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URGENT – CALL TO ACTION Congress Still Negotiating Stimulus Package Ambulance Specific Relief Not Yet Included: Act Now!

Written by on . Posted in Advocacy Priorities, Executive, Government Affairs, Legislative, Regulatory, Reimbursement.

None of the proposals offered so far on an economic stimulus package to address the impact of COVID-19 include our specific provisions to provide ambulance relief! Negotiators on a final package failed to reach an agreement over the weekend. There is still time to influence the final outcome! Please write to your members of Congress!

There are provisions in the packages that would help businesses, first responders and Medicare providers and suppliers. However, the AAA is advocating for specific help for ambulance services with the prioritization of COVID-19 resources, coverage of services, as well as direct financial assistance. The Congress has heard directly from the AAA about our requests and they need to hear from their constituents about assistance to your operations. If you have not yet contacted your members of Congress, please do so today!

Please e-mail today the health aides for your members of Congress!

It will take you only a few minutes per congressional office to email a letter. Just follow these steps.

1. USE LETTER TEMPLATE: CLICK HERE to access a draft letter. Please customize your letter including the cities and towns you serve, if you are sending to the office of a Senator or Representative and any additional details as to services you are providing during the COVID-19 outbreak and the financial impact on your operation.

2. LOOK UP HEALTH STAFFER AND EMAIL ADDRESS: CLICK HERE to access a list of the name of the health staffer and email address for all congressional offices.

3. SEND E-MAILS TO STAFFERS: Copy and paste the email address of the health staffer and copy and paste the letter as the body of the e-mail and send.

While the Congress may not include all of our requests in this stimulus package, there are likely to be future legislative vehicles in which the AAA will continue to press for passage of additional relief for ambulance service organizations and personnel.

Federal Coronavirus Stimulus Measures

Written by akingump on . Posted in Executive, Government Affairs, Reimbursement, Uncategorized.

Read a summary of President Trump’s proposed stimulus package developed by analysts from AAA lobbying firm Akin Gump.

As was the case following September 11, and during the Great Recession, President Trump and Congress have managed to bridge partisan divides and quickly develop several legislative packages to address the expanding impact of the coronavirus (COVID-19) on America’s public health system and the broader economy. Phase 1—the supplemental appropriations bill—has already become law. Phase 2—targeted relief for individuals, including paid family leave—has passed the House and is poised to pass the Senate this week. Phase 3—broader economic stimulus designed to deliver cash to individuals to help them weather the downturn, as well as industry-specific relief—is being crafted as we write, hopefully with a bipartisan agreement and quick enactment in a matter of days, not weeks. Continue reading►

Now On-Demand: Member Government Affairs Webinar

Written by Matt Swift on . Posted in Executive, Government Affairs, Legislative, Regulatory.

The American Ambulance Association (AAA) hosted the Government Affairs and Member Forum on June 29 to provide an update on legislation on the expiring temporary Medicare ambulance add-on payments, the immediate and long-term goals of AAA on Medicare reform, and how members can get involved with ambulance service-related issues. Mark Postma, president of AAA, and a panel of experts covered varied topics, including where Senate Bill S.967 stands and what changes might occur within the industry, and then fielded questions from members to offer a better understanding of regulatory issues and what’s happening in Washington.

“We put a forum together at this critical time because we currently have a Senate bill to make the add-on permanent, and we’ve been working on a House bill for a long-term extension of the add-ons to be dropped soon,” said Postma. “We have been working diligently to get the appropriate bills introduced, to keep the Medicare extenders and other items that we’ll discuss in this forum.”

Capitol Hill Landscape

The Senate “Medicare Ambulance Access, Fraud Prevention and Reform Act” (S.967) has bipartisan support and is currently being championed Sen. Debbie Stabenow (D-MI), Pat Roberts (R-KS), Chuck Schumer (D-NY), Susan Collins (R-ME) and Patrick Leahy (D-VT). The bill would make permanent the temporary Medicare add-ons, treat ambulance service suppliers more like providers, cut down on dialysis transport fraud and abuse, and implement our preferred cost-data collection system that is beneficial, not burdensome, to ambulance services.

The AAA is currently working on the language for a bill to introduce the House of Representatives. While the bill has yet to be introduced, the AAA is collaborating with our House supporters and Committee staff to put together a bill that, at the very least, extends the Medicare add-ons for five years.  The bill will also include cost-data reporting on which the AAA is negotiating the final details.

“This year really is critical for us,” said Tristan North, senior vice president of government affairs for AAA. “We need to make sure  the Medicare add-on payments don’t expire on December 31.”

Going Forward

The panel discussed immediate, intermediate, and long-term goals to improve the ambulance fee schedule in the foreseeable future. The pending legislation covers many of the immediate goals, but AAA consultant Kathy Lester offered information that could impact the industry in the future.

Lester talked about better defining nonemergency services, the “Uber-ization” of medical transport, and what community paramedicine means to ambulance service providers.

The panel agreed that members and the community need to show their support for legislation, causes, and issues that will shape the future of ambulance services. It was suggested that members advocate to their representatives and leaders—offering to take them on ambulance “ride-alongs,” writing letters, or showing up at government functions—and explain to them how important these pieces of legislation and resources are to the EMS profession.

“We’re working hard and hoping for change in the future,” AAA’s Chair of Government Affairs, Jamie Pafford-Gresham, said. “We need you professionals and the relationships you have with your elected officials… your voices matter to Congress and they matter to us.”

Watch On Demand

Download the PowerPoint

 

ACA Repeal and Replace Update

Written by John Jonas on . Posted in Executive, Government Affairs, Legislative, Member-Only, News.

Congress returns to Washington next week, and House Republican Leadership maintains an ambitious agenda to pass the American Health Care Act (AHCA) despite an unclear path navigating its moderate and conservative factions. President Trump, who refuses to let health care reform disappear from the agenda, is especially eager for a victory, and today predicted AHCA would pass within the next few weeks.

During the in-district work period these past two weeks, the White House, House Leadership and Republican committee staff have kept conversations going with the two disagreeing factions within their caucus – the moderate Tuesday Group and the conservative Freedom Caucus. At this stage, there appears to be no agreement within the Republican Caucus, and there are varying reports on how close are discussions. The wild card is whether President Trump and his team can help force a deal. As soon as a deal materializes, the House will move the bill to the floor.

In addition to health care, the discretionary aspects of the Federal government are under a temporary continuing resolution which expires at the end of next week. An effort is underway to pass a measure that will fund the government through the remainder of the 2017 Fiscal Year, which ends September 30. This effort is not without controversy, and includes an attempt by the Trump Administration to appropriate funds to build its border wall. However, Republicans will need at least eight Senate Democrats to vote with them to pass an omnibus spending bill, so compromise will be required. There may be a series of short-term funding patches as Congress considers spending priorities.

One of the more interesting issues Congress and the Trump Administration face is what to do with Affordable Care Act (ACA) subsidies that were meant to help reduce cost sharing (deductibles, co-payments) for especially poor, non-Medicaid eligible individuals buying insurance on the exchange. House Republicans had successfully sued the Obama Administration in district court arguing that Congress must appropriate the money before the ACA’s Cost Sharing Reduction (CSR) subsidies could be paid. With an injunction from the district court in place, Congress must decide whether to appropriate the money in the upcoming spending bill. Some Democrats have stated they will not vote to pass any budget without funds for the CSR program included. If Republicans can pass a budget without funding the CSR subsidies, they aren’t out of the woods yet on the CSR program. Specifically, the President still has to decide whether to appeal the district court decision on May 22. If President Trump chooses to accept the district court decision and there is no appropriation, the President could unilaterally shut down the CSR subsidy program. The President has threatened to use this court decision to bring Democrats to the negotiating table, in the event that the program is not appropriated and AHCA is not passed.

The AAA will continue to keep members up to date on these issues.

Trump Healthcare Transition Analysis

Written by John Jonas on . Posted in Executive, Government Affairs.

President-elect Donald Trump is naming more members of his transition team as he prepares to form his cabinet and key White House position.  In the healthcare arena Andrew Bremberg will take the lead on transition issues related to the Department of Health and Human Services (HHS). Bremberg, who has been working on the Trump transition team since the Republican National Convention in July, worked at HHS for nearly eight years under the George W. Bush Administration. Bremberg later advised Senate Majority Leader Mitch McConnell on health policy and served on Mitt Romney’s transition team in 2012. Most recently, he worked on Scott Walker’s health care team during the Wisconsin governor’s presidential campaign.  He is viewed as a traditional inside professional with a strong working knowledge of the health care system.

The Trump transition team is currently focused on cabinet-level picks. Candidates to become HHS Secretary in the new Administration reportedly include:  Dr. Ben Carson, a retired neurosurgeon and former GOP presidential candidate; former House Speaker Newt Gingrich; former Louisiana Gov. Bobby Jindal; Rich Bagger (we previously worked with him when he was at Pfizer and we represented the company), executive director of the Trump Transition team and a pharmaceutical executive; and Florida Gov. Rick Scott,  Congressman Tom Price (GA), a Member of the House Ways & Means Committee, has also expressed interest in being Secretary.

Topping the list of health care priorities for Congressional Republicans is repealing and replacing the Affordable Care Act. The GOP will likely seek to pass a budget resolution, and then a reconciliation bill to repeal major portions of the health law, including the individual and employer mandates and various taxes. The budget reconciliation process will allow the Senate to advance a repeal bill with only a 51-vote majority.  Both a FY 17 and FY 18 reconciliation bills are possible

Rep. Kevin Brady (R-TX) is expected to remain as Ways and Means Committee Chairman, and Rep. Pat Tiberi as Chairman of the Health Subcommittee. Republicans will need to fill a few seats on the Committee; Rep. Charles Boustany (R-LA) lost his Senate race, while Rep. Todd Young (R-IN) won his. Rep. Robert Dold (R-IL) lost his re-election bid.  On the Democratic side, it is not clear whether the six seats gained by the Democrats will change the Committee ratios in any way.  Brian Higgins will likely regain his seat on the Ways & Means Committee to fill one of the seats vacated by Charlie Rangel and Jim McDermott.  A fair number of Members on both the Republican and Democratic side are lobbying for positions on the key Ways & Means Committee.

We will continue these updates as we collect additional information on the Trump transition, particularly as it looks at sub-cabinet level positions in HHS and CMS.  I have attached for folks’ review, the Ways & Means Committee document, A Better Way, which discusses their replacement for the ACA and is probably the best starting point for those looking to begin to discern what repeal and replace will look like.  We will provide more updates on this process as they begin to take shape.

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