Congress Passes SIREN Act

On December 12, 2018, Congress passed the 2018 Farm Bill (S. 3042) by a 386-47 vote in the House and 87 – 13 vote in the Senate. Included in the final Bill was language similar to the SIREN Act (S. 2830, H.R. 5429) to reauthorize the Rural EMS Grant program. In an effort to ensure the funding would go to the most needy, small, and rural EMS providers, the language of the amendment and SIREN Act would change the eligibility to just governmental and non-profit EMS agencies. Therefore, small rural for-profit ambulance service providers would no longer be eligible to apply for grants – which haven’t been funded for over a decade. These grants would now provide funds up to $200,000 for training, equipment, and personnel retention in rural areas. The grants also require a 10% contribution by the grant recipient. The Health Resources and Services Administration (HRSA) will issue a guidance with the details on how these grants will be administered. Since the program has been unfunded for so long, it is unclear at this time, how it will be rolled out. HRSA will most likely follow past protocol providing details through guidance including how to submit and deadlines. (more…)

Federal District Court Judge Strikes Down the ACA

On December 14, 2018, a federal district court judge for the Northern District of Texas issued a ruling striking down the Affordable Care Act (ACA) on the grounds that the Individual Mandate was unconstitutional, and that the rest of the law cannot withstand constitutional scrutiny without the Individual Mandate. District Court Judge Reed O’Connor’s decision relates to a lawsuit filed earlier this year by 20 states and two individuals. The plaintiffs argued that the Tax Cuts and Jobs Act of 2017 — which amended the Individual Mandate to eliminate the penalty on individuals that failed to purchase qualifying insurance effect January 1, 2019 — rendered the Individual Mandate unconstitutional. The plaintiffs further argued that the Individual Mandate was inseverable from the rest of the ACA, and, therefore, that the entire ACA should be struck down. The defendants in this case were the United States of America, the U.S. Department of Health and Human Services (HHS), Alex Azar, in his capacity as the Secretary of HHS, and David J. Kautter, in his capacity as the Acting Commissioner of the Internal Revenue Service (IRS). 16 states and the District of Columbia intervened as additional defendants. In order to properly understand the district (more…)

Senate Introduces NEATSA Act Companion Bill (S. 3619)

Earlier this year, Congress included in the Bipartisan Budget Act of 2018 an offset to go along with the extension of the add-ons that will cut reimbursement for BLS nonemergency transports to and from dialysis centers by an additional 13%. This will be on top of the existing 10% reduction. Senators Bill Cassidy (R-LA) and Doug Jones (D-AL) just introduced S. 3619 which would restructure the offset so that a majority of the additional reduction would be focused on those ambulance service agencies in which 50% or more of their volume are repetitive BLS nonemergency transports to and from dialysis centers. S. 3619 will serve as a companion Bill to the House version, the NEATSA Act (H.R.6269) by Congressman LaHood (R-IL) and Congresswoman Sewell (D-AL) which was introduced in June 2018. The additional cut went into effect on October 1 and impacted AAA members and the AAA are working to get this legislation passed. The AAA will be sure to keep members updated as this legislation moves through Congress. Questions?: Contact Us If you have questions about the legislation or regulatory initiatives being undertaken by the AAA, please do not hesitate to contact a member of the AAA Government Affairs (more…)

Rural Health Day Advocacy Update

Happy National Rural Health Day! Thank you to all of the ambulance service providers who work hard providing life-saving treatment in rural areas every day. In part of our ongoing advocacy efforts, the AAA sent a letter today to the Rural Caucuses in the United States Senate and House of Representatives. Addressed to leadership of the caucuses, Sen. Pat Roberts (R-KS), Sen. Heidi Heitkamp (D-ND), Rep. Adrian Smith (R-NE), and Rep. Tim Walz (D-MN), this in-depth letter highlights the critical work that our members do every day around the country and raises important issues affecting the industry. Issues covered in the letter include: Stabilizing the Ambulance Fee Schedule Make the add-ons permanent and build them into the base rate Use new data from the ambulance cost collection program to ensure reimbursement is adequate going forward New data should be used to assess the problems with the current ZIP-code methodology for determining rural and super-rural services Ambulance Fee Schedule Reform Proposed alternative models for rural ambulance services Encouraging Congress to look at alternative destination options for ambulance service providers Recognizing Ambulance Services as Providers of Health Care Moving non-fire-based ambulance services from suppliers to providers under Medicare The letter also highlights...

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Wisconsin Office of Rural Health Interview

In honor of today’s National Rural Health Day, the American Ambulance Association interviewed John Eich, Director of the Wisconsin Office of Rural Health. The transcript below was lightly edited for clarity. Amanda Riordan: Thank you for joining us today. My name is Amanda Riordan, and I am the vice president of member services for the American Ambulance Association. I’m also the administrator for the Professional Ambulance Association of Wisconsin. I’m so happy to have the opportunity to interview John Eich, the director of the Wisconsin Office of Rural Health. John is an exceptional contributor to rural health in Wisconsin. He’s also a sterling advocate for the power of EMS to assist with public health in the least accessible areas of Wisconsin. I’ll ask John a couple of questions today about the recent Rural EMS Listening Sessions that he conducted in a number of areas across the state. John, thanks again for joining us. Would you mind telling me a little bit about your background and how you became the director of the Wisconsin Office of Rural Health? John Eich: I appreciate your inviting me to talk about some of our programs, so thank you. I took a bit of a wandering (more…)

 Mid-Term Election Analysis Webinar

Join AAA Government Affairs Committee Chair, Jamie Pafford-Gresham, AAA SVP of Government Affairs, Tristan North, AAA Senior Manager of Federal Affairs, Ruth Hazdovac, and Manager of State & Federal Government Affairs, Aidan Camas, as they provide a brief re-cap of the recent mid-term elections. This pre-recorded webinar provides an update on federal and state election results, and how they may impact our industry. We review possible leadership changes in the House & Senate as well as on key committees of jurisdiction over ambulance related legislation. The webinar also provides a brief look ahead into AAA legislative priorities for 2019. If you have any questions about material covered on the presentation, please email Aidan Camas at acamas@ambulance.org. ►Watch the video on Youtube here...

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Mid-term Election Analysis

As a result of Tuesdays’ elections, Democrats will control the U.S. House of Representatives next Congress and Republicans will have a larger majority in the United States Senate. Presently, Democrats have gained a net of 30 seats in the House with Republicans netting two seats in the Senate. Democrats needed to capture 23 seats from Republicans to gain the majority. There are still several races in the House and Senate to be called which will likely add to those totals. Akin Gump, the lobbying firm for the AAA, has put together a synopsis of the election results as of this morning and a slide deck on historical trends and the outcome of races called so far. Key supporters of the industry who will not be returning next Congress include Representatives Peter Roskam (R-IL), Mike Coffman (R-CO) and Erik Paulsen (R-MN). All three members have been supportive of ambulance initiatives with Roskam in his position as Chair of the House Ways and Means Health Subcommittee and Paulsen as a member of the Subcommittee. Coffman sponsored legislation to apply the prudent layperson definition to emergency ambulance services provided to veterans. In late breaking news, the Senate race in Montana was called in favor for (more…)

HIPAA Breach Results in Highest Settlement in OCR History

The U.S. Department of Health and Human Services (HHS) Office of Civil Rights (OCR) announced earlier this month that is has entered into the largest settlement agreement in the history of the Department with Anthem, Inc., the largest Blue Cross and Blue Shield health benefit companies in the country.  Anthem, Inc. agreed to pay $16 million to HHS and take substantial corrective action to settle numerous potential violations of both HIPAA Privacy and Security Rules after it exposed protected health information (PHI) for nearly 79 million people. In March 2015 Anthem filed a breach report with OCR after they discovered that their Information Technology (IT) systems were infiltrated by cyber-attackers who had gained access to their systems after an Anthem employee opened a phishing email.  This email released an undetected continuous persistent threat attack that permitted the cyber-attackers to access their systems from December 2014 through the end of January 2015.  This attack opened access that ultimately resulted in the PHI of nearly 79 million people to be stolen. OCR’s investigation revealed that Anthem failed to conduct an enterprise-wide risk analysis.  Additionally, OCR determined that Anthem “failed to have sufficient policies and procedures to regularly review IT system activity, identify...

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