Author: AAA Staff

Spotlight: Daniel Cavin

Daniel Cavin
Saint Louis, Missouri, USA
Director of Paramedic Education, IHM Academy of EMS

Tell us a little about yourself.

I was born and raised here in a suburb of St. Louis, Missouri to Dennis and Cindy Cavin. I was the youngest of three with an eldest brother, Scott, and sister, Meghan. My parents have since divorced, but we all still have a very close knit relationship that is vital to all of us. I am married to my beautiful wife, Stacy, who gave me a lovely daughter, Ariya Shae Cavin.

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Spotlight: James Rattunde, 2015 Star of Life

James Rattunde
Baraboo, Wisconsin, USA
NR-EMT at Baraboo District Ambulance Service
2015 AAA Stars of Life Honoree

Tell us a little about yourself.

I have lived in Necedah, WI my entire life. I will have been married to my first wife for 39 years in August. We were blessed with twins, a daughter and a son. We also have five grandchildren ages 10, 8, 6, 4, and 2. I love the outdoors, landscaping, lawn and garden, camping (although now in a 5th wheel—not a tent), waterskiing and watersports, and helping others.

How did you come to work in the industry? How long have you been involved?

When my younger brother was about 7 or 8 years old he fell down the stairs with a piece of candy in his mouth. The candy got caught in his throat and he started choking. I never forgot the look on my mother’s face as my brother turned blue and we thought surely he would die. Henry Wegner came running thru the front door of our house and—probably due to his military training—knew just what to do. Henry was able to dislodge the candy and my brother survived. By the way, the ambulance was a white 1962 Ford with a 352 Thunderbird V-8 and a Siebert chasis. I believe to this day that this event is what inspired me to want to be able to help others, just the way Henry did. Mr. Wegner died just a couple of years ago well into his 90s.

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Join Our Efforts to Receive Permanent Medicare Relief

After countless hours of work by the American Ambulance Association’s (AAA) legislative team, our champions on Capitol Hill, volunteer leaders, members and other organizations, we are pleased to once again announce the 33-month extension of Medicare ambulance relief.  This extension will continue the 2% bonus for urban areas, the 3% bonus for rural transports and the bonus payment for super rural areas.  This is a major victory for the AAA and its members as the extension will supply important funding to allow ambulance services to continue to provide essential medical care to their communities.

That being said, we can’t let the momentum stop!  The AAA is still fighting and pushing on Capitol Hill for a permanent extension of Medicare relief rather than a temporary fix.  With a short-term extension it remains difficult for ambulance services to properly budget for the future and prepare for the uncertainties of being a health care provider.  The AAA continues to seek support and cosponsors for the Medicare Ambulance, Access, Fraud Prevention, and reform Act of 2015 (S. 377, H.R. 745).  In addition to permanent Medicare ambulance relief, this bill includes several additional provisions that will help ambulance services to grow and provide critical care services to patients.  These additional provisions include:

–     Categorizing ambulance services as “providers” rather than “suppliers”. The AAA wants its members and all ambulance services to be recognized properly for the medical services they provide.  As you are aware, an ambulance is often the first place that a patient is provided critical care and service.  For this reason, the bill includes language that would recognize ambulance services as “providers” rather than “suppliers”.

–     Prior Authorization Program. The same bill that extended Medicare ambulance relief for 33 months also included a prior authorization program that would extend to several states on the East Coast in 2016 and nationwide in 2017.  The AAA is working with legislators on Capitol Hill, our Medicare Consultants, and AAA members to help with the roll-out of the prior authorization program.  Keep your eyes peeled for further information and resources that the AAA will be providing.

–     Ambulance Cost Data Collection. The bill directs the Centers for Medicare and Medicaid Services (CMS) to use a survey approach to collecting cost data from a statistically significant number of ambulance service providers.  It is critical that Congress have cost data from all the different types of providers to make future changes to the ambulance fee schedule.

With each of these significant provisions, the Medicare Ambulance Access, Fraud Prevention and Reform Act of 2015 will help position AAA members and ambulance services for the future.  It will provide critical funding as well as opportunities for recognition, growth and knowledge.

Shawn Baird, Co-Owner of Woodburn Ambulance Service and Co-Chair of the AAA’s Government Affairs Committee, said this about the Medicare Ambulance Access, Fraud Prevention and Reform Act of 2015

“While the extension of our temporary ambulance relief provides hard earned breathing room, it is more essential than ever to get members of Congress signed on as co-sponsors of our permanent ambulance relief bills S. 377 and H.R. 745.  Using this precious time to secure permanent funding, data collection that works for the industry and provider status with CMS is the only way we will be able to keep our issue a priority on Congress’s busy agenda. In our ambulance services at home we all know how important it is to keep pushing our companies to be ready for that next emergency call.   We never say it’s time to sit back and relax now that we ran that last call. It is the same with our effort on Capitol Hill. We have been building success and let’s keep it rolling forward!”

The American Ambulance Association asks that you help in our efforts to make Medicare ambulance relief permanent!   Please contact your members of Congress using the AAA’s online letter writing tool and ask them to co-sponsor the Medicare Ambulance Access, Fraud Prevention, and Reform Acts (S. 377 and H.R. 745).

Each member of the AAA plays a critical role in helping to achieve success in our legislative efforts.  With your help and expertise, we look to continue to represent you and your interests on Capitol Hill.

Just Released—Compare Your Service With 2013 Medicare Data

See how your service stacks up according to several key Centers for Medicare and Medicaid Services (CMS) measures. The  recently released 2013 Medicare Provider Utilization and Payment Data lists all providers by National Provider Identifier (NPI), and includes figures on utilization, total payments, and submitted charges.

AAA members, read more in today’s Member Advisory by expert Medicare consultant Brian Werfel.

Not yet a member? Learn more about how AAA membership can help you stay up-to-date on critical regulatory and reimbursement issues that impact your ambulance service.

Community Paramedicine’s Growth Hindered by Reimbursement Issues

From Politico’s “Reimbursement issues block paramedics from expanded role“—

Despite the track record of [community paramedicine] initiatives in places like Nevada and Texas, where paramedics are providing in-home care, coordinating patient services and saving millions in the process, Medicare, Medicaid and most private insurance plans still won’t reimburse for such work. The program successes to date are only beginning to change that…

Nationwide, the impact from reducing ambulance calls and demands on ERs while freeing up doctors could be huge. A 2013 study in Health Affairs estimated that more flexible reimbursement for paramedicine approaches could save Medicare $283 million to $560 million annually and similar sums for private insurers.

AAA Members Named to NEMSAC

On May 12, 2015, two AAA member leaders were appointed to the  National Emergency Medical Services Advisory Council (NEMSAC) by U.S. Transportation Secretary Anthony Foxx. NEMSAC advises the Department of Transportation and the Federal Interagency Committee on critical EMS issues.

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Public Safety Officers’ Benefits (PSOB)

For many years, one of the top legislative priorities of the AAA has been the expansion of the Public Safety Officer’s Benefits (PSOB) to all private emergency medical services (EMS) professionals.  Originally, Congress established the PSOB program to provide assistance to police officers, firefighters, paramedics and emergency medical technicians (EMT) in the event of a death in the line of duty.  However, the benefits only apply to those public safety officers employed by a federal, state, or local government entity or a private non-profit emergency medical services agency or company.

Paramedics and EMTs employed by a private, for-profit EMS company provide identical services to their governmental and private non-profit counterparts and do so daily in the same dangerous environments. The Federal Emergency Management Agency (FEMA) is presently reviewing its guidelines on “active shooter” and may revise its policy of paramedics and EMTs waiting until a scene is secure before entering to provide urgent medical care to a victim. While paramedics and EMTs employed by private EMS companies already put the lives of others first, the review of the FEMA guidelines as federal policy puts a greater emphasis on the need to apply the federal PSOB program to all first responders.

The Dale Long Act, 2012

In 2012, our voice was heard when the Dale Long Act (S. 385, Public Law 112-239) was signed into legislation.  The act extends the PSOB program to employees and volunteer members of non-profit EMS organizations.  While we would have liked to see the benefits extended to all EMS professionals, both public and private, we celebrated the victory and continue to fight for complete coverage.

It is inequitable to penalize dedicated public safety officers and their families simply because of their employer type and it is now time for Congress to fully correct this disparity and legislate that the PSOB program cover those paramedics and EMTs employed by a private EMS company.

What You Can Do to Help

Currently, the AAA is continuing efforts to find House and Senate sponsors for expansion of the PSOB to for-profit service providers.  In the past, members of Congress have been motivated to act by specific examples of inequity within their states and districts.  If you have a strong relationship with your elected officials and feel that you can help with this issue, please contact Tristan North, Senior Vice President of Government Affairs, at tnorth@ambulance.org.

Fort Worth ICD-10 Sold Out!

Join the American Ambulance Association at MedStar Mobile Healthcare in Dallas/Ft. Worth for a one day, hands on ICD-10 Workshop. Spend the day in a relaxed atmosphere with plenty of individual attention geared to your specific service type. There will also be ample time for Q&A with our subject matter experts. Amanda Jimeson, CPC, will share the program she developed for EMSA and joining Amanda will the AAA’s Medicare Regulatory co-chairs, Angie Lehman, Vice President of Finance, EMSA, and Rebecca Williamson, Compliance Officer for Muskogee EMS and author of the AAA Compliance Guide. And to put it all in perspective will be AAA’s Medicare Consultant, Brian Werfel. You’ll receive helpful tools and walk away with an intimate understanding of ICD-10 coding and its proper application.

 

Location

MedStar Mobile Healthcare
2900 Alta Mere Drive
Ft. Worth, TX 76110

Agenda

9:00am-9:15am
Welcome, Speaker introductions and course objectives

9:15am-10:30am
ICD-10  Part I

10:30am-10:45am
Break

10:45am-12:00pm
ICD-10 Part II

12:00pm-12:15pm
Tour of Host Facility

12:15pm-1:15pm
Networking Lunch with Sponsors

1:15-pm-2:30pm
Medicare Update Part I with Brian Werfel

2:30pm-2:45pm
PM Break

2:45pm-3:30pm
Medicare Update Part II

3:30pm-4:30pm
Putting it into Practice and Closing Comments

4:30-5:00pm
Final Q&A

Sponsored by

private ambulance services

Solutions-Group-200

ambulance membership

6.5 CEUs

aaa conference Ambulance Coding

Hotel Information

La Quinta (New Property!)
7310 Calmont Avenue, Fort Worth, TX 76116
Phone: (817) 244-4777
Distance from MedStar: 0.3 miles
The La Quinta Inn & Suites Fort Worth West/I-30 hotel is conveniently located off I-30 in the Fort Worth Business District, near Lockheed Martin, Ridgemar Mall and the Naval Air Station and Joint Reserve Base. Some of our hotel amenities include a Free Bright Side Breakfast and wifi.

Fairfield Inn & Suites Fort Worth I-30 West
6851 West Freeway, Fort Worth Texas 76116
Phone: (817) 731-9600
Fairfield Inn & Suites Fort Worth I-30 West Near NAS JRB is in Fort Worth, TX and has outstanding amenities to make travel easy. Guests enjoy complimentary breakfast and on-site fitness facilities.

[map width=”590″ height=”365″ lat=”32.732699″ long=”-97.442409″ zoom=”12″ type=”map2″ address=”2900 Alta Mere Drive Ft. Worth, TX 76116″ title=”MedStar Mobile Health”]

St. Louis ICD-10 Regional Workshop

6.5 NAAC CEU’s

Join the American Ambulance Association our one day, hands-on ICD-10 workshop. Our first stop on on our ICD-10 junket will be Abbott EMS in St. Louis. Spend the day in a relaxed atmosphere with plenty of individual attention geared to your specific service type. There will also be ample time for Q&A with our subject matter experts. Amanda Jimeson, CPC, will share the program she developed for EMSA and joining Amanda will the AAA’s Medicare Regulatory co-chairs, Angie Lehman, Vice President of Finance, EMSA & Rebecca Williamson, Compliance Officer for Muskogee EMS and author of the AAA Compliance Guide. And to put it all in perspective will be AAA’s Medicare Consultant, Brian Werfel. You’ll receive helpful tools and walk away with an intimate understanding of ICD-10 coding and its proper application.

2500 Abbott Place
St. Louis MO 63143

AAA Needs You! Speak or Write to Share Your Passion

Speak at AAA 2015!
Speak at AAA 2015!

One of the best things about the American Ambulance Association community is the strength of our practitioner network. Members connect with one another at annual conference and beyond to solve problems, share best practices, and discuss key legislative issues.

Your active participation in this exchange of ideas is what enables AAA to serve its mission. We would like to invite you to take your involvement to the next level through the contribution of member content. Please read below to learn how you can speak or write for AAA and build your resume while supporting excellence and community in ambulance services.

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Kaiser Health News: REMSA Paramedics Steer Non-Emergency Patients Away From ERs

Innovation in Reno
REMSA program empowers EMS, helps patient outcomes, and cuts costs.

Yesterday Kaiser Health News reported that AAA member organization Regional Emergency Medical Services Authority (REMSA), is serving its community in innovative ways that reduce healthcare costs and improve patient outcomes. Initiatives led by REMSA CEO Jim Gubbels empower Reno paramedics to lower the number of preventable emergency room visits and close gaps in primary health care.

Using a $9.8 million federal grant, [REMSA CEO Jim Gubbels’] agency launched three different projects. In addition to providing paramedic home visits and offering patients options besides the ER, the agency started a nurse-run health line to give people with health questions another number to call in non-emergency situations.

An early evaluation by the University of Nevada, Reno, which was based on insurance claims and hospital data, shows that the projects saved $5.5 million in 2013 and 2014. They helped avoid 3,483 emergency department visits, 674 ambulance transports and 59 hospital re-admissions, according to the preliminary data. The federal government plans to do its own evaluation.

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Spotlight: Paul Pedersen

Paul Pedersen
Sierra Vista, Arizona, USA
Managing Partner at Arizona Ambulance Transport
Director Region 5, AAA Board

Tell us a little about yourself.
I was born and raised in Berkeley, California. I have a wife and two grown children, and enjoy traveling.

How did you come to work in the industry?
After 20 years in law enforcement and five years in public safety communications, I became general manager for Rural/Metro in southern Arizona. I subsequently co-founded our company, Arizona Ambulance Transport, in 2000.

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Recognition of EMS Personnel Licensure Interstate Project

Mar 27, 2015

In one of the most labor intensive projects of national significance in its history, the National Association of State EMS Officials brought industry partners and experts in the field of interstate compacts together over the last two years to develop model legislation for states’ consideration and enactment. The “Recognition of EMS Personnel Licensure Interstate CompAct” (“REPLICA”) final model legislation is attached and was distributed to State EMS Directors and State EMS Medical Directors earlier this week. EMS is at the leading edge of a growing wave of medical disciplines’ national bodies of state regulatory agencies that have discovered that interstate compacts are a novel yet time tested way to solve the pervasive dilemma of providing appropriately credentialed individuals from other states the legal ability to practice under specified conditions, introduce unprecedented accountability related to those personnel, and create means of information sharing among states that have never existed before.

In order to become a member of the compact, a state must introduce the attached as a piece of legislation, enact it without any substantial changes, and the Governor must sign it into law. The Federation of State Medical Boards (FSMB), the members of which include your state medical board(s’) Executive Director(s), has also just completed a model interstate compact to streamline physician licensure across state lines. Information about the FSMB initiative and a link to download their model compact can be found here. These initiatives would dovetail nicely as companion bills and solve interstate practice issues for both EMS personnel and their medical directors concurrently.

At its annual meeting last month, the Council of State Governments (CSG) Board of Directors passed a resolution supporting the establishment of REPLICA and encouraging its member jurisdictions to consider adoption as an “innovative policy solution”. You can view and download the resolution here.

The record set for adoption of a new compact in recent years was by 11 states in the first legislative cycle following model compact distribution, and just within the last few months, the number of compacts in use by all 50 states grew to four, and most have DC and territories as members as well. Your legislators or legislative services staff may be more comfortable communicating with CSG, in which case their contact person is Crady deGolian, Director of the CSG National Center for Interstate Compacts via cdegolian@csg.org or by telephone at 859-244-8068. CSG houses comprehensive information about interstate compacts here.

NASEMSO is grateful to the US Department of Homeland Security for the resources that made this possible, and all of the national organizations who contributed time and expertise during this process. Most specifically, we are indebted to the states of Colorado, Idaho and Maryland, and the Commonwealths of Kentucky and Virginia for generously making state EMS office staff with notable expertise in legislation drafting and personnel licensure available to be heavy lifters in the project.

View the final model legislation.

Permanent Medicare Ambulance Relief

Please reach out to your members of Congress and ask that they cosponsor the Medicare Ambulance Access, Fraud Prevention and Reform Act (H.R. 745, S. 377) and support an extension of the temporary Medicare ambulance add-on payments.  H.R. 745 and S. 377 would make the current temporary Medicare increases of 2% urban, 3% rural and the super rural bonus payment permanent. Please also ask your members of Congress to support an extension of the increases, which expire on March 31.

In the next few weeks, Congress is expected to consider an extension of the temporary fix to the physician fee schedule. This package would also be the legislative vehicle for an extension of the Medicare ambulance add-on payments. An extension of these increases will ensure the continuation of short-term relief while we push to make the increases permanent. So please write today!

Thank you in advance for writing to your members of Congress.

Zip Code Delay Comment Letter

On December 30, 2014, AAA submitted a comment letter to CMS asking the Agency to delay implementation of the changes in zip codes losing their rural status starting in 2015. In its comment letter, the AAA based the one-year delay on the lack of proper notice of the changes in the geographical delineations of zip codes and the omission of a small entity impact certification in the proposed or final rules. In the proposed rule, CMS stated only 122 zip codes would lose rural status but in the final rule cited 3,038 zip codes switching from rural to urban. The AAA was able to get that number corrected to 1,599 zip codes but believes CMS still needs to delay implementation of the change for one-year to give ambulance service providers adequate time to determine and budget for the loss of revenue.

View Letter

Comment Letter on Proposed Fee Schedule Changes

On August 29, 2014, the AAA sent a Proposed Rule Comment Letter to the Centers for Medicare and Medicaid Services (CMS) regarding the CY2015 Fee Schedule Changes.  The AAA determined the recently published proposed rule on updates to the Medicare ambulance fee scheduled for CY 2015 likely significantly underestimated the number of zip codes that would change geographic area designation. In the proposed rule, CMS stated 120 zip codes would change from rural to urban and 100 zip codes would change from urban to rural. The AAA has estimated 1,524 zip codes would change from rural to urban and 449 zip codes would change from urban to rural.

AAA Proposed Rule Comment Letter

2015 Changed Zip Totals by State

CMS Proposed Rule on CY2015 Fee Schedule Changes

The AAA determined the recently published proposed rule on updates to the Medicare ambulance fee scheduled for CY 2015 likely significantly underestimated the number of zip codes that would change geographic area designation. In the proposed rule, CMS stated 120 zip codes would change from rural to urban and 100 zip codes would change from urban to rural. The AAA has estimated 1,524 zip codes would change from rural to urban and 449 zip codes would change from urban to rural.

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2014 Ride-Along Toolkit

Congressional Ambulance Ride-Alongs and National Emergency Preparedness Month

The immediate response to a catastrophic disaster, act of terrorism or other public health emergency involves many local public safety, public health and health care organizations. As first responders, America’s ambulance service providers are an essential resource and perform vital services as part of each community’s emergency response system and health care safety net. Therefore, we urge ambulance service providers to:

  1. Participate on local and state homeland security advisory panels
  2. Upgrade emergency preparedness and response plans regarding ambulance response capabilities during a disaster incident
  3. Develop and submit grant applications to local (city and county) or state government officials to secure local, state and federal funds for planning, exercises, equipment and personal protective equipment
  4. Organize Ride-Alongs for your members of Congress during the August Recess
  5. Participate in local National Emergency Preparedness Month (September) activities
  6. Generate local media to increase public awareness about the role of ambulance service providers in the community’s response to disasters and to provide an incentive to local officials to provide the necessary funding

The following tool kit is designed to assist members of the American Ambulance Association to achieve all six of the above objectives.