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Author: Tristan North

Congress Extends Medicare Ambulance Add-On Payments

Written by Tristan North on . Posted in Medicare, Member Advisories, News, Reimbursement.

On Saturday, December 21, the American Relief Act of 2025 (H.R. 10545) became law and thereby averted a partial federal government shutdown. Of critical importance to ground ambulance service organizations, H.R. 10545 also extends the temporary Medicare ambulance add-on payments of 2% urban, 3% rural and 22.6% super rural through March 31, 2025. In addition, the new law wipes clean the PAYGO scorecard preventing a potential 4% cut in Medicare reimbursement for ground ambulance and other Medicare services.

The House of Representatives passed by a vote of 366 to 34 the Continuing Resolution (H.R. 10545) to extend funding for the federal government just hours before reaching the previous funding deadline of midnight on December 20th. The Senate then passed H.R. 10545 by a vote of 85 to 11 late that evening. The CR funds the federal government primarily at current funding levels through March 14, 2025.

The negotiations on the American Relief Act were extremely tense with a more robust initial legislative package, which would have extended the Medicare ambulance add-ons for two years, being replaced with a slimmer bill with fewer and shorter health care provisions. The extension of ground ambulance service payments ended up being just one of twenty-five provisions in the final 118-page Continuing Resolution, which was originally over 1,600 pages.

The AAA greatly appreciates the advocacy of our champions and supporters on Capitol Hill to ensure that the temporary ambulance payments extension was included in the final CR. We also want to thank our AAA members for reaching out to their members of Congress to request their help with the add-on payments. We will continue to push for a longer extension of the ambulance payments at percentages higher than the current levels upon the expiration of the CR. 

Congressman Mike Bost Honored with Legislative Recognition Award

Written by Tristan North on . Posted in Legislative, Legislative Awards, Press, Veterans Affairs.

FOR IMMEDIATE RELEASE

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

Congressman Mike Bost Honored with Legislative Recognition Award

from the American Ambulance Association

 

Washington, D.C. — The American Ambulance Association (AAA) has awarded Mike Bost (IL) a 2024 AAA Legislative Recognition Award in recognition of his leadership in ensuring veterans continue to have access to emergency 9-1-1 and interfacility ground ambulance services.

Congressman Bost introduced the bipartisan VA Emergency Transportation Access Act (S. 2757, H.R. 6433) to direct the Department of Veterans Affairs (VA) to further analyze the impact of the VA Final Rule on Special Modes of Transportation and create an advisory committee to evaluate future reimbursement rates for ambulance services.

The Rule as it stands would reimburse ambulance service providers below the costs of providing medical and transport services. S. 2757 would help ensure that ambulance service providers throughout Kansas and the country do not face further cuts to VA reimbursement which would limit their ability to provide lifesaving emergency medical services to our nation’s veterans.

Due to the efforts of Congressman Bost and a bipartisan group of Senators and Representatives, the VA has recently stated it will delay implementation of the Final Rule for four years which would provide time to determine more fair and adequate payment rates for ambulance services.

“We greatly appreciate the leadership of Congressman Moran in ensuring that our veterans and entire communities will continue to have access to vital ground ambulance service,” said AAA President, Randy Strozyk. “His perseverance paid off with the VA recognizing the need to delay implementation of the final rule to provide more time to address concerns that the new payment system could adversely affect ambulance access for veterans.”

The American Ambulance Association will be presenting Congressman Bost with his Legislative Recognition Award this November at the AAA Annual Stars of Life Event, which honors emergency medical services professionals from around the nation who have gone above and beyond in service to their communities.

Congressman Ryan Zinke Honored with Legislative Recognition Award

Written by Tristan North on . Posted in Legislative, Legislative Awards, Press, Veterans Affairs.

FOR IMMEDIATE RELEASE

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

Congressman Ryan Zinke Honored with Legislative Recognition Award

from the American Ambulance Association

 

Washington, D.C. — The American Ambulance Association (AAA) has awarded Congressman Ryan Zinke (MT) a 2024 AAA Legislative Recognition Award in recognition of his leadership in ensuring veterans continue to have access to emergency 9-1-1 and interfacility ground ambulance services.

Congressman Zinke has led efforts to restrict the ability of the Department of Veterans Affairs to implement its Final Rule on Special Modes of Transportation which would reimburse ambulance service providers below the costs of providing medical and transport services to our veterans. Congressman Zinke has supported efforts to instead create an advisory committee to evaluate future VA reimbursement rates for ambulance services.

Due to the efforts of Congressman Zinke and a bipartisan group of Senators and Representatives, the VA has recently stated it will delay implementation of the Final Rule for four years which would provide time to determine more fair and adequate payment rates for ambulance services.

“We thank Congressman Zinke for his dedication and perseverance to ensuring that our veterans and entire communities will continue to have access to vital ground ambulance service,” said AAA President, Randy Strozyk.

The American Ambulance Association will be presenting Congressman Zinke with his Legislative Recognition Award this November at the AAA Annual Stars of Life Event, which honors emergency medical services professionals from around the nation who have gone above and beyond in service to their communities.

Senator Jerry Moran Honored with Legislative Recognition Award

Written by Tristan North on . Posted in Legislative, Legislative Awards, News, Press, Veterans Affairs.

FOR IMMEDIATE RELEASE

Contact:
Tristan North
tnorth@ambulance.org
October 8, 2024

Senator Jerry Moran Honored with Legislative Recognition Award

from the American Ambulance Association

Washington, D.C. — The American Ambulance Association (AAA) has awarded Jerry Moran (KS) a 2024 AAA Legislative Recognition Award in recognition of his leadership in ensuring veterans continue to have access to emergency 9-1-1 and interfacility ground ambulance services.

Senator Moran introduced with a bipartisan group of Senators the VA Emergency Transportation Access Act (S. 2757, H.R. 6433) to direct the Department of Veterans Affairs (VA) to further analyze the impact of the VA Final Rule on Special Modes of Transportation and create an advisory committee to evaluate future reimbursement rates for ambulance services.

The Rule as it stands would reimburse ambulance service providers below the costs of providing medical and transport services. S. 2757 would help ensure that ambulance service providers throughout Kansas and the country do not face further cuts to VA reimbursement which would limit their ability to provide lifesaving emergency medical services to our nation’s veterans.

Due to the efforts of Senator Moran and a bipartisan group of Senators and Representatives, the VA has recently stated it will delay implementation of the Final Rule for four years which would provide time to determine more fair and adequate payment rates for ambulance services.

“We greatly appreciate the leadership of Senator Moran in ensuring that our veterans and entire communities will continue to have access to vital ground ambulance service,” said AAA President, Randy Strozyk. “His perseverance paid off with the VA recognizing the need to delay implementation of the final rule to provide more time to address concerns that the new payment system could adversely affect ambulance access for veterans.”

The American Ambulance Association will be presenting Senator Moran with his Legislative Recognition Award this November at the AAA Annual Stars of Life Event, which honors emergency medical services professionals from around the nation who have gone above and beyond in service to their communities.

Senator Jon Tester Honored with Legislative Recognition Award

Written by Tristan North on . Posted in Legislative Awards, Press, Stars of Life, Veterans Affairs.

FOR IMMEDIATE RELEASE

Contact:
Tristan North
tnorth@ambulance.org
October 7, 2024

Senator Jon Tester Honored with Legislative Recognition Award

from the American Ambulance Association

Washington, D.C. — The American Ambulance Association (AAA) has awarded Senator Jon Tester (MT) a 2024 AAA Legislative Recognition Award in recognition of his leadership in ensuring veterans continue to have access to emergency 9-1-1 and interfacility ground ambulance services.

Senator Tester introduced with a bipartisan group of Senators the VA Emergency Transportation Access Act (S. 2757, H.R. 6433) to direct the Department of Veterans Affairs (VA) to further analyze the impact of the VA Final Rule on Special Modes of Transportation and create an advisory committee to evaluate future reimbursement rates for ambulance services.

The Rule as it stands would reimburse ambulance service providers below the costs of providing medical and transport services. S. 2757 would help ensure that ambulance service providers throughout Montana and the country do not face further cuts to VA reimbursement which would limit their ability to provide lifesaving emergency medical services to our nation’s veterans.

Due to the efforts of Senator Tester and a bipartisan group of Senators and Representatives, the VA has recently stated it will delay implementation of the Final Rule for four years which would provide time to determine more fair and adequate payment rates for ambulance services.

“Senator Tester’s leadership on this issue has been instrumental in advancing our mission to preserve emergency medical services for veterans and entire communities,” said AAA President, Randy Strozyk. “His dedication to supporting our nation’s heroes exemplifies the kind of leadership we need to ensure that all veterans have access to timely and efficient emergency care.”

The American Ambulance Association will be presenting Senator Jon Tester with his Legislative Recognition Award this November at the AAA Annual Stars of Life Event, which honors emergency medical services professionals from around the nation who have gone above and beyond in service to their communitie

VA Notifies Tester/Moran of Delay of Final Rule until 2029

Written by Tristan North on . Posted in Executive, Government Affairs, News, Veterans Affairs.

The Department of Veterans Affairs (VA) has notified Senate Committee on Veterans Affairs Chairman Jon Tester (D-MT) and Ranking Member Jerry Moran (R-KS) that the Department will be delaying implementation of the Final Rule on Special Modes of Transportation until February 16, 2029. The Committee has released a statement on the delay and the VA should be issuing a formal notification of the delay shortly in the Federal Register.

“I appreciate the VA providing the additional time to ensure a process for proper reimbursement of critical ambulance services for veterans and wholeheartedly thank Chairman Tester and Ranking Member Moran for their successful and tireless efforts in advocating for the delay,” stated AAA President Randy Strozyk. “Reimbursing ground ambulance services at Medicare rates would have a devasting impact on our members who are already struggling financially.”

The delay will allow time for a framework like the one outlined in the VA Emergency Transportation Access Act (S. 2757, H.R. 5530) to allow stakeholder input on future rates. “Our members appreciate the efforts of Senators Tester, Moran, Patty Murray, John Boozman and Susan Collins and Representatives Mike Bost and Ryan Zinke and the dozens of other members of Congress who helped push for the delay.”

The Final Rule on Special Modes of Transportation was originally scheduled to take effect on February 16, 2024, but in December 2023 the VA announced a one-year delay with the latest announcement delaying implementation for an additional four years. Under the final rule, the VA would reimburse for ambulance services provided through its beneficiary travel program at the lesser of the actual charges or Medicare rates.

We will provide more details about the delay when the VA issues its formal notice.

Updates on the VA Final Rule and NDAA Workforce Amendment

Written by Tristan North on . Posted in Uncategorized.

House Passes Language to Stop FY2025 Start of VA Final Rule

On June 5, the U.S. House of Representatives passed the FY2025 MilCon-VA-Related Agencies Appropriations bill. Included in the bill was language championed by Subcommittee Chair John Carter (R-TX) and Representatives Ryan Zinke (R-MT), Michael Guest (R-MS), Val Hoyle (D-OR), Brad Finstad (R-MN) and John Rutherford (R-FL) amongst numerous others that would prohibit the Department of Veterans Affairs from using funding during FY2025 (October 1, 2024 through September 20, 2025) to implement the Final Rule on Special Modes of Transportation. The Rule would reduce reimbursement under the VA travel pay program to Medicare rates for noncontracted ambulance services.

The Association of Air Medical Services, and several air and ground ambulance service organizations, as well as the AAA had submitted requests to several of the offices on language. In addition, the Committee included report language directing the VA to work with stakeholders to identify appropriate levels of reimbursement and to report to Congress on those efforts.

FY25 VA Approps Special Modes Language

Perez/Finstad Offer NDAA EMS Workforce Amendment

Representatives Gluesenkamp Perez (D-WA) and Finstad (R-MN) have submitted a bipartisan amendment (No. 809) to the National Defense Authorization Act (NDAA) (H.R. 8070) that would provide states with funding to help cover the transition costs of a military medic becoming a civilian paramedic or EMT when leaving the Armed Services. The language of the amendment is a modified version of the provision included in the PARA-EMT bill (H.R. 6433) being championed by Gluesenkamp Perez and Finstad.

The AAA along with the National Association of EMTs and National Rural Health Association worked with the two congressional offices on the revised legislative text. The House Rules Committee is expected to meet the week of June 10 to determine the rule for floor consideration of H.R. 8070 and decide on allowed amendments.

Also, NAEMT working with the House Armed Services Committee was able to get report language to accompany the NDAA directing the Department of Defense to provide a report to the Committee on efforts to help ensure that EMTs and paramedics are better positioned to make the transition to the civilian workforce upon leaving the military

NDA EMS Workforce Amendment

AAA Submits Paramedic Expedited Visa Comments in Line with PARA-EMT Act

Written by Tristan North on . Posted in Legislative, Regulatory, Workforce Shortage.

On May 13, the AAA submitted a Comment Letter to the Department of Labor (DOL) in response to their Request for Information (RFI) on modernizing the process and updating the occupations that fall under the Schedule A program. Schedule A is a program administered by DOL which allows for expedited visa processing for occupations with a predetermined workforce shortage. The AAA advocated in our letter for the DOL to add paramedics and EMTs to Schedule A which currently includes nurses, physical therapists and individuals with exceptional abilities in the sciences and arts.
The comment letter by the AAA is in line with a provision of the PARA-EMT Act (H.R. 6433) by Congresswoman Gluesenkamp Perez (D-WA) and Congressman Brad Finstad that would direct DOL to conduct a study on the EMS workforce shortage and report to Congress on consideration by the Department to add paramedics and EMTs to the list of occupations under Schedule A.

Gluesenkamp Perez and Finstad Introduce EMS Workforce Shortage Bill

Written by Tristan North on . Posted in Government Affairs, Legislative, News, Recruitment & Retention, Workforce Shortage.

Yesterday, November 15, Congresswoman Marie Gluesenkamp Perez (D-WA) and Congressman Brad Finstad (R-MN) introduced the Preserve Access to Rapid Ambulance Emergency Medical Treatment (PARA-EMT) Act (H.R. 6433). H.R. 6433 is the first broad, stand-alone piece of legislation specifically designed to focus solely on helping address the EMS workforce shortage.

“We greatly appreciate the leadership of Congresswoman Gluesenkamp Perez and Congressman Finstad on introducing this momentous legislation to assist with the hiring and retention of paramedics and EMTs,” stated AAA President Randy Strozyk. “We look forward to working with them on passage of the bill.”

H.R. 6433 would establish a pilot grant program under the Assistant Secretary for Preparedness and Response (ASPR) at the Department of Health and Human Services (HHS) for the recruitment and training of paramedics and EMTs. The grant program would be authorized from 2024 through 2028 with $50 million a year in funding.

The legislation would also provide states with funding to help facilitate and expedite the transition of medics coming out of military service with the requirements of becoming a civilian paramedic or EMT. The program would be authorized from 2024 through 2028 with $20 million a year in grant funding for states.

Lastly, H.R. 6433 would direct the Secretary of Labor to conduct a study on the EMS workforce shortage and issue a report to Congress. The report would include an analysis on potentially adding paramedics and EMTs to the list of health care occupations which benefit from an easier hiring process of professionals outside the U.S.

The American Ambulance Association, National Rural Health Association and Washington Ambulance Association have endorsed H.R. 6433. In the coming days, the AAA will be launching a Call to Action to encourage and assist our members in contacting their U.S. Representatives in support of cosponsoring H.R. 6433.

Thank you to all of the AAA members and volunteer leaders who worked tirelessly to push for the introduction of this important EMS legislation!

Notice on Ground Ambulance and Patient Billing Advisory Committee

Written by Tristan North on . Posted in Executive, Government Affairs, News, Regulatory.

The Centers for Medicare and Medicaid Services (CMS) has filed for publication in the Federal Register the Solicitation of Nominations Notice for the Ground Ambulance and Patient Billing (GAPB) Advisory Committee. The Notice is scheduled to be included in the Federal Register for tomorrow, Tuesday, November 23.

The Congress created the GAPB Advisory Committee as part of The No Surprises Act enacted last year and currently being implemented by the Departments of Health and Human Services, Labor and the Treasury. The American Ambulance Association, International Association of Fire Chiefs, International Association of Fire Fighters, National Association of Emergency Medical Technicians, and the National Volunteer Fire Council successfully advocated that the Congress take into consideration the unique characteristics of ground ambulance services when determining balance billing policy for our services. The Congress excluded ground ambulance services from the provisions of The No Surprises Act and created the GAPB Advisory Committee to address balance billing.

The AAA has identified candidates, including AAA President Baird, who we will be supporting for inclusion on the Advisory Committee who we believe are well-positioned to represent the AAA membership. Once formed, the Advisory Committee has 180 days in which to report its recommendations to the Congress. The directive of the Committee is to review options to “improve the disclosure of charges and fees for ground ambulance services, better inform consumers of insurance options for such services, and protect consumers from balance billing.” We will be keeping the AAA membership continually informed of the actions and deliberations of the GAPB Advisory Committee.

Should you have any questions regarding the GAPB Advisory Committee, please contact AAA Senior Vice President of Government Affairs Tristan North. He can be reached at tnorth@ambulance.org.

Medicare 2% Cut Freeze Extended

Written by Tristan North on . Posted in Legislative.

Yesterday, Presiden Biden signed into law legislation (H.R. 1868) to extend the current temporary freeze on the 2% Medicare sequestration cut. H.R. 1868 extends the deadline of the freeze from today until December 31. Contractors had been holding Medicare claims to avoid any issues but will again start processing claims. The AAA as well as other national EMS and fire organizations had pushed for the extension of the freeze.

Senate Passes Sequestration Suspension Extension Bill

Written by Tristan North on . Posted in Government Affairs.

Last week, the Senate by a vote of 90 to 2 passed legislation (H.R. 1868) to further extend the suspension of the 2% Medicare sequestration cut. H.R. 1868 would extend the suspension from March 31 to December 31. The Senate amended the bill so it goes back to the House which will likely consider the legislation the week of April 12 when it returns from the Easter holiday break. The House is expected to easily pass the bill. CMS will hold claims until the House passes the bill to avoid any retroactivity issues.

The House had previously passed a version of H.R. 1868 which would not only extend the sequestration suspension until December 31 but also prevent a potential 4% sequestration cut later this year. The additional cut is the result of a provision in the Budget Control Act which was triggered with passage of the American Rescue Plan. Senate Republicans objected to addressing the additional cut as part of the legislation and a compromise was reached to just extend the 2% cut suspension for the time being.

The AAA as well as the IAFC, IAFF, NVFC, CFSI and NAEMT had written to congressional leaders in support of passage of the House-passed version of H.R. 1868.

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