Preliminary Calculation of 2020 Ambulance Inflation Update

Section 1834(l)(3)(B) of the Social Security Act mandates that the Medicare Ambulance Fee Schedule be updated each year to reflect inflation.  This update is referred to as the “Ambulance Inflation Factor” or “AIF”.

The AIF is calculated by measuring the increase in the consumer price index for all urban consumers (CPI-U) for the 12-month period ending with June of the previous year.  Starting in calendar year 2011, the change in the CPI-U is now reduced by a so-called “productivity adjustment”, which is equal to the 10-year moving average of changes in the economy-wide private nonfarm business multi-factor productivity index (MFP).  The MFP reduction may result in a negative AIF for any calendar year.  The resulting AIF is then added to the conversion factor used to calculate Medicare payments under the Ambulance Fee Schedule.

For the 12-month period ending in June 2020, the federal Bureau of Labor Statistics (BLS) has calculated that the CPI-U has increased by 0.646%.

Cautionary Note Regarding CPI-U.  Members should be advised that the BLS’ calculations of the CPI-U are preliminary, and may be subject to later adjustment.  Therefore, it is possible that these numbers may change.

CMS has yet to release its estimate for the MFP for calendar year 2021.  Since its inception, this number has fluctuated between 0.3% and 1.2%.  For calendar year 2020, the MFP was 0.7%.  Under normal circumstances, it would be reasonable to expect the 2021 MFP to be within a percentage point or two of the 2020 MFP.  However, the economic impact of the COVID-19 pandemic makes predictions on the MFP difficult at this point.

Accordingly, the AAA is not in a position to confidently project the 2021 Ambulance Inflation Factor at this point in time.  However, the relative low increase in the CPI-U strongly suggests that the 2021 Ambulance Inflation Factor will be significantly lower than last year’s increase of 0.9%.

The AAA will notify members once CMS issues a transmittal setting forth the official 2021 Ambulance Inflation Factor.

 

 

NEMSIS | HIPAA and Bidirectional Data Exchange White Paper

Prepared by Page, Wolfberg, and Wirth

Overview

Emergency Medical Service (EMS) agencies nationwide still widely report that hospitals and other healthcare providers refuse to share patient information with them, citing concerns under the Health Insurance Portability and Accountability Act (HIPAA).1 Misconceptions about HIPAA have created an  artificial barrier to legitimate, approved bidirectional data exchange between EMS and other providers. As a result, many healthcare systems are missing a critical opportunity to improve patient outcomes and advance evidence-based practices in prehospital care.

Download White Paper

 

HHS Report Calls for Congressional Action to Combat Surprise Billing

From HHS.gov on July 29, 2020

HHS Secretary’s Report Calls for Congressional Action to Combat Surprise Billing and Promote Price Transparency

Today, the U.S. Department of Health and Human Services released the HHS Secretary’s Report on Addressing Surprise Billing. The report, called for in Section 7 of President Trump’s Executive Order 13877, Improving Price and Quality Transparency in American Healthcare to Put Patients First, outlines critical steps, including Congressional action, to implement the Administration’s principles on surprise billing. Sound surprise billing legislation will not only protect patients but will encourage a fairer, more transparent, patient-centered healthcare system that benefits all Americans.

“Americans have the right to know what a healthcare service is going to cost before they receive it,” said HHS Secretary Alex Azar. “President Trump and his administration have done their part to deliver historic transparency around the prices of many procedures. Now it’s time for Congress to do what we all agree is necessary: combat surprise billing with an approach that puts patients in control and benefits all Americans.”

Surprise medical billing is a widespread and costly problem in the United States, and the need to address it has been highlighted during the Public Health Emergency (PHE) presented by COVID-19. Research shows that 41 percent of insured adults nationwide were surprised by a medical bill in the past two years alone, and that two thirds of adults worry about their ability to afford an unexpected medical bill.  At a time when Americans are increasingly seeking medical care, practices such as surprise billing leave many patients vulnerable to the financial burdens presented by a nationwide pandemic.

HHS has taken regulatory and administrative action to increase price transparency permanently. On June 24, 2019, President Trump signed Executive Order 13877. Following direction from this Executive Order, HHS published two rules supporting the Administration’s mission to improve accessibility of healthcare price information to help patients make informed decisions about their use of healthcare services. The first, poised to go into effect January 1, 2021, requires hospitals operating in the United States to establish, update, and make public, at least annually, a list of their standard charges for the items and services that they provide. The second companion proposed rule would demand similar transparency from most group health plans and issuers of health insurance coverage within both the individual and group markets.

To supplement this progress, Congress must take additional action to build on the achievements of the Administration to eliminate the threat of surprise billing once and for all. This should be accomplished with the following principles in mind, as laid out by the Trump Administration on May 9th, 2019:

  • Patients receiving emergency care should not be forced to shoulder extra costs billed by a care provider but not covered by their insurer;
  • Patients receiving scheduled care should have information about whether providers are in or out of their network and what costs they may face;
  • Patients should not receive surprise bills from out-of-network providers they did not choose; and
  • Federal healthcare expenditures should not increase.

If done swiftly, a remarkable burden will be lifted from the shoulders of millions of Americans. By building on the foundation placed by Executive Order 13877, there is an opportunity to fill the remaining gaps and solve comprehensively a longstanding flaw, equivalent to price-gouging, within our healthcare industry.

hippa

HHS | Post-Payment Notice of Reporting Requirements

From HHS on July 20, 2020

General and Targeted Distribution Post-Payment Notice of Reporting Requirements

July 20, 2020

Purpose

The purpose of this notice is to inform Provider Relief Fund (PRF) recipients that received one or more payments exceeding $10,000 in the aggregate from the PRF of the timing of future reporting requirements. Detailed instructions regarding these reports will be released by August 17, 2020.

Overview

Congress appropriated funding to reimburse eligible health care providers for health care related expenses or lost revenues attributable to coronavirus. The Health Resources and Services Administration (HRSA) is administering the distribution of payments under the PRF program, funded through appropriations in the Coronavirus Aid, Relief, and Economic Security (CARES) Act (P.L. 116-136) and the Paycheck Protection Program and Health Care Enhancement Act (P.L. 116-139). Each recipient of a payment from the PRF that used any part of that payment agreed to a set of Terms and Conditions (T&Cs) which, among other obligations, require each recipient to submit reports to the Department of Health and Human Services (HHS). The reports shall be in such form, with such content, as specified by the Secretary of HHS in future program instructions directed to all recipients. HHS will be releasing detailed reporting instructions by August 17, 2020.

These reporting instructions will provide directions on reporting obligations applicable to any provider that received a payment from the following CARES Act/PRF distributions:

General Distributions:
  • Initial Medicare Distribution
  • Additional Medicare Distribution
  •  Medicaid, Dental & CHIP Distribution
Targeted Distributions:
  • High Impact Area Distribution
  •  Rural Distribution
  •  Skilled Nursing Facilities Distribution
  •  Indian Health Service Distribution
  •  Safety Net Hospital Distribution

The reports will allow providers to demonstrate compliance with the T&Cs, including use of funds for allowable purposes, for each PRF payment. HRSA plans to provide recipients with Question and Answer (Q&A) Sessions via Webinar in advance of the submission deadline. Additional details will follow regarding the Q&A Sessions.

Notice on Timing of Reports

The reporting system will become available to recipients for reporting on October 1, 2020.

  • All recipients must report within 45 days of the end of calendar year 2020 on their expenditures through the period ending December 31, 2020.
  •  Recipients who have expended funds in full prior to December 31, 2020 may submit a single final report at any time during the window that begins October 1, 2020, but no later than February 15, 2021.
  •  Recipients with funds unexpended after December 31, 2020, must submit a second and final report no later than July 31, 2021.
  •  Detailed PRF reporting instructions and a data collection template with the necessary data elements will be available through the HRSA website by August 17, 2020.

 

New Benefit | Credit Card Fee Class Action Settlement

Dear AAA Members:

As you may know, there is a class action lawsuit pending in the U.S. alleging Visa, MasterCard and their member banks engaged in anticompetitive practices. The case, Payment Card Interchange Fee Settlement, alleges activity that includes collusion which artificially inflated the interchange fee that all AAA members paid to accept Visa and MasterCard branded credit cards. The proposed settlement provides that any merchant that accepted Visa and MasterCard credit cards at any time between January 1, 2004 and January 25, 2019 will be entitled to participate in the $5.54 billion-dollar settlement

Sign Up Now

Class Action Refund has over 17 years of experience in managing complex claims and is an innovator of a niche service that specializes in the recovery of antitrust settlements for businesses, which includes large organizations like the AAA. Class Action Refund can ease the burden of self-filing. The life cycle of a claim can take several years to settle and may require various types of documentation and correspondence with the claims administrator in order to substantiate the claim. Class Action Refund will manage the entire filing process and inform you of milestones as necessary, so that you may stay focused on your core business. Additionally, there are NO OUT-OF-POCKET COSTS TO AAA MEMBERS. Class Action Refund will reduce its normal 33% contingency fee of funds recovered to 25% for AAA members.  If no recovery is made, then no fee is charged.

Any member interested in availing themselves of Class Action Refund’s recovery management services, for the Payment Card Interchange Fee Settlement can quickly and easily sign up below!

Sign Up Now

Mr. Hugh Bellingreri, Senior Account Manager, is the contact person for members. Please call Hugh directly at 914-630-5116, or you can reach him by email at hbellingreri@classactionrefund.com with any questions. 

Sign Up Now

Disclaimer: No claim forms are available at this time, and no claim-filing deadline exists. No-cost assistance will be available from the Class Administrator and Class Counsel during any claims-filing period. No one is required to sign up with any third-party service in order to participate in any settlement. For additional information regarding the status of the litigation, interested persons may visit www.paymentcardsettlement.com, the Court-approved website for this case.

CMS Announces Resumption of Program Integrity Functions

On July 7, 2020, CMS updated its Coronavirus Disease 2019 (COVID-19) Provider Burden Relief Frequently Asked Questions (FAQs).  As part of this update, CMS indicated that it would resume several program integrity functions, starting on August 3, 2020.  This includes pre-payment and post-payment medical reviews by its Medicare Administrative Contractors (MACs), the Supplemental Medical Review Contractor (SMRC), and the Recovery Audit Contractors (RACs).  This also includes the resumption of the Prior Authorization Model for scheduled, repetitive non-emergency ambulance transports.  These programs had been suspended by CMS in March in response to the COVID-19 pandemic.

Resumption of Medicare Fee-For-Service Medical Reviews

 CMS suspended most Medicare FFS medical reviews on March 30, 2020.  This included pre-payment medical reviews conducted by its MACs under the Targeted Probe and Educate program, as well as post-payment reviews by its MACs, the SMRC, and the RACs.  CMS indicated that, given the importance of medical review activities to CMS’ program integrity efforts, it expects to discontinue its “enforcement discretion” beginning on August 3, 2020.

CMS indicated that providers selected for review should discuss any COVID-related hardships that might affect the provider’s ability to respond to the audit in a timely fashion with their contractor.

CMS further indicated that its contractors will be required to consider any waivers and flexibilities in place at the time of the dates of service of claims selected for future review.

Resumption of Prior Authorization Model

 Under the Repetitive, Scheduled, Non-Emergent Ambulance Transport Prior Authorization Model, ground ambulance providers in affected states are required to seek and obtain prior authorization for the transportation of repetitive patients beyond the third round-trip in a 30-day period.  The Prior Authorization Model is currently in place in Delaware, Maryland, New Jersey, North Carolina, Pennsylvania, South Carolina, Virginia, West Virginia, and the District of Columbia.

On March 29, 2020, CMS suspended certain claims processing requirements under the Prior Authorization Model.  During this “pause,” claims for repetitive, scheduled, non-emergency transports were not be stopped for pre-payment review to the extent prior authorization had not been requested prior to the fourth round trip in a 30-day period.  However, CMS continued to permit ambulance providers to submit prior authorization requests to their MACs.

CMS indicated that full model operations and pre-payment review would resume for repetitive, scheduled non-emergent ambulance transportation submitted in the model states on or after August 3, 2020.  CMS stated that the MACs will be required to conduct postpayment review on claims that were subject to the model, and which were submitted and paid during the pause.  CMS further indicated that it would work with the affected providers to develop a schedule for postpayment reviews that does not significantly increase the burden on providers.

CMS stated that claims that received a provision affirmation prior authorization review decision, and which were submitted with an affirmed Unique Tracking Number (UTN) will continue to be excluded from most future medical review.

IRS Guidance on Taxation of HHS Provider Relief Funds

On July 7, 2020, the Internal Revenue Service published a series of Frequently Asked Questions that address the taxation of payments to health care providers under the HHS Provider Relief Fund.

As part of the Coronavirus Aid, Relief and Economic Security Act (CARES Act), Congress appropriated $100 billion to reimburse eligible health care providers for health care-related expenses and/or lost revenue attributable to the COVID-19 pandemic.  The Paycheck Protection Program and Health Care Enhancement Act appropriated an additional $75 billion to the Provider Relief Fund.

The first FAQ addressed the issue of taxation for for-profit health care providers.  Specifically, the IRS was asked whether a for-profit health care provider is required to include HHS Provider Relief Fund payments in its calculation of “gross income” under Section 61 of the Internal Revenue Code (Code), or whether such payments were excluded from gross income as “qualified disaster relief payments” under Section 139 of the Code.

The IRS indicated that payment from the Provider Relief Fund do not qualify as qualified disaster relief payments under Section 139 of the Code.  As a result, these payments are includible in the gross income of the entity.  The IRS further indicated that this holds true even for businesses organized as sole proprietorships.

The second FAQ addressed the issue of taxation for tax-exempt organizations.  The IRS indicated that health care providers that are exempt from federal income taxation under Section 501(a) would normally not be subject to tax on payments from the Provider Relief Fund.  Notwithstanding this general rule, the IRS indicated that the payment may be subject to tax under Section 511 of the Code to the extent the payment is used to reimburse the provider for expenses or lost revenue attributable to an unrelated trade or business as defined in Section 513 of the Code.

The IRS FAQ can be viewed in its entirety by clicking here.  Members are advised to discuss the issue of potential taxation of any relief funding they received with their tax professionals.

Colorado Natural Hazards Center Grants

The Colorado Natural Hazards Center is offering three grants of $4000 for original research.

  • 1) Communications, the Pandemic, and Local Transportation Resources: What strategies are being implemented, and how effective are they? What are best practices in communicating and messaging by transportation organizations?
  • 2) Transportation, Vulnerable Populations, and COVID-19: What are best practices in providing useful and safe transportation for various socially and economically vulnerable population groups that are traditionally heavily reliant on public transit such as low-income people and racial and ethnic minorities? What about newly vulnerable populations, such as seniors, transportation workers, bus drivers, and so forth? How can the needs of all be met while assuring health and safety among particularly medically fragile or economically marginalized people?
  • 3) Transportation and Emergency Management Policy: How should transportation leaders and emergency managers work together to deliver community services? Including but also beyond ESF-1, what are innovative ways and best practices within and among communities and transportation services to accomplish community objectives during the pandemic? For example: transit agencies have launched food delivery services for vulnerable populations using their idled vehicles and drivers; state DOT facilities have been used a COVID-19 testing sites; Wi-Fi equipped vehicles have been used as local community hot spots.

Learn more ►

For-profit providers have to pay taxes on COVID-19 relief grants

From Modern Healthcare on July 13, 2020

The IRS clarified that for-profit healthcare providers will have to pay taxes on the grants they received from the COVID-19 Provider Relief Fund.

The two laws that set aside $175 billion in grants to help providers cover lost revenue and coronavirus-related expenses didn’t explicitly state that the funds would be taxable. However, the IRS issued guidance stating that the grants are taxable income days before a tax filing deadline on July 15. The change means that grants to for-profit healthcare providers including hospitals and independent physician practices will be subject to the 21% corporate tax rate.

Continue reading►

Covid-19 Is Bankrupting American Companies at a Relentless Pace

From Bloomberg on July 9, 2020.

Retailers, airlines, restaurants. But also sports leagues, a cannabis company and an archdiocese plagued by sex-abuse allegations. These are some of the more than 110 companies that declared bankruptcy in the U.S. this year and blamed Covid-19 in part for their demise.

Many were in deep financial trouble even before governors ordered non-essential businesses shut to help contain the spread of the virus. Most will reorganize and emerge from court smaller and less-indebted. The hardest hit, however, are selling off assets and closing for good.

Continue Reading►

HHS HRSA Provider Relief Fund Webinars

CARES Act Provider Relief Fund

The Provider Relief Funds supports American families, workers, and the heroic healthcare providers in the battle against the COVID-19 outbreak. HHS is distributing $175 billion to hospitals and healthcare providers on the front lines of the coronavirus response.

HHS expects to distribute $15 billion to eligible Medicaid and CHIP providers through the Provider Relief Fund. Join our webcast to learn more about the application process. Please pre-register to reserve a spot on your preferred date:

Fed expands Main Street Lending Program

On June 8, the U.S. Federal Reserve expanded its Main Street Lending Program to allow more small businesses to receive financial support. The Main Street Lending Program (MSLP) was established by the Federal Reserve and the U.S. Treasury under the CARES Act to support small and medium-sized businesses that were in sound financial condition before the onset of the COVID-19 pandemic.

Among the changes, the Fed lowered the minimum loan amount and raised the maximum loan limit. It also extended loan terms to five years from four years and will allow businesses to defer principal payments for the first two years of the loan, instead of the first year. The expanded MSLP will also accept loans that under the previously announced terms, if funded before June 10, 2020.

Unlike the popular Paycheck Protection Program for small businesses, the MSLP’s loans cannot be forgiven. However, the latest changes are designed to make the program attractive to a wider range of small businesses.

The MSLP is open to companies with up to 15,000 employees or less than $5 billion in revenue last year. Small businesses that have received PPP loans are permitted to borrow under the Main Street program.

The AAA leadership and staff will continue to tirelessly advocate for the much-needed relief to ensure that our members can keep their doors open, receive the equipment necessary to protect their staff, and the resources to provide excellence in mobile healthcare. We will keep you abreast of our advocacy efforts as well as changes to the MSLP as soon as the details become available.

Webinar 6/30 | Financial Sustainability Ideas for EMS

June 30, 2020 | 14:00 ET

Three ambulance leaders with diverse backgrounds share innovative tips for financial sustainability in this fast-paced one hour webinar. From insurance captives to employee engagement to data-driven decision-making, Jamie Pafford-Gresham, P. Sean Tyler, and Wayne Jurecki will lend their unique perspectives on ways to keep service rolling during these extraordinarily challenging times.

Watch On-Demand►

Jamie Pafford-Gresham
CEO, Pafford Medical Services
Director, AAA Board
Chair, AAA Government Affairs Committee
Hope, Arkansas

Wayne Jurecki
COO, Bell Ambulance Service
Director, AAA Board
Milwaukee, Wisconsin

P. Sean Tyler
CEO, Transformative Healthcare
President & CEO, Fallon Ambulance Service
Board Secretary, Massachusetts Ambulance Association
Quincy, Massachusetts

Watch On-Demand►

The Hill | Coronavirus crisis squeezes ambulance operators

From May 19, 2020’s The Hill article by Reid Wilson

…The coronavirus crisis is putting an unexpected financial squeeze on ambulance operators, ratcheting up costs and tanking revenue even as they audibly remind people of the virus’s proliferation throughout the county…

Read the full article featuring interviews with many AAA members, including Bell Ambulance, Empress EMS, Great Falls Emergency Services, and REMSA!

CMS Issues Additional Staffing and Licensing Waivers

On May 1, 2020, CMS updated its “COVID-19 Frequently Asked Questions (FAQs) on Medicare Fee-for-Service (FFS) Billing.”  The full document can be viewed by clicking here.

In the updated FAQ, CMS answers three important questions related to ambulance vehicle and staffing requirements:

  1. Expired Ambulance Operating Licenses. CMS was asked whether a ground ambulance vehicle operating under an expired license could nevertheless satisfy the Medicare regulations related to vehicle licensing.  CMS indicated that the ground ambulance would remain in compliance with Medicare Program rules to the extent it was permitted to operate without a renewed license under a valid state or local law, regulation, or legally adequate waiver.  It is important to note that this is not a “waiver” of CMS rules per se.  Rather, CMS correctly noted that additional flexibility being provided is based on the state waiving or relaxing its existing rules related to licensures.
  2. Modified Staffing Requirements. CMS was asked whether an ambulance service that staffs its vehicles with personnel that fall below the previously required levels of certification would be in compliance with Medicare Program rules.  The Medicare regulations at 42 C.F.R. §410.41(b) set forth the requirements for vehicle staffing.  These regulations largely defer to state and local laws.  However, they do require a certain minimum level of staffing.  Specifically, the Medicare regulations require that: (i) BLS vehicles be staffed with at least two people, at least one of whom must be certified as an EMT and (ii) ALS vehicles be staffed by at least two people, at least one of whom must be certified as a paramedic or an EMT that is permitted to perform one or more ALS services (e.g., an EMT-Intermediate).  CMS is indicating that it is waiving this minimum staffing requirement under its 1135 Waiver Authority for the duration of the Public Health Emergency.  Under this waiver, CMS will consider the vehicle staffing requirement to be met to the extent state or local law, regulation, or waiver permits an alternative staffing arrangement.  CMS specifically cited examples where the state or locality would permit BLS vehicles to be staffed with EMRs instead of EMT-Basics, or ALS vehicles staffed with RNs instead of paramedics.  Note: claims submitted in reliance upon this waiver should be submitted using the “CR” modifier after the origin/destination modifiers.
  3. Ambulance Services Rendered Across State Lines. CMS was asked whether an ambulance service that provides care across state lines, in a state where it is not certified to provider services or in which its personnel are not licensed, would be in compliance with Medicare Program rules.  CMS indicated that it is using its 1135 Waiver Authority to waive the requirement under 42 C.F.R. 410.41(b) that vehicle personnel be licensed in the state in which they are furnishing services to the extent that: (i) they have an equivalent licensing or certification in another state and (ii) they are not affirmatively excluded from practicing in that state or any other state.  Please note that this waiver only applies to the Medicare certification requirements.  CMS lacks the authority to waive the licensing requirements of the other state or locality.  Thus, for this waiver to apply, you must be permitted to operate in the other state pursuant to that state’s laws, regulations, and/or validly issued waiver.  Note: claims submitted in reliance upon this waiver should be submitted using the “CR” modifier after the origin/destination modifiers.

COVID-19 Uninsured Program Now Includes Air, Water

HHS Updates Guidance on Provider Relief Funding for Uninsured to include Air and Water Ambulance

The Department of Health and Human Services recently updated its guidance on the disbursement of provider relief funds under the CARES Act for the testing and treatment of the uninsured.  Previously, HHS indicated that this allocation was only available for the reimbursement of emergency and non-emergency ground ambulance transportation.  However, in its most recent update, HHS has removed the restriction that limited participation to ground ambulance providers and suppliers.  The new guidance indicates that the relief funds are now available for all emergency ambulance transportation and non-emergency patient transfers via ambulance.

Thus, it appears that air and water ambulance providers and suppliers are now eligible to receive funding for the treatment of COVID-19 patients. 

Is there anything my air or water ambulance organization needs to do to claim reimbursement for treatment of uninsured COVID patients?

Yes.  In order to be eligible for payments for the treatment of uninsured COVID patients, you must enroll as a participant in the program.  Enrollment must be done through an online portal that can be accessed at: http://www.coviduninsuredclaim.hrsa.gov.

Once my organization enrolls, when can we start submitting claims for reimbursement for treatment of uninsured COVID patients?

HHS has indicated that it will begin to accept claims for reimbursement for treatment of the uninsured on May 6, 2020.

FUNDING FOR TREATMENT OF UNINSURED COVID PATIENTS IS SUBJECTED TO AVAILABLE FUNDING, AND IS THEREFORE ON A FIRST-COME, FIRST-SERVED BASIS.  IT IS EXPECTED THAT THESE FUNDS WILL BE EXHAUSTED IN FAIRLY SHORT ORDER.

COVID-19 Financial Impact Calculator

The American Ambulance Association is working nonstop on advocating for financial relief from the impact of the Coronavirus (COVID-19) for our members. Now that ground ambulance service providers and suppliers are receiving federal funding to help partially offset the negative financial impact of the Coronavirus (COVID-19), the Congress is asking for information to substantiate that additional funding is necessary. Instead of providing just anecdotal information on the increased costs and lost revenue from COVID-19, we need to provide more wide-ranging data demonstrating the dire financial situation facing our industry.

To this end, the American Ambulance Association has developed a Financial Impact Calculator to gather information from our members to help us make our case for additional financial relief. The Calculator is also designed for members to use in completing the application for more funding under the General Allocation second distribution of the Public Health and Social Services Emergency Fund.

Download the  Excel Version of the Financial Impact Calculator as a reference. The Instructions include definitions for fields in both the Excel and online calculators.

WE STRONGLY RECOMMEND USE OF THE CONVENIENT ONLINE CALCULATOR as this enables AAA to  synthesize data from ambulances across the country for use in advocacy efforts on behalf of mobile healthcare. Your data will be safely stored, and will  be shared only in aggregate.

Please DO NOT enter commas or dollar signs  when providing data. The system will format automatically. 

General Allocation Calculator & PPP Loan Estimator

2020 COVID-19 Financial Impact Calculator

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  • Contact Name