House Passes PPP Extension

On July 1, The U.S. House of Representatives unanimously passed a bill to extend the deadline to apply for forgivable small business loans through the Paycheck Protection Program. The legislation was previously passed by the Senate and President Trump is expected to sign the bill into law. The bill extends the deadline to request Paycheck Protection Program loans to August 8 from June 30. The U.S. Small Business Administration (SBA), which oversees the program with the Treasury Department, stopped accepting loan applications at midnight Tuesday. The extension is intended to provide more time for small businesses to apply for the approximately $129 billion in PPP funding remaining. The program provides forgivable loans that small businesses and other qualifying entities can use to cover payroll and other select costs. The AAA will continue to press the Congress and federal agencies for help to ensure ambulance service organizations and our paramedics and EMTs serving on the front lines of the COVID-19 pandemic have the necessary resources and financial assistance to serve their communities....

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Government Affairs Update: What We’re Working On

With the U.S. Senate on track to consider a fourth economic stimulus package before their August recess, the AAA is working hard to promote legislative language that positively impact the EMS industry and ambulance services across the country. Here is a snapshot of those current efforts. Ambulance Funding in Response to COVID-19 As the Senate develops its next economic stimulus legislation to address the impact of COVID-19, the AAA has met with leaders and staff on Capitol Hill to increase the percentage of the general allocation of funds under the Public Health and Social Services Emergency Fund (PHSSEF) for ground ambulance services providers and suppliers to equal a total of $2.89 billion in funds for our industry. The $2.89 billion reflects $48,000 per ambulance with an estimated 60,000 registered vehicles. We greatly appreciate the recent payments under the Fund which will help with our current situation. However, the ground ambulance services industry is only 0.90% of Medicare fee-for-service annual outlays which resulted in $270 million for our industry in round one of PHSSEF payments. This figure is disproportional to the large role of ground ambulance service providers and suppliers in responding to COVID-19 and our increased costs and reduced revenues...

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Always In Our Hearts

Please join the American Ambulance Association in honoring those who have fallen serving their communities in the COVID-19 pandemic. What does it mean to be a hero? Paramedics, EMTs, nurses, and firefighters risk their lives every day to serve on the… Posted by American Ambulance Association on Tuesday, June 30, 2020 #EMS providers risk their lives every day to serve on the front lines of #COVID19. Tragically, this means that some don’t make it home to their families. It is our responsibility to honor their memories and support their loved ones. #SupportEMS #PSOB #NotJustaRide #alwaysopen pic.twitter.com/vv7XF7mCH6 — AmericanAmbulanceAsc (@amerambassoc) June 30, 2020

Senate Passes PPP Flexibility Act

On June 3, the U.S. Senate passed on voice vote the Paycheck Protection Program Flexibility Act of 2020. The legislation was passed by the House on May 28. The President is expected shortly to sign the bill into law. The Paycheck Protection Program Flexibility Act (H.R. 7010) provides small businesses with more flexibility in how the Paycheck Protection Program (PPP) funds established under the CARES Act can be spent. Under this new bill, borrowers who furloughed or laid-off workers will not be subject to a loan forgiveness reduction due to reduced employee count as long as they restore their pre-COVID employment by the new deadline of December 31, 2020. Businesses will also have 24 weeks instead of just 8 weeks to spend the funds. This legislation lowers the minimum percentage of PPP loans that must be allocated towards payroll from 75% to 60% and clarifies a borrower does not have to begin repaying a loan until the SBA determines whether or not the business is eligible for loan forgiveness. The PPP Flexibility Act also lifts the ban on borrowers whose loans were partially or completely forgiven from deferring payment of payroll taxes. The payroll tax deferral is now open to...

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AAA Sends letter on Accelerated Payments

On May 26, the AAA sent a letter to HHS Secretary Alex Azar and CMS Administrator Seema Verma, requesting improvements to the Medicare Accelerated and Advance Payment (MAAP) Programs. The nation’s response to the COVID-19 pandemic is putting an increased financial strain on emergency medical services, and ground ambulance service providers and suppliers already faced significant funding challenges. The suggested improvements include: Extending the interim period prior to the date repayment begins from four months to at least 12 months; Reducing the amount that is withheld during the repayment period from one hundred percent (100%) of the Medicare payment to not more than twenty-five percent (25%); Extending the date on which interest first begins to accrue from 210 days to at least 2 years (preferably 3 years); Reduce the interest rate that would be applicable after that date from the current 9.625 percent to a rate of no more than 2%; and Reopen the MAAP to allow EMS agencies that did not request a Medicare advance prior to April 26, 2020 to request an advance. The AAA believes the improvements to the MAAP discussed above would provide short-term financial relief to ambulance service providers and suppliers nationwide and allow us...

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Justice Department Responds on PSOB

On April 9, the AAA and the National Association of Emergency Medical Technicians (NAEMT) sent a letter to U.S. Attorney General William Barr requesting the Department of Justice extend coverage under the Public Safety Officers’ Benefits (PSOB) program to all paramedics and EMTs during the COVID-19 national health emergency. While paramedics and EMTs employed by governmental and non-profit EMS agencies are currently eligible for the program, those employed by private for-profit organizations and on the front lines of responding to COVID-19 pandemic are not covered. Read our letter HERE. On May 22, the AAA received a written response from the DOJ denying any expansion of the PSOB program. They state paramedics and emergency medical technicians employed by private for-profit EMS agencies do not meet the definition of “public safety officers” for purposes of PSOB eligibility as defined under the 1976 PSOB Act despite the waiver of said eligibility requirements by former Attorney General Ashcroft in the aftermath of September 11, 2001. Read their Response HERE. The AAA continues to pursue an expansion of the PSOB program to include all paramedics and EMTs and will push for a legislative solution on Capitol Hill....

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CMS Modifies the Cost Data Collection System Year 1 Data Collection

CMS has issued a blanket waiver modifying the data collection period for the ground ambulance services that were selected to report in Year 1.  Under the current law, these organizations would have been required to collect data beginning January 1, 2020, and through December 31, 2020.  The waiver allows these organizations to select a new continuous 12-month data collection period that begins between January 1, 2021 and ends December 31, 2021.  This modification means that such organizations will collect and report data during the same time period as the ground organizations that CMS will select for Year 2 of the cost collection program. From the summary of the waiver, it appears that organizations will have the choice of submitting data in Year 1 or Year 2.  CMS has not moved the timeline for any other data collection year, so there is the potential for a substantial number of organizations to report in Year 2, which would increase the amount of data available. The AAA has supported the data collection system to make sure that CMS and the Congress have valid and reliable data to support maintaining the geographic add-ons to the Medicare Ambulance Fee Schedule and to support efforts to...

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AAA Sends COVID-19 Relief Request Letter to President Trump

On April 28, the American Ambulance Association sent a letter to President Donald Trump with four requests as to how his Administration can best help ground ambulance service providers mitigate the COVID-19 pandemic. The AAA requested the following: Increase Financial Assistance Related to COVID-19 for Ground Ambulance Services Increase the percentage of the general allocation of funds under the Public Health and Social Services Emergency Fund (PHSSEF) for ground ambulance services providers and suppliers to equal a total of $2.89 billion in funds for our industry. The $2.89 billion reflects $48,000 per ambulance with an estimated 60,000 registered vehicles. We greatly appreciate the recent payments under the Fund which will help with our current situation. However, the ground ambulance services industry is only 0.90% of Medicare fee-for-service annual outlays which resulted in $270 million for our industry in round one of PHSSEF payments. This figure is disproportional to the large role of ground ambulance service providers and suppliers in responding to COVID-19 and our increased costs and reduced revenues during the PHE. Priority Access for Paramedics and EMTs to PPE, COVID-19 Testing and Tax Relief Protect paramedics and EMTs by directing federal agencies to provide them with higher priority access...

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AAA Sends Letter Requesting Priority Testing for EMS

AAA Sends Letter to Requesting Priority Testing for First Responders Earlier today, the AAA sent a letter to the U.S. Public Health Service (USPHS) requesting that first responders with COVID-19 symptoms be given priority one status in the order of groups to be tested for COVID-19. The USPHS had issued guidance that assigned first responders a level two status. The AAA stated paramedics and EMTs should be included in the top level with other health care professionals who are on the front lines of caring for patients with COVID-19.  Read the Letter HERE.  ...

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Congress Provides More PPP and Health Care Funds

Congress Provides More PPP and Health Care Funds Moments ago, the U.S. House of Representatives passed by a vote of 388 to 5 the Paycheck Protection Program and Health Care Enhancement Act. The United States Senate had passed the legislation by unanimous consent on Tuesday evening. The legislation is a bridge package between the CARES Act and Stimulus Package 4 which is still under development. The Paycheck Protection Program and Health Care Enhancement Act provides an additional $310 billion for the Paycheck Protection Program (PPP) established under the CARES Act. The PPP had run out of its initial funding on April 9 and the program has been closed to new applications. The PPP provides businesses with fewer than 500 employees, including ambulance service organizations, with access to loans at favorable terms to cover employee payroll for eight weeks. A borrower can have all or a portion of the loan forgiven depending on the percentage of retained employees. The legislation also allocates an additional $75 billion in funds for the Public Health and Social Services Emergency Fund (PHSSEF). Like the initial $100 billion funding from the CARES Act, these funds are intended to provide economic relief to health care providers during...

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