3/16 | CMS Ambulance Open Door Forum

The next CMS Ambulance Open Door Forum scheduled for:

Thursday, March 16, 2023
2:00pm-3:00pm PM Eastern Time (ET);

This call will be Conference Call Only.
To participate by phone:
Dial: 1-888-455-1397 & Reference Conference Passcode: 4325849

Conference Leaders: Jill Darling, Maria Durham

**This Agenda is Subject to Change**
I. Opening Remarks
Chair- Maria Durham, Director, Division of Data Analysis and Market Based Pricing
Moderator – Jill Darling (Office of Communications)

II. Announcements & Updates
• Medicare Ground Ambulance Data Collection System
(GADCS): Top 5 Tips for Selected Organizations in Year 1, 2, 3, and 4
Slide presentation will be available on CMS’ Ambulances
Services Center website: https://www.cms.gov/medicare/ambulance-fee-schedule-zipcode-files/ambulance-events
Please see the following information regarding COVID-19
PHE Updated Guidance for Ambulance Organizations:
Public Health Emergency (PHE) 1135 Waivers: Updated
Guidance for Providers

III. Open Q&A
**DATE IS SUBJECT TO CHANGE**
Next Ambulance Open Door Forum: TBA
ODF email: AMBULANCEODF@cms.hhs.gov

———————————————————————
This Open Door Forum is open to everyone, but if you are a member of the Press,
you may listen in but please refrain from asking questions during the Q & A portion of
the call. If you have inquiries, please contact CMS at Press@cms.hhs.gov. Thank
you.

Open Door Participation Instructions:
This call will be Conference Call Only.
To participate by phone:
Dial: 1-888-455-1397 & Reference Conference Passcode: 4325849

Persons participating by phone do not need to RSVP. TTY Communications Relay
Services are available for the Hearing Impaired. For TTY services dial 7-1-1 or 1-
800-855-2880. A Relay Communications Assistant will help.
Instant Replay: 1-800-814-6745; Conference Passcode: No Passcode needed
Instant Replay is an audio recording of this call that can be accessed by dialing 1-
800-814-6745 and entering the Conference Passcode beginning 1 hours after the call
has ended. The recording is available until March 18, 2023, 11:59PM ET.
For ODF schedule updates and E-Mailing List registration, visit our website at
http://www.cms.gov/OpenDoorForums/.
Were you unable to attend the recent Ambulance ODF call? We encourage you to
visit our CMS Podcasts and Transcript webpage where you can listen and view the
most recent Ambulance ODF call. The audio and transcript will be posted to:
https://www.cms.gov/Outreach-andEducation/Outreach/OpenDoorForums/PodcastAndTranscripts.html.
CMS provides free auxiliary aids and services including information in accessible
formats. Click here for more information. This will point partners to our CMS.gov
version of the “Accessibility & Nondiscrimination notice” page. Thank you.

March 15 | NAEMSP/AAA Town Hall

NAEMSP/AAA Town Hall:
The Future of Healthcare Policy After the COVID 19 Public Health Emergency: What does it mean for Emergency Medical Services?

March 15th  //  12-1pm ET

The COVID-19 pandemic has had a significant impact on the healthcare system and has highlighted the need for healthcare reform. As the world moves forward from the pandemic, it is likely that the future of healthcare will be shaped by the need for cost containment while continuing to shift the healthcare delivery system to a more value-based care model.

For the past three years, we have seen new innovative approaches to healthcare delivery including the rapid adoption of telemedicine, and it is expected that this trend will continue in the post-pandemic world. Reimbursement reform continues to be an important issue for Emergency Medical Services (EMS) systems, as it affects their ability to provide high-quality care to patients. Despite the disruption that we have seen for the last three years, the EMS industry has continued to push forward with new innovative approaches to service delivery including the expansion of community paramedicine programs and the implementation of alternative programs like the Emergency Triage, Treat, and Transport (ET3) model. During this session, the panelists will discuss the current healthcare landscape, including what innovative programs may be here to stay and what it means for EMS Systems.

Moderator

Jose G. Cabañas, MD, MPH, FAEMS
President, NAEMSP

Panelists

Jonathan Oberlander, PhD
Professor & Chair of Social Medicine and Professor of Health Policy & Management
University of North Carolina – Chapel Hill

Paul Hinchey, MD, MBA, FAEMS
COO for University Hospitals in Cleveland, Ohio

Larry McMillan, MHA
Chief Compliance Officer & ET3 Project Lead, Wake County EMS

Randy Strozyk, MBA
President, American Ambulance Association

Lekshmi Kumar, MD, MPH, FAEMS
Medical Director, Grady EMS

Melissa Kroll, MD
Washington University, St. Louis

NEMSM Board of Directors Announced

From the National EMS Museum

In October 2022, The National EMS Museum Board of Directors made a progressive and far-reaching decision to re-image the function and direction of the Museum and its Board of Directors. At that time, the Board decided to announce an initiative to reach out to more communities to recruit a diverse and interested group of leaders that could aggressively move the Museum forward through new strategic initiatives. After an extensive search and interview process conducted by an independent review panel, The National EMS Museum is pleased to announce the new members of The National EMS Museum Board of Directors with skills in EMS, museum management, fundraising and sponsorship development:

Larry J. Appel, M.B.A., EMT joins the NEMSM Board of Directors with 45 years of experience in EMS as an EMT.  His experiences include non-profit director, business owner, manager of several Maryland-based commercial ambulance services, paid 911 EMS provider, V.P. of Ambulance Sales for FR Conversions, and currently the EMS Business Development Manager for Bioquell (An Ecolab Solution).

Fred Claridge is retired and living in North Carolina after a 41-year career in EMS and emergency management. He served as a field provider, EMS instructor, and administrator, including directing one of the largest EMS systems in the country, as well as service as an emergency planner. Additionally, Fred has served as the inaugural editor of the EMS Historian: The Journal of The National EMS Museum.

Fred is serving at the National EMS Museum Vice President, 2023-2025

Elyssa Gonzales is a Master of Arts candidate at Johns Hopkins University for Museum Studies and Nonprofit Management with an additional focus on understanding museum operations and the continuing value to their communities. Her interests lay in supporting the building and/or restructuring museums from the ground up and to help museums find their unique way of supporting their communities.

J. Sam Hurley, MPH, EMPS, NRP currently serves as the Director of Maine’s Bureau of Emergency Medical Services. Sam began his career in EMS in North Carolina at a small rural volunteer fire department and subsequently continued his involvement with EMS throughout his undergraduate studies at the University of North Carolina at Chapel Hill and graduate school at Emory University, where he worked for Grady Health System in downtown Atlanta.

Cindy Kessler holds a Bachelors of Science in Design and has worked in various positions with museums, aquariums, and nonprofit organizations for the better part of three decades. Outside of her nonprofit work, Cindy is an avid singer, having performed at Carnegie Hall and The Kennedy Center. She is also a writer and artist, and enjoys directing youth theater performances in her spare time.

Cindy is serving at the National EMS Museum Secretary, 2023

Christopher Montera has more than 34 years of experience in Paramedic Services, Public Health, and the Fire Service. He is the Director of State and Federal Programs for ESO and the former Chief Executive Officer at Eagle County Health Service District and holds a Master’s in Health Leadership.

Chris is serving at the National EMS Museum Treasurer, 2023

Gary M. Schindele has been an EMT for 47 years and is a leading subject matter expert in the field of emergency preparedness design and implementation and serves as a member of the Central Florida Disaster Medical Coalition. Gary also volunteers as the Public Affairs Officer for the United States Naval Sea Cadet Corps youth program. Gary is also the President and Owner of Paladin Healthcare LLC which manufactures the original Fairfield Equipment Rail, once the standard for Equipment Management in most ambulances back in the late 70’s and 80’s.

Dave Zaiman has been in and around EMS for over 30 years. He spent 15 years working in the field as an EMT, EMD, and Paramedic. Dave finished his career at Hennepin County Medical Center in Minneapolis MN. Since then, Dave has held several leadership roles in the healthcare technology industry. Dave currently serves as Pulsara’s VP Sales – Midwest.

Dave is serving at the National EMS Museum President, 2023-2025

Alan DeYoung is the current Executive Director of the Wisconsin EMS Association with a passion for strategic development and business marketing.  Alan will serve as an Ex-Officio member of the Board of Directors as the Immediate Past President, 2023-2025.

The Board of Directors will continue to be supported by Kristy Van Hoven (Museum Director), Tom Scott (Accounting), and the incredible volunteers of this organization. We invite anyone interested in volunteering to reach out to the Board of Directors at board@emsmuseum. org or Kristy at director@emsmuseum. org.

The National EMS Museum is a volunteer-led organization that collects, preserves, and shares the history of emergency medical response in the United States to celebrate the contributions of providers across the country and inspire future professionals to take up the call. To learn more about The National EMS Museum, please visit emsmuseum.org.

NREMT | In Memoriam: Rocco V. Morando leaves a rich legacy for EMS

 

Rocco V. Morando, the Founder and first Executive Director of the National Registry of Emergency Medical Technicians passed away peacefully and surrounded by family on the morning of February 21, 2023 after a prolonged illness. He was 95.

“It is with a heavy heart and deep sadness that I inform you of the passing of our organization’s founder,” Bill Seifarth, the current executive director of the organization announced to his staff and board this afternoon. “Rocco Morando was a luminary in the EMS profession and was instrumental in helping shape the lifesaving system we know today. His legacy will continue to provide inspiration for years to come, and we are grateful for his contributions.”

On June 4, 1970, the National Registry of Emergency Medical Technicians was established following the recommendation of a task force assembled under President Lyndon B. Johnson’s Committee on Highway Traffic Safety. Morando was selected as the National Registry’s founding executive director in 1971 and held that position for nearly two decades.

During his career at the National Registry, Morando oversaw a number of accomplishments, including: the first basic NREMT-A examination administered simultaneously to 1,520 ambulance personnel at 51 test sites throughout the United States (1971);  the first recertification of Nationally Registered EMTs based on re-evaluation of skills (1973); the development of the first national paramedic curriculum in conjunction with leading EMS agencies and the University of Pittsburgh (1976-77);  and the first NREMT-Paramedic examination (1978); the development of the first NREMT-Intermediate curriculum  and examination (1980).

Upon his retirement on December 31, 1988, Morando was honored with a celebration attended by hundreds of friends and representatives from national EMS organizations. The National Registry’s headquarters in Columbus, Ohio was renamed the Rocco V. Morando Building that same year.

The Rocco V. Morando Lifetime Achievement Award, named in his honor, recognizes a lifetime of commitment, contributions and leadership to Emergency Medical Services (EMS). The award is presented by the National Association of EMTs and is sponsored by the National Registry.

Current and former employees, along with those throughout the EMS community, send their thoughts and condolences to Rocco’s family and friends.

Funeral arrangements are still being made at this time. More information will be available on the funeral home’s website.

CONFIDENTIALITY NOTE: This e-mail is intended only for the use of the individual or entity to which it is addressed and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If the reader of this e-mail message is not the intended recipient, or the employee or agent responsible for delivery of the message to the intended recipient, you are hereby notified that any dissemination, distribution or copying of this communication is prohibited. If you have received this e-mail in error, please notify us immediately by telephone at (614) 888-4484 and also indicate the sender’s name. Thank you, National Registry of EMTs.
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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