address AAA’s Request for Workforce Assistance

Message from AAA President Shawn Baird

The paramedic and EMT shortage has become a top policy priority of the AAA as we pursue several short and long-term initiatives to address this unprecedented crisis. Over the last several months, the AAA has been working closely with Members of the Senate Appropriations Problem Committee and the Office of the Assistant Secretary for Preparedness and Response (ASPR) to secure a grant program that would assist ground ambulance service organizations in hiring and retaining paramedics and EMTs. I am extremely pleased to report that the Fiscal Year 2023 Senate HHS appropriations package includes the program language for which the AAA has been advocating.

The language in the Senate Report reads:

EMS Preparedness and Response Workforce Shortage Program.— The Committee recognizes that our Nation is facing a crippling EMS workforce shortage which threatens public health and jeopardizes our ability to respond to healthcare emergencies on a timely basis. ASPR should prioritize ensuring a well-trained and adequate ground ambulance services workforce in underserved, rural, and Tribal areas and/or addressing health disparities related to accessing prehospital ground ambulance healthcare services, including critical care transport.

In the House, the AAA’s efforts contributed to House appropriators increasing the ASPR account funding for the Hospital Preparedness Program (HPP) (more than $30 million). We anticipate that ASPR would focus its efforts to address the ground ambulance workforce shortage through the HPP, so this increase in funding is also a critical component of the AAA’s efforts.

Although the appropriations process has many more steps to go through before final passage, having the EMS workforce shortage highlighted in the Senate report is a critical step toward achieving our goal to provide ground ambulance services across the country with the help they need during this unprecedent time.

The AAA will continue to work closely with Congressional champions and the ASPR team as they shepherd this language through the next steps in the process. I would like to thank Chairman Patrick Leahy (D-VT), Chair Patty Murray (D-WA), Senators Bill Cassidy (R-LA), Susan Collins (R-ME), Shelly Moore Capito (R-WV), Cindy Hyde-Smith (R-MS), Jeff Merkley (D-OR) and Ranking Members Richard Shelby (R-AL) and Roy Blunt (R-MO) for championing and supporting the effort.

AAA President
Shawn Baird

 

Application Period Extended for FY 2021 Assistance to Firefighters Grant (AFG) Program

Please see the below notice from FEMA on the extension of the Assistance to Firefighter Grant (AFG) Program:

“FEMA has been working with the General Services Administration to resolve interface issues related to SAM.gov that were affecting some applicants’ ability to begin inputting their federal fiscal year (FY) 2021 Assistance to Firefighters Grant (AFG) Program applications into the FEMA GO System. Specifically, this issue included applicants that received error messages stating their organizations were not found and that their Unique Entity Identifier (UEI)/Electronic Funds Transfer (EFT) combination did not exist despite the applicants’ SAM.gov accounts being fully active.

As this issue is ongoing, the FY 2021 AFG Program application period will remain open until January 21, 2022 5:00 p.m. ET. All applicants will automatically be granted this extension. This ensures that applicants affected by the UEI/EFT issue will have sufficient time to complete the online application. The extension to the application period will not affect the award timeline. In the meantime, FEMA continues to strongly encourage applicants to review the FY 2021 AFG Program Notice of Funding Opportunity and the associated tools posted on the FEMA website here: FY 2021 Assistance to Firefighters Grant (AFG) Application Guidance Materials | FEMA.gov. In preparation for application submission, applicants may also draft their narratives separately and cut and paste them into the appropriate areas of FEMA GO once the SAM.gov interface issue is resolved. The questions that are asked in the narrative section may be found in the FY 2021 AFG Program Narrative Get Ready Guide.

Fire Grants Help Desk: If you have questions about the NOFO or application process, call or email the Fire Grants Help Desk. The toll-free number is 1-866-274-0960; the e-mail address for questions is firegrants@fema.dhs.gov.The Fire Grants Help Desk is open Monday – Friday, 8 a.m. – 4:30 p.m. ET. “

 

Assistance to Firefighters Grant Program- Non Affiliated EMS Organizations Are Eligible

The Federal Emergency Management Agency (FEMA) Assistance to Firefighters Grant Program (AFG) applications are open. The goal of the grant program is to assist fire departments and non-affiliated emergency medical service organizations in meeting their needs to serve their communities. The grant assists these organizations in obtaining equipment, protective gear, emergency vehicles, training and other resources. Non-affiliated EMS organizations including non-hospital based (private or public) nonprofit, or governmental organizations are eligible to apply. Applications close on Friday, December 17, 2021 at 5pm ET.

Eligible organizations can review the help documents linked below:

If you need assistance in completing your grant application or have any questions you can call or email the Fire Grants Help Desk at 1-866-274-0960 or firegrants@fema.dhs.gov Monday-Friday from 8am-4:30pm ET.

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