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President’s Perspective: April 2018

Dear Fellow AAA Member,

Spring has sprung, and the American Ambulance Association is busier than ever working on your behalf to build the future of EMS.

The AAA is pleased to announce that since our last Response Times update, Congress has passed the 5-year extension of the Medicare ambulance add-ons. The extension included the AAA’s preferred method of cost data collection that provides flexibility to the Secretary of HHS in developing the system. Consultation with the industry is required so that it strikes the appropriate balance between obtaining meaningful data and avoiding overly burdening or onerously penalizing the ambulance services. This legislation was a true victory for the AAA and the entire industry. Learn more►

This success would not have been possible without months of effort by AAA volunteer leaders, advocacy experts, and staff, as well as support from our key champions in Congress. In particular, the AAA would like to thank Senator Debbie Stabenow for spearheading our legislation and ensuring that the Senate language prevailed. In recognition of Senator Stabenow’s support, she has been named the AAA’s 2018 Legislator of the Year. The AAA would also like to thank Senators Schumer, Roberts, Collins, Leahy, Hatch, Wyden, Thune, and many others who will be receiving AAA Legislative Recognition Awards this year. The successful passage of this legislation would not have occurred without also having strong champions in the House of Representatives. The AAA is sincerely thankful to Representative Devin Nunes (2015 Legislator of the Year Award winner) for his continued leadership in the House on this issue. The AAA also wishes to thank Representatives Sewell, Upton, Welch, Walden, Neal, Brady, Pallone, and Speaker Ryan for supporting this crucial extension of the Medicare add-on payments.
Despite this success, the AAA is not resting on its laurels. AAA Committees, staff, and consultants are taking proactive steps to ensure that the new cost data system both collects meaningful data and is not overly burdensome on providers. The AAA will continue to update members as this process moves forward. Thank you, again, for your support. We truly couldn’t have made it this far without you!

Get Involved!

In mid-May, AAA will open the nominations process for our board of directors. (Full details and criteria for participation will be posted then.) In the meantime, I encourage you to consider becoming more involved with the American Ambulance Association by joining a committee with open positions, and following us on Facebook and Twitter.

Stars of Life

I look forward to seeing many of you in Washington, DC in June at Stars of Life. Stars recognizes EMS providers from across the nation who have served their communities with distinction. The Stars, accompanied by their executive-level Hosts, meet with legislators to shine a light on the importance of ambulance services to our healthcare network.

I hope you will enjoy meeting the 2018 class of Stars as we share their stories and accomplishments on our website and social media.

Haven’t yet nominated a Star? It’s not too late! The deadline has been extended to this Friday, April 20. Nominate a Star►

Education

The Education Committee has been hard at work developing the program for the 2018 AAA Annual Conference & Trade Show. We look forward to announcing the full agenda in June, and hope that you will join us in exciting Las Vegas September 6–8. (Yes, I said September! Our conference is two months earlier than usual this year.)

Regional & Online Education

In the meantime, why not learn from our experts at an AAA Supervisor SimLab workshop? If you’re short on time, AAA is also proud to offer a wide variety of live and on-demand webinars on human resources, reimbursement, compliance, and other topics.

It continues to be my pleasure to serve so many talented, dedicated health care professionals. Thank you for your service to your communities, and I wish you continued success in 2018!

—POST
Mark Postma
President
American Ambulance Association
“Representing EMS in America”

Closed: 2018 Annual Conference Call for Presentations

AAA 2018 Annual Conference & Trade Show
September 6-8, 2018 at MGM Grand, Las Vegas, NV

We are asking those individuals interested in presenting at the American Ambulance Association’s Annual Conference & Trade Show to respond to our Call for Presentations. DEADLINE EXTENDED – Submissions are due March 1.

This premier event is one of the largest inclusive gatherings of ambulance and pre-hospital care leaders, and features distinct tracks for Operations, Reimbursement and Policy, and Executive Leadership. Our primary focus continues to be providing critical information that both new and established ambulance services may utilize to better serve their communities and operate their services more efficiently and profitably. To submit a proposal, please fill out our Call for Presentations form.

The following are general topics areas to be addressed, but other subject areas are welcome:

  • Recruitment, Retention, and Human Resources
  • Operations, Risk Management and Safety
  • Management and Supervision
  • Leadership Development & Structure
  • Improved Fleet Maintenance/Management
  • Clinical/Quality Assurance Programs
  • Reimbursement/Patient Accounts
  • Innovations, Technology, and Communications
  • Emerging Healthcare Trends/Hot Topics
  • Healthcare Reform/Public Health

Format of Sessions

Sessions will range from larger audience general sessions, to smaller breakout sessions within various topic tracks. We are accepting single speaker as well as panel discussions. Sessions may be either classroom style or set for small work groups. Audience involvement is encouraged.

Proposal Instructions

Please be advised that participation as a presenter is strictly on a voluntary basis. AAA is unable to pay speaker fees or travel and lodging expenses. Participation will be at your own expense for your own exposure.

To submit a presentation for consideration, please fill out our Call for Presentations online form.

Information to be included with your proposal submission:
Name, title, organization affiliation, address, city, state, zip code, business phone number with area code and e-mail address
Title of proposed session
Experience level of speaker/s for large national conference or audiences. Please include the event names & dates.
A detailed narrative description of the proposed session or workshop, including the following, as appropriate:
Experience level (basic, intermediate or advanced) of intended audience
50-75 word description of your presentation for marketing purposes
Description of what your audience will be able to take away from your presentation and of what they will be able to use immediately in their business or personal life
Recommendations, findings, or practice models for replication

The deadline for submissions is March 1, 2018. Applicants may have more than one submission for any type of session. Audience involvement is highly encouraged.

Submit a Proposal

President’s Perspective: January 2018

Dear Fellow AAA Members,

Happy New Year from the American Ambulance Association!

This year promises to bring new challenges and opportunities for ambulance services. As your association, AAA, its experts, and the whole member community will be there to support you every step of the way.

Advocacy Update

If you’ve missed your recent member advocacy emails, you may be wondering “What is going on with the add-ons?!” I’d like to address this first and foremost.

Despite the best efforts of the American Ambulance Association and other industry stakeholders, the temporary Medicare ambulance increases expired December 31. However, please rest assured that the AAA lobbying team, volunteer leadership, and staff are working tirelessly around-the-clock to advocate for this critical EMS revenue.

The good news is that the end may be in sight. However, we must remain engaged, active, and unified as an industry to carry this effort through in the face of the today’s contentious and unpredictable political climate.

Republicans and Democrats in the House and Senate are working toward a long-term extension of the Children’s Health Insurance Program (CHIP).  As part of these negotiations, the House and Senate are working through the details of a Medicare provider extender package. Thanks to the work of our lobbying team and countless Hill visits, phone calls and letters by dedicated AAA members and our supporters on Capitol Hill, both the House and Senate proposals include five-year extensions of the ambulance increases retroactive to January 1, 2018.

We are cautiously optimistic that Congress will include CHIP in the next Continuing Resolution (CR) on or around January 19. Depending on the outcomes of last-minute discussions, the Medicare provider extender package may be attached to the CHIP bill or moved forward separately shortly thereafter.  However, of course, Congress in 2018 is predictably unpredictable: we ask for your patience, and your continued confidence that AAA is doing everything possible on this issue.

To support this effort, AAA joined forces with other healthcare industry groups to send a letter to Congress urging them to pass the larger Medicare provider extender package. The AAA has also made the case to Congress that it must act now on the ambulance extension as ambulance service providers and suppliers are first responders and cannot afford to hold claims for prolonged periods of time. Congress must therefore move immediately to ensure that our nation’s health care safety net is not put at risk. We pointed out that submitting claims with the increases paid retroactively could result in long delays in providers and suppliers getting the additional funds, an unacceptable risk for an EMS network made up primarily of small providers. As a last resort, we have asked that if Congress cannot address a Medicare provider extender package by January 19 that they pass a short-term extension of the ambulance increases to sustain our operations.

The AAA is also working with congressional offices and committees of jurisdiction to implement a workable system for collecting cost data from ambulance service providers and suppliers and on an offset focused on reducing reimbursement just for those entities which abuse the dialysis transport benefit. The reality is that ambulance services will have to report their costs to the federal government. However, AAA will work to ensure that the system implemented is fair and does not place undue burden on ambulance services or subject ambulance services to standards and penalties that are not applied to other Medicare providers.

While we believe we may be approaching the endzone on the extender renewals, we must continue to push Congress to do what is right for EMS. Now, more than ever, we need you to add your voice to those of AAA, state-level ambulance associations, and thousands of your peers. Please take a moment today to send Congress your message of support for the Medicare ambulance add-onsit takes just two clicks. Write a letter now>

Our advocacy team will continue to provide frequent updates as we work to keep this issue at the forefront.

Stars of Life

Despite the challenges on the Hill, I look forward to seeing many of you in Washington, DC in June at Stars of Life. Stars recognizes EMS providers from across the nation who have served their communities with great distinction. The Stars, accompanied by their executive-level Hosts, meet with legislators to shine a light on the importance of ambulance services to our healthcare network. Nominate your Stars today, and help AAA celebrate the best in EMS! (Early bird registration rates end March 31.)

Renew Your Support of AAA

Has your organization renewed its AAA membership? Your continued support is critically important as AAA fights for fair ambulance reimbursement. Membership also include benefits such as free use of the Savvik Buying Group, complimentary CISM and EAP-based counseling for your employees, and access to industry experts on Medicare, operations, and HR.

If you have already renewed, please accept our most sincere thanks. If you have not yet submitted payment for this year’s membership, I encourage you to renew online or reach out to staff at info@ambulance.org for assistance.

AAA Annual Conference & Trade Show

The 2017 AAA Annual Conference was an overwhelming success. In addition to powerful industry-centric presentations on leadership, reimbursement, and operations, this year’s AAA Annual Conference & Trade Show featured three inspiring keynotes—Steven M.R. Covey, Mel Robbins, and Dr. Zubin “ZDoggMD” Damania. Additionally, we honored AMBY Award winners and those who responded to the tragic Route 91 shootings. Check out the photo album for AAA 2017 on our Facebook page.

I hope that you will join me and hundreds of our colleagues for networking, learning, and fun in Las Vegas at next year’s Annual event September 6–8Early bird registration is open now!

Webcasts & Regional Workshops

AAA is working hard to make it easier than ever to educate your team. Join us in 2018 for a variety of live and on-demand webcasts as well as convenient regional workshops. Upcoming webinar topics include sexual harassment, CMS low volume settlements, and cybersecurity. This year, we are also proud to host one-day workshops in each of AAA’s five regions (calendar soon to be announced).

Thank You, Members!

I would like to give special thanks to the members who dedicate their time and thought to AAA’s board, committees, and task forces. We literally could not do it without you.

It continues to be my pleasure to serve these individuals, as well as the many other talented, dedicated healthcare professionals who make up the AAA membership. We deeply appreciate your continued support, participation, and unity. Thank you!

—POST!
Mark Postma—President
American Ambulance Association
Representing EMS in America

 

Release: Midwest EMS Expo Announced!

State and National Ambulance Associations Unite to Bring Key Education to Midwestern EMS Providers

Midwest EMS Expo | May 2–3, 2018 | La Crosse Center

La Crosse, WI– The American Ambulance Association (AAA), Minnesota Ambulance Association (MAA), and Professional Ambulance Association of Wisconsin (PAAW) today officially announced the launch of the Midwest EMS Expo conference and trade show. This event will take place annually in La Crosse, Wisconsin beginning in May 2018, and will feature content from national- and state-level ambulance experts.

“AAA is proud to partner with PAAW and MAA in the development of the Midwest EMS Expo. We look forward to bringing together the best in ambulance expertise to deliver a powerful educational experience for EMS leaders,” said American Ambulance Association President Mark Postma.

The program will open on Wednesday, May 2, with key updates from the American Ambulance Association’s renowned experts on EMS reimbursement and advocacy. Highlights include a federal legislative overview by AAA President Mark Postma, as well as strategies for maximizing revenue from reimbursement gurus Asbel Montes, Brian Werfel, Brian Choate, and Scott Moore.

Thursday, May 3rd’s programming was developed collaboratively by the Minnesota Ambulance Association and Professional Ambulance Association of Wisconsin. The day will begin with speaker Captain Ray Dupuis of the Watertown Police Department. In this riveting keynote, he will share what happened in first minutes after the explosions at the marathon finish line, then explain police and EMS action plans that day. Don’t miss this opportunity to learn from a seasoned public servant who helped to lead his city in its darkest hour.

Additional conference topics include employee recruitment and retention, billing and compliance, executive leadership, community paramedicine, employment law, managing across generations, EMS resilience, and many more. For a complete conference agenda, visit www.midwestemsexpo.com/schedule.

According to PAAW President Dana Sechler, “The Midwest EMS Expo will offer a platform for the exchange of ideas and information among ambulance leaders of all levels. Given the constantly changing nature of EMS, it is critical to bring this educational and networking opportunity to our region.”

In addition to powerful educational content, the Midwest EMS Expo will offer attendees the opportunity to experience the best in products, services, and vehicles for EMS providers. Gold Sponsor Savvik Buying Group will be joined by Silver Sponsor Cindy Elbert Insurance Services, Bronze Sponsor eCore, and dozens more exhibitors on the show floor. For a complete list of current vendors, please visit www.midwestemsexpo.com/exhibitors.

Conference registration is now open, with member early-bird rates as low as $200 per attendee. Sponsorship, booths, and vehicle spaces are also available online at low introductory rates. To register for the Midwest EMS Expo or view the complete schedule of events, please visit www.midwestemsexpo.com.

# # #

About the American Ambulance Association

Founded in 1979, the AAA represents hundreds of ambulance services across the United States that participate in emergency and nonemergency care and medical transportation. The Association serves as a voice and clearinghouse for ambulance services, and views prehospital care not only as a public service, but also as an essential part of the total public health care system. www.ambulance.org

About the Minnesota Ambulance Association

The Minnesota Ambulance Association represents Minnesota’s EMS providers by working with and monitoring legislation that impacts EMS, recruitment & retention, financial issues, education & leadership. We work closely with our peers in the hospitals, fire service, police, emergency managers, sheriffs & other associations. www.mnems.org

About the Professional Ambulance Association of Wisconsin

The Professional Ambulance Association of Wisconsin (PAAW) was founded in 2005 to represent the interests of ambulance services in the state of Wisconsin. In addition, PAAW works to create and promote opportunities for collaboration and networking between ambulance service executives, directors, and managers. PAAW serves as an EMS stakeholder group to promote excellence and quality in the ambulance industry in Wisconsin. www.paaw.us

President’s Perspective: July 2017

Dear Fellow AAA Member,

I am proud to share with you that just yesterday legislation was introduced in the House on a long-term extension of Medicare ambulance add-ons. The House bill follows introduction of the Medicare Ambulance Access, Fraud Prevention and Reform Act (S. 967) in the Senate, giving us a bill in both houses of Congress.

The Ambulance Medicare Budget and Operations Act (H.R. 3236) would extend for five years the 2% urban, 3% rural, and super rural bonus increases. The bill would also direct CMS to collect cost data from ambulance service suppliers. The AAA has been working with Congressman Nunes (R-CA) and Upton (R-MI) as well as the House Ways and Means and Energy and Commerce Committees on the bill language. You will soon receive a Call to Action to reach out to your Representatives to cosponsor the new House bill.

  1. 967 would make the add-on payments permanent and direct CMS to collect cost data from ambulance service suppliers using a survey methodology. Since its introduction, four additional Senators have signed on to co-sponsor S. 967, Senators Sanders (VT), Cochran (MS), Tester (MT) and Gillibrand (NY), bringing the total number of cosponsors to nine. While this is good progress, we need our member’s continued assistance in getting more co-sponsors on both of our bills.

While both bills meet the needs of our industry, the language in the two bills is different. That being said, it is not uncommon for the Senate bill and the House bill to have minor differences in their respective language that have to be worked out before getting final approval. When this happens, a special conference committee made up of members from both houses will work together to come to consensus about the different provisions in the bill. It is unlikely that our bills will be passed as stand-alone legislation. Instead, our provisions will likely be included in a larger bill similar to how the extenders were passed last time as a part of the CHIP (Children’s Health Insurance Program) Reauthorization Act. It is crucial that we have as many co-sponsors on both of our bills so that we can again be included on a larger piece of legislation.

The Medicare ambulance add-on payments will expire on December 31, 2017. To ensure continued access these critically-necessary extenders, we need the collective advocacy of ambulance services across the country. We ask that you please add your voice to the AAA’s by writing your Senators in support of Bill S.967. Additionally, you will soon receive a Call to Action to reach out to your Representatives to cosponsor the new House bill.

As always, the AAA Board, Government Affairs Committee, advocacy consultants, and staff are working diligently to build support on Capitol Hill to ensure that this vital revenue remains in place. If you missed our June 29 government affairs update webinar, I invite you to watch it on-demand now.

Annual Conference

The Education Committee recently finalized programming for the 2017 AAA Annual Conference & Trade Show. This year, we welcome three exciting keynotes—Steven M.R. Covey, Mel Robbins, and Dr. Zubin “ZDoggMD” Damania—as well as dozens of industry leaders and experts. I hope that you will join me and hundreds of our colleagues in ambulance leadership in Las Vegas in November! Online registration is open now.

Educational Events

AAA will host its inaugural SimLab workshop in Tulsa, Oklahoma on September 28. We are excited to share with members this immersive learning experience. AAA SimLab content will also be featured at the Mississippians for EMS Conference October 2–4 in Biloxi, Mississippi.

Save the date for AAA’s newest educational partnership, the Midwest EMS Expo May 2–3, 2018 in La Crosse, Wisconsin. Co-hosted with the Minnesota Ambulance Association and the Professional Ambulance Association of Wisconsin, the Midwest EMS Expo will bring together the best in national and regional education.

AAA is also proud to offer learning on-the-go, in the form of engaging webinars on human resources, reimbursement, compliance, and other topics. Don’t miss upcoming sessions on drug use, the OIG Safe Harbor on Cost Sharing, and the management of airborne medical emergencies.

Website

I am happy to share with you that AAA has a new URL, www.ambulance.org. This updated domain should assist us in clearly communicating our identity to the world, as well as in attracting new members not previously familiar with our organization.

Capital Campaign

To date, we have raised more than $255,000 of our $1mm Capital Campaign goal through the generous contributions of our fellow members. Our deepest thanks to all who have given. If you have not done so already, please consider donating today. Funds contributed to this campaign are managed separately from operating accounts, and can only be accessed after a full Board vote.

Stars of Life

It was a privilege to see many of you at Stars of Life in Washington in June. This year’s Stars program recognized 108 EMS providers from across the nation who have served their communities with distinction. The Stars, accompanied by their executive-level Hosts, met with their Senators and US Representatives to shine a light on the importance of ambulance services to our healthcare infrastructure. Nominations for the 2018 class of Stars will open in January. We hope to meet your Stars in D.C. next year.

As always, please don’t hesitate to contact the AAA at 703-610-9018 or info@ambulance.org if we can be of assistance to your service.

Thank you for your service to your communities, and have a great summer.

Mark Postma
President
American Ambulance Association
“Representing EMS in America”
www.ambulance.org

Discovering the Meaning of EMS Week

Being in EMS since 1990 I can certainly tell you I have seen numerous EMS Week celebrations come and go. Did you know EMS week owes its founding to the American College of Emergency Physicians? In 1974, ACEP asked former President Gerald R. Ford to declare November 3-10 as National Emergency Medical Services Week. Since then, ACEP has moved the annual observance numerous times, finally landing on the third week in May. This move provided a distinction between EMS and Fire Prevention week.

EMS has always been a part of my life, from the EMT-M class I took in January 1990 to becoming an RN in 2008.  I have done almost everything in EMS a person could do, volunteer EMT, Paramedic, Critical Care Education, ED RN and now vice president of EMS Education at OnCourse Learning.

Let’s discuss ideally what EMS providers actually want most for EMS Week. This year, let’s dismiss all of the usual tchotchkes, mugs, t-shirts, hot dogs, pens and flash lights. I can honestly say after 25+ years, I’ve gotten it all and am a bit tired of it. The ED sponsored pizza, while a very kind gesture, always seems to go uneaten for a variety of reasons.

Let’s face it, we know we are under paid and over worked. Although I am always grateful for the sentiment people have for us as a profession during EMS week I’d prefer recognition more frequently, even every day. Don’t get me wrong, I’m not being ungrateful, the hot dogs and pens are appreciated. But let’s focus on what matters most for pre-hospital professionals – better pay, working conditions, and meaningful education.

Which brings me to the area I can influence most. Not the everyday education, you know card certs PHTLS, ITLS, APLS, PEPP, and EVDT etc. I want something more. I want continuing education that excites me. That embraces my desire to improve EMS and helps us all to change and improve the care we deliver to our patients. To change the protocols that guide us in the care we provide. Basically, what I am asking for is a seat at the table, minus the pens and hots dogs. Let’s start with a better educational foundation, a voice in the care we provide and deliver better care to those who rely on us to care for their loved ones.

About the Author
Scott F. McConnell is Vice President of EMS Education for OnCourse Learning and one of the Founders of Distance CME.  Since its inception in 2010, more than 10,000 learners worldwide have relied on Distance CME to recertify their credentials. Scott is a true believer in sharing not only his perspectives and experiences but also those of other providers in educational settings.

Free Post-Election Analysis Webinar for Members

Post-Election Analysis Webinar – Thursday, November 17th, 2:00pm EST

post-election-analysis

The recent elections resulted with Republicans taking control of the White House and retaining a majority in the House and Senate. In the first 100 days of the Trump Administration, we will see a major shift from the policy positions of the current administration. It is likely that there will be immediate efforts toward the repeal, amendment, and replacement of the Affordable Care Act as well as tax reform and infrastructure improvement. Join us for this free webinar, and hear former Members of Congress Bill Paxon (R-NY) and Vic Fazio (D-CA), whom both served in their respective party leadership, give their analysis of the elections and of where the new Administration and Congress go from here.

Register Now

Unable to Attend?

No problem! All webinars will be recorded and available to stream On-Demand. Register now and watch on your own time!

Questions?

Please contact Colleen Crowley at ccrowley@ambulance.org.

That Special Time of Year (President’s Perspective)

That time of the year is rapidly approaching… no, not the elections, Thanksgiving, or Christmas, but the American Ambulance Association Annual Meeting—November 7 through 9.

Last year, our Annual Conference was a huge success, with a buzz in and around the meeting. That buzz was the result of energy that our members took away from each and every part of the meeting, from our keynote speakers, exhibit hall vendors, interactive educational sessions, and our newly re-launched AMBY awards.

I want to extend an invitation to our entire membership to attend this fantastic event. The take away information from the educational sessions will assist you in operating your business back at home.

The Committee Meetings that occur at the AAA meeting are a valuable opportunity to hear about a wide array of issues in our industry, but even more importantly, offer the opportunity for you to provide your valued input on strategies for our association.

If those benefits are not enough, I feel the most important benefit is the networking that occurs. Before, during, and after the sessions, you will be able to share and learn from best practices from fellow industry leaders from Coast to Coast.

I hope you are excited as I am about our upcoming meeting this November. I urge you to attend, learn, share, and take back many pearls of wisdom for your business.

I hope to see you there, and please track me down to say “Hi”!

 


Mike Hall of Nature Coast EMS is the president of the American Ambulance Association.

2016 AAA Award Winners Announced

The AAA is proud to announce this year’s award winners. Awards will be presented at the AAA Annual Conference and Tradeshow Awards Reception on Tuesday, November 8, 2016. Please join us in congratulating the winners.

J. Walter Schaefer Award

Randy Strozyk, American Medical Response

The J. Walter Schaefer Award is given annually to an individual whose work in EMS has contributed positively to the advancement of the industry as a whole. Randy has achieved this through his tireless dedication and service to the industry and his role in elevating the association and its members to national prominence.

Robert L. Forbuss Lifetime Achievement Award

Julie Rose, Community Care Ambulance

The Robert L. Forbuss Lifetime Achievement Award is named in honor of the first Executive Director of the American Ambulance Association. It recognizes a volunteer leader who has made a significant long-term impact on the association. Julie has held numerous leadership positions in the AAA including Membership Committee Chair, Region III Director and Alternate Director. Julie has worked tirelessly to get members of her Region to join the AAA, knowing that it is important to participate in the national organization to be part of the team finding solutions to today’s challenges in EMS.

President’s Award

Jon Howell, Huntsville Emergency Medical Services, Inc. (HEMSI)
Asbel Montes, Acadian Ambulance Service
David Tetrault, St. Francois County Ambulance District

These awards are given by the President to volunteer leaders who have shown commitment to the advancement of the AAA above and beyond the call of duty. This year the three outstanding volunteers represent tireless work on behalf of the AAA.

Jon Howell has served as the chair of the AAA’s nominating committee for 4 years and in that time has worked to grown the involvement of our members to participate in the AAA nominating and election process.  Asbel Montes has worked tirelessly as Co-Chair of the Payment Reform Committee, and David Tetrault has served as a Region IV Board or Director as well as an active participant on the Membership and Education Committee.  AAA President Hall was quoted as saying, “this award is given by the sole discretion of the President of the AAA and I cannot think of three more deserving individuals than Jon, Asbel and David.  No matter what I have asked them to do for the AAA, they have taken on the task with determination, commitment and a level of servant leadership rarely seen anymore.”

Distinguished Service Award

Brian Choate, Solutions Group
Kathy Lester, MPH, JD, Lester Health Law & AAA Healthcare Consultant
Scott Moore, Esq., EMS Resource Advisors LLC & AAA Human Resources Consultant
Brian Werfel, Esq., Werfel & Werfel, PLLC & AAA Medicare Consultant

The American Ambulance Association (AAA) is proud to award Brian Choate, Kathy Lester, Scott Moore, and Brian Werfel with 2016 Distinguished Service Awards.

The Regional Workshop team worked countless hours to create the content for the four compliance, billing and reimbursement policy workshops that were presented throughout the country. The workshops were designed to help all types of services structure their billing departments more maximum efficiency and integrity.

It is for this dedication of the team members to the AAA that we are proud to recognize Brian Choate, Kathy Lester, Scott Moore, and Brian Werfel with the 2016 Distinguished Service Award.

Partner of the Year Award

National Association of Emergency Medical Technicians (NAEMT)

The Partner of the Year Award is given to an EMS partner whose collaboration with the AAA enhances educational programs, legislative priorities and/or member benefits. This pas year the NAEMT has partnered with the AAA on numerous projects including Medicare Relief, EMS Compass and most recently issues a joint statement regarding Payment Reform Policies for EMS.

Affiliate of the Year Award

AVESTA

The American Ambulance Association (AAA) is proud to award Avesta with the 2016 Affiliate of the Year Award. The award is given to the vendor whose supports the programs of the association. Avesta is dedicated to solely to the practice of Human Capital Management and the development of solutions that meet the unique human resource challenges of their EMS clients. This year’s Affiliate winner has shown unconditional support of the AAA Stars of Life Program. The Stars of Life event, held annually in Washington, D.C., publically recognized and celebrates the achievements and exceptional work of EMS professionals.

Summary of CMS Ambulance Open Door Forum of November 5, 2015

By David M. Werfel, Esq. | Updated November 6, 2015

On November 5, 2015, the Centers for Medicare and Medicaid Services (CMS) conducted its latest Ambulance Open Door Forum.  As usual, CMS started with announcements, which were as follows:

As required under the Medicare Access and CHIP Reauthorization Act (HR 2), the pilot program for prior authorization for non-emergency repetitive patients will be expanded to Delaware, the District of Columbia, Maryland, North Carolina, Virginia and West Virginia, effective January 1, 2016.  A Special Open Door Forum on the topic will be held by CMS on November 10, 2015 from 12:30 to 1:30 pm. (Link to PDF).

Payment Policies

On October 30, CMS released the final rule on changes in CY 2016 to the Medicare ambulance fee schedule.  The final rule will be published in the Federal Register on November 16, 2015.  The rule finalizes the following:

  • The 2% urban, 3% rural and 22.6% super rural adjustments have been extended through December 31, 2017.
  • Urban/Rural Designations – CMS will continue in 2016 and thereafter with the current geographic designations of urban and rural that were implemented on January 1, 2015. CMS also stated the Agency is further reviewing those zip codes which are a RUCA 2 or 3 and have a portion that include a rural census tract.  The Agency will issue possible changes in a proposed rule.  This review was requested by the AAA and should result in more urban zip codes being designated as rural.
  • Vehicle/Staff – For Medicare purposes, a BLS vehicle must include at least a driver and an EMT-Basic.  However, the vehicle/staff must also meet all state and local rules.

ICD-10 – CMS published an ambulance crosswalk from ICD-9 codes to ICD-10 codes.  Also, the condition codes list is only a guide and using one of the codes does not guarantee coverage.

Meeting at the AAA

  • Rogers spoke at the AAA Workshop on Prior Authorization held at the AAA headquarters on October 2.  He thanked the AAA for inviting him as a speaker.
  • Rogers mentioned one of the issues he discussed at the AAA headquarters was the transportation of psychiatric patients. Dr. Rogers indicated that his opinion is that when patients are in a “psychiatric hold”, that the psychiatric hold, by itself, does not constitute Medicare coverage for an ambulance.  He indicated that coverage would exist if there was IV, EKG, medications administered, etc., but that possible elopement was not enough for coverage.  Dr. Rogers’s statement was his individual opinion.  The AAA does not agree with that opinion and we will be following up with Dr. Rogers and CMS on the matter.
  • Rogers stated another issue discussed at the AAA headquarters was on the proper level of service being determined at the time of dispatch. He stated that it was his opinion that Medicare should reimburse for the level of service dispatched.

Healthcare Marketplace – individuals can apply for health coverage through the marketplace from November 1, 2015 to January 31, 2016 through healthcare.gov.

Medicare Open Enrollment – CMS announced the Open Enrollment period has begun for Medicare beneficiaries to select their plan.

The question and answer period followed the announcements.  As usual, several resulted in the caller being asked to e-mail their question to CMS.  Questions concerning the prior authorization program were asked but the callers were told the questions would be answered on the Special Open Door Forum for prior authorization that will be held on November 10.  Answers to questions asked were as follows:

  • Medicare does not cover an ambulance transport of a psych patient, as the patient can be transported safely by other means, such as by law enforcement.
  • When physicians and facilities do not provide records needed for prior authorization, the ambulance provider may have to choose discontinuing transportation of that patient.
  • The denial rate for ICD-10 codes is the same as it was for ICD-9 codes.
  • No solution was offered for situations where the SNF uses 911 to call for an ambulance that they know is not needed.
  • When Medicaid pays and takes back its payment more than a year after the date of service, due to the patient receiving retroactive Medicare eligibility, Medicare can be billed.

No date was given for the next Ambulance Open Door Forum, other than the November 10 date for the Special Open Door Forum on the expansion of prior authorization.

HHS OIG Report Discussion Added to Annual Conference

Late breaking AAA Conference update:

In order to address a Medicare reimbursement issue we feel is critical, AAA has decided to modify the Tuesday afternoon conference session being led by Brian S. Werfel, Esq.

Instead of covering medicare audits in this session, Mr. Werfel will now be leading an in depth discussion about a recent OIG Report on Questionable Billing Practices. The originally schedule session on preparing for medicare audits will be offered as a webinar. Further information about this new conference session is provided below.

Understanding the Recent OIG Report on Questionable Billing Practices

On September 29, 2015, the Department of Health and Human Services Office of the Inspector General released a report on “Inappropriate Payments and Question Billing for Part B Ambulance Transports”.  The report concluded that Medicare paid $24.2 million during the first half of 2012 for ambulance transports that did not meet Medicare program requirements.
In this special session, AAA Medicare Consultant Brian S. Werfel, Esq. will breakdown the OIG’s report, with special attention being paid to each of the 7 billing practices the OIG identified as “questionable”.  The session will include strategies that companies can implement to avoid these practices.  Brian will also discuss ongoing OIG enforcement activities related to the issues identified in this report.  The session will conclude with a Question & Answer period.

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Novitas Issues Guidance for Ambulance Providers, Facilities and Beneficiaries Regarding Expansion of Prior Authorization Project for Repetitive Patients

September 17, 2015

Novitas Solutions, Inc. (Novitas) recently issued a series of guidance documents on the expansion of the prior authorization demonstration project for repetitive scheduled non-emergency ambulance transports. This demonstration project is currently operating in the states of New Jersey, Pennsylvania, and South Carolina.

The Medicare Access and CHIP Reauthorization Act of 2015 (Pub. Law 114-10), enacted on April 16, 2015, requires that this program be expanded into the remaining states of MAC Regions L (Delaware, Maryland, and the District of Columbia) and M (North Carolina, Virginia, and West Virginia), effective January 1, 2016. The program will be further expanded to cover all remaining states starting on January 1, 2017.

Novitas is the Medicare Administrative Contractor for MAC Region L, and therefore will be responsible for implementing this program in Delaware, Maryland and the District of Columbia. These guidance documents are intended to educate ambulance services, health care professionals and facilities, and beneficiaries located in these states on the programs requirements.

Guidance Document for Ambulance Services

On August 17, 2015, Novitas issued a “Dear Ambulance Company” letter that provides guidance to ambulance companies on how the program will operate. As noted in the letter, participation is voluntary.

However, ambulance services that elect not to seek prior authorization for repetitive patients (defined as a patient that is transported by non-emergency ambulance for the same service either: (1) three or more times in a 10-day period or (2) once a week for three straight weeks) will find that claims for these patients will be subject to a prepayment review. For this reason, it is anticipated that most ambulance services will elect to seek prior authorization for their repetitive patient population.

The letter further summarizes the documentation requirements needed to request prior authorization for a patient. These include the submission of a prior authorization cover sheet (which can be found on Novitas’ website), a valid Physician Certification Statement (PCS) signed by the beneficiary’s attending physician within sixty (60) days of the requested first transport date, and all other medical records supporting medical necessity.

Novitas will review the submitted documentation and issue either a prior authorization covering all transports within a set date range, or a rejection. To the extent an application is rejected, the provider will be entitled to resubmit the application with additional documentation to support medical necessity.

Guidance Document for Health Care Professionals and Facilities

On August 24, 2015, Novitas issued a “Dear Healthcare Provider/Facility” letter that provides guidance to physicians, healthcare practitioners, and facilities on how the prior authorization project will operate. This letter includes bolded language that indicates that these individuals and facilities must provide certain records to the transporting ambulance service and/or the beneficiary. The letter specifically includes a statement that “[a]ttending physicians must provide a physician certification statement (PCS) and medical records that support medical necessity.” Members may want to download copies of this letter for distribution to physicians and facilities from which they may need to obtain PCS forms and other medical records.

Guidance Document for Beneficiaries

On August 20, 2015, Novitas issued a “Dear Medicare Beneficiary” letter that is intended to educate Medicare beneficiaries on the operation of the prior authorization project. The letter indicates that the pre-approval process is intended to allow the beneficiary to know whether his or her transports will be covered by Medicare prior to the provision of services. The letter indicates that either the beneficiary or the ambulance service can obtain a prior authorization, but notes that the ambulance provider will typically be the one submitting requests. Members may want to download copies of this letter for distribution to beneficiaries and their families.

AAA to hold Prior Authorization Workshop on October 2, 2015

The AAA will be holding a one-day workshop devoted exclusively to the prior authorization program. The workshop will take place on October 2, 2015 at the AAA Headquarters located in McLean, Virginia. This workshop will feature representatives from both Novitas and Palmetto (the MAC for Region M), who will be able to provide additional details on how the project will operate in their areas. Dr. William Rogers from the Centers for Medicare and Medicaid Services will also be in attendance to offer CMS’ perspective on this new program. This is a wonderful opportunity for CEOs and senior ambulance executives in the affected states to hear first-hand how this project will impact their ambulance services.

Spotlight: David Tetrault

David Tetrault
Farmington, MO, USA
Administrator/CEO, St. Francois County Ambulance District
Director, AAA Board, Region 4

Tell us a little about yourself, please.

I grew up in Jennings, Missouri, a small town in St. Louis County. I’m the baby of six kids—four brothers and a sister. I am very proud of my twin girls who just graduated from high school while simultaneously completing their associates degrees. They are now off to college to Rolla, Missouri, to finish their bachelors degrees. In addition to sharing time with my family and friends, I enjoy softball, camping, swimming, tennis, and walking.

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

David with some of his staff at a recent AAA workshop.
David with some of his team at a recent AAA workshop.

Years ago I was involved in part of the law enforcement arena called “Police Explorers”, primarily because my brother was a police officer. From there, I progressed through many different facets of law enforcement. The one thing that sticks out in my mind is that every time I was involved in an incident including a sick person or trauma, I really felt as if I would filling my calling. I could calm people and make them feel better, even when at that point I had only first responder training.

I have been involved with EMS for more than 30 years now, from my early days as a dispatcher, then up the ranks to Training Officer, then Manager, and now CEO/Administrator here in St. Francois County.

What do you enjoy most about your job?

I enjoy working with the public, people in our community, and my staff. They are my second family.

What is your biggest professional challenge?

Dealing with the younger spirited individuals coming into the world of EMS. Understanding the different challenges in funding, retention of our employee’s, the right mix of people and balancing the good/bad at the same time.

Making sure the Emergency Medical Services is not the forgotten one in the mix of Fire and Police. We all have a very important roles and the same amount of responsibility.

What is your typical day like?

My day typically starts with putting out fires and finishing my to do list from the previous day. Having 24/7 responsibility for a large program has its ups and downs—including sometimes getting called into work in the middle of the night. By sunrise, I have usually been up and on the highway for several hours. During typical office hours, I attend meetings and handle projects, budgeting, scheduling, and other tasks that need to be completed to keep our service operating. I also address any concerns or needs of the board of directors.

How has participation in AAA membership and advocacy helped your organization?

The American Ambulance Association has bridged the gap for me in my role as a service Administrator/CEO. AAA has many valuable resources, and provides me access to a vast network of ambulance services across the United States. My fellow AAA members as well as staff are always available to answer questions.

AAA has been the leader in ambulance services resources for many years, and they continue to strive to be the best in everything they offer. I enjoy the daily updates, and feel that the work AAA does with benchmarking and standands forms the backbone of the industry. The American Ambulance Association is truly a leader for EMS.

 

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