Congratulations, Senator Schumer!

Congratulations to Senator Chuck Schumer, who will now serve as Majority Leader.

Congratulations to Senator Chuck Schumer of New York, who will now serve as Majority Leader. Senator Chuck Schumer D-NY'…

Posted by American Ambulance Association on Tuesday, January 12, 2021

Medicare | 2% Sequestration Suspended Through March

From CMS on December 28

Medicare FFS Claims: 2% Payment Adjustment (Sequestration) Suspended Through March

The Coronavirus Aid, Relief, and Economic Security (CARES) Act suspended the payment adjustment percentage of 2% applied to all Medicare Fee-For-Service (FFS) claims from May 1 through December 31. The Consolidated Appropriations Act, 2021, signed into law on December 27, extends the suspension period to March 31, 2021.

Legislative Update: EMS Counts Act

While negotiations for a fourth Stimulus package to address the impacts of the coronavirus remain at an impasse, the AAA continues to monitor Congressional activity for other legislation which impacts ambulance service providers and suppliers:

H.R. 8592 – EMS Counts Act of 2020

Introduced on October 13, 2020, by Rep. Susan Wild (D-PA-07) H.R. 8592 requires the Secretary of Labor to revise the Standard Occupational Classification System to accurately count the number of emergency medical services practitioners in the United States.

The Standard Occupational Classification system is a statistical standard used by federal agencies to classify workers into occupational categories for the purpose of collecting, calculating, or disseminating data. All workers are classified into one of 867 detailed occupations according to their occupational definition.

H.R. 8592 has been referred to the House Committee on Education and Labor for consideration.

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.

If you have any questions about the AAA’s advocacy efforts, please do not hesitate to contact us at Info@Ambulance.org.

CMS Announces New AAP Repayment Terms

CMS Announces New Repayment Terms for Medicare Loans made to Providers during COVID-19

New recoupment terms allow providers and suppliers one additional year to start loan payments

The Centers for Medicare & Medicaid Services (CMS) announced amended terms for payments issued under the Accelerated and Advance Payment (AAP) Program as required by recent action by President Trump and Congress.  This Medicare loan program allows CMS to make advance payments to providers and are typically used in emergency situations.  Under the Continuing Appropriations Act, 2021 and Other Extensions Act repayment will now begin one year from the issuance date of each provider or supplier’s accelerated or advance payment.  CMS issued $106 billion in payments to providers and suppliers in order to alleviate the financial burden healthcare providers faced while experiencing cash flow issues in the early stages of combating the coronavirus disease 2019 (COVID-19) Public Health Emergency (PHE).

“In the throes of an unprecedented pandemic, providers and suppliers on the frontlines needed a lifeline to help keep them afloat,” said CMS Administrator Seema Verma.  “CMS’ advanced payments were loans given to providers and suppliers to avoid having to close their doors and potentially causing a disruption in service for seniors.  While we are seeing patients return to hospitals and doctors providing care we are not yet back to normal,” she added.

CMS expanded the AAP Program on March 28, 2020 and gave these loans to healthcare providers and suppliers in order to combat the financial burden of the pandemic.  CMS successfully paid more than 22,000 Part A providers, totaling more than $98 billion in accelerated payments.  This included payments to Part A providers for Part B items and services they furnished.  In addition, more than 28,000 Part B suppliers, including doctors, non-physician practitioners, and Durable Medical Equipment (DME) suppliers, received advance payments totaling more than $8.5 billion.

Providers were required to make payments starting in August of this year, but with this action, repayment will be delayed until one year after payment was issued.  After that first year, Medicare will automatically recoup 25 percent of Medicare payments otherwise owed to the provider or supplier for eleven months.  At the end of the eleven-month period, recoupment will increase to 50 percent for another six months.  If the provider or supplier is unable to repay the total amount of the AAP during this time-period (a total of 29 months), CMS will issue letters requiring repayment of any outstanding balance, subject to an interest rate of four percent.

The letter also provides guidance on how to request an Extended Repayment Schedule (ERS) for providers and suppliers who are experiencing financial hardships.  An ERS is a debt installment payment plan that allows a provider or supplier to pay debts over the course of three years, or, up to five years in the case of extreme hardship.  Providers and suppliers are encouraged to contact their Medicare Administrative Contractor (MAC) for information on how to request an ERS.  To allow even more flexibility in paying back the loans, the $175 billion issued in Provider Relief funds can be used towards repayment of these Medicare loans.  CMS will be communicating with each provider and supplier in the coming weeks as to the repayment terms and amounts owed as applicable for any accelerated or advance payment issued.

HHS Funding Portal Open for Tranche 3

The online portal for ambulance service providers and suppliers to submit applications for additional funding under the HHS Provider Relief Fund is now open.

Access Portal Now

Apply Soon for Funds!

While providers and suppliers have until November 6 to apply for funding, we strongly recommend that AAA members submit applications as soon as you are prepared as funding is on a first-come, first-served basis. HHS allocated a total of $20 billion for this round of funding.

Attend Today’s AAA Funding Webinar

The AAA will be hosting a webinar today, Monday, October 5, at 11:00 am (eastern), on how to apply for the funds and what information you will need in applying.

Register for the Webinar

Thank You AAA Members!

As reported by the AAA on October 1, the additional funds are a direct result of the efforts of the AAA and our members and we thank all of you who reached out to the White House or your members of Congress advocating for the funds.

 

 

 

America First Healthcare Executive Order on Surprise Coverage

President Trump’s “An America-First Healthcare Plan” Executive Order on Surprise Billing Policy

by Kathy Lester, J.D., M.P.H.

As the American Ambulance Association (AAA) reported yesterday, President Trump issued an Executive Order (EO) “An America-First Healthcare Plan.”  The EO includes several provisions, including related to drug importation generally and for insulin specifically.  It also includes statements that indicate if the Congress does not act before the end of the year, the President will have the Department of Health and Human Services (HHS) “take administrative action to prevent a patient from receiving a bill for out-of-pocket expenses that the patient could not have reasonably foreseen.”  It does not mention ground ambulances.

In addition to suggesting action if the Congress does not pass legislation, the EO also states that within 180 days, the Secretary will update the Medicare.gov Hospital Compare website to inform beneficiaries of hospital billing quality, including:

  • Whether the hospital is in compliance with the Hospital Price Transparency Final Rule;
  • Whether, upon discharge, the hospital provides patients with a receipt that includes a list of itemized services received during a hospital stay; and
  • How often the hospital pursues legal action against patients, including to garnish wages, to place a lien on a patient’s home, or to withdraw money from a patient’s income tax refund.

The narrative related to balance billing (surprise coverage) reads as follows:

My Administration is transforming the black-box hospital and insurance pricing systems to be transparent about price and quality.  Regardless of health-insurance coverage, two‑thirds of adults in America still worry about the threat of unexpected medical bills.  This fear is the result of a system under which individuals and employers are unable to see how insurance companies, pharmacy benefit managers, insurance brokers, and providers are or will be paid.  One major culprit is the practice of “surprise billing,” in which a patient receives unexpected bills at highly inflated prices from providers who are not part of the patient’s insurance network, even if the patient was treated at a hospital that was part of the patient’s network.  Patients can receive these bills despite having no opportunity to select around an out-of-network provider in advance.

On May 9, 2019, I announced four principles to guide congressional efforts to prohibit exorbitant bills resulting from patients’ accidentally or unknowingly receiving services from out-of-network physicians.  Unfortunately, the Congress has failed to act, and patients remain vulnerable to surprise billing.

In the absence of congressional action, my Administration has already taken strong and decisive action to make healthcare prices more transparent.  On June 24, 2019, I signed Executive Order 13877 (Improving Price and Quality Transparency in American Healthcare to Put Patients First), directing certain agencies — for the first time ever — to make sure patients have access to meaningful price and quality information prior to the delivery of care.  Beginning January 1, 2021, hospitals will be required to publish their real price for every service, and publicly display in a consumer-friendly, easy-to-understand format the prices of at least 300 different common services that are able to be shopped for in advance.

We have also taken some concrete steps to eliminate surprise out‑of-network bills.  For example, on April 10, 2020, my Administration required providers to certify, as a condition of receiving supplemental COVID-19 funding, that they would not seek to collect out-of-pocket expenses from a patient for treatment related to COVID-19 in an amount greater than what the patient would have otherwise been required to pay for care by an in-network provider.  These initiatives have made important progress, although additional efforts are necessary.

Not all hospitals allow for surprise bills.  But many do.  Unfortunately, surprise billing has become sufficiently pervasive that the fear of receiving a surprise bill may dissuade patients from seeking appropriate care.  And research suggests a correlation between hospitals that frequently allow surprise billing and increases in hospital admissions and imaging procedures, putting patients at risk of receiving unnecessary services, which can lead to physical harm and threatens the long-term financial sustainability of Medicare.

Efforts to limit surprise billing and increase the number of providers participating in the same insurance network as the hospital in which they work would correspondingly streamline the ability of patients to receive care and reduce time spent on billing disputes.

The AAA will continue to advocate for the resources necessary to sustain life-saving mobile healthcare.

U.S. House of Representatives Approves Continuing Resolution

On September 22, 2020, the U.S. House of Representatives approved a continuing resolution to keep the government funded through December 11, 2020.  Under current law, government funding is set to expire at midnight on September 30, 2020. The House resolution is a stopgap measure that would maintain funding for most government programs at their current…

This content is available only to AAA members.
Log In or Register

Contact the White House About Ambulance Funding

Congressional leaders and White House senior officials remain deeply divided in negotiating an additional stimulus package in response to the COVID-19 pandemic. Last week, Senate Republicans unveiled a smaller, limited package of COVID-19 relief. This “skinny” bill failed in the Senate in a 52-47 vote, with all Republicans except Sen. Rand Paul of Kentucky supporting it, falling short of the 60 votes needed to advance.

Unfortunately, Democrats and Republicans in Congress remain far from a passable stimulus package, and little progress is expected until after the 2020 election. Until then, the American Ambulance Association remains focused on ensuring ambulance service providers and suppliers have the resources they need to continue combating the coronavirus. The AAA is keeping in contact with Congressional and Administration officials as we push for expanded federal relief for the EMS industry.

Not over yet

While negotiations between Congress and the White House have stalled, there are still opportunities to advance the needs of EMS. The federal Department of Health and Human Services holds $50 billion in unappropriated stimulus dollars in its Provider Relief Fund. The AAA and our members have been doing a full-court press on the White House to allocate part of the $50 billion for ground ambulance services. We at the AAA strongly encourage you to use our platform to contact your federal elected officials and urge them to appropriate an additional $2.62 billion from the Provider Relief Fund directly to ambulance service providers and suppliers

We would like to thank the hundreds of AAA members who have already written their elected officials about the need for increased funding for EMS using our new platform which makes contacting your federal elected officials as easy as a few clicks.

Help us help you

If you have not already done so, please use our platform to contact your Members of Congress and the White House to ensure EMS voices are heard during these unprecedented times.

Contact your Elected Officials

 

Amid Stimulus Impasse, Bipartisan Group Offers $1.5 Trillion Compromise

From the New York Times

Members of the House Problem Solvers Caucus plan to map out a recovery package they hope can push top Democrats and White House officials back to the negotiating table…

A bipartisan group of 50 centrist lawmakers plans on Tuesday to present a $1.5 trillion plan to prop up the coronavirus-ravaged economy, making a last-ditch attempt to broach a compromise in hopes of breaking a stalemate in stimulus talks before November’s elections.

The proposal faces long odds amid partisan divisions over what should be included in such a package, and members of the group — which calls itself the House Problem Solvers Caucus — concede privately that their framework stands little chance of becoming law. But the decision to offer it up publicly reflects frustration among rank-and-file lawmakers in both parties at the failure by their leaders to agree to another round of pandemic aid, and a reluctance to return home weeks before Election Day without cementing such help.

Continue Reading

Use AAA’s New Online System to Contact Your Members of Congress on EMS Funding

The American Ambulance Association is pleased to announce our new advocacy software to make contacting your Members of Congress even easier. With just a few clicks, you can contact your Senators and Representative without hassle.

Follow the button below to send messages to Congress within minutes:

Contact Congress Today

As we reach the end of Congressional negotiations, it is critical now more than ever that you contact your Senators and Representative and ask them to support increased funding for ambulance service providers under the Public Health and Social Services Emergency Fund specifically for the increased costs, loss of revenue and uncompensated care facing ground ambulance service organizations due to COVID-19.

In addition to advocating for Congress to include funding specifically for ground ambulance services in the next COVID-19 economic relief package, the AAA is pressing for the Department of Health and Human Services to allocate more funding to EMS under the $75 billion already appropriated to the PHSSEF through the Paycheck Protection Program and Health Care Assistance Act.

The AAA will continue to fight for our members as your paramedics and EMTs are on the front lines of combating the Coronavirus.

 

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.

URGENT: Ask Congress to Support EMS-Specific Relief

Ambulance services, please follow the instructions below. Members of the community, please click here to send an email!

Contact Your Members of Congress Today on Ambulance Specific Funding!

Congress returned this week from recess and has three weeks in which to get another COVID relief package passed before their August recess.

Please contact your Senators and Representative today and ask that they advocate for a funding program under the Public Health and Social Services Emergency Fund specifically for the increased costs, loss of revenue and uncompensated care facing ground ambulance service organizations due to COVID-19.

Please e-mail your Senators and Representative today!

 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, 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 YOUR SENATORS AND THEIR WEBFORM ADDRESS: CLICK HERE to access a list of the webform addresses of your Senators.

3. LOOK UP YOUR REPRESENTATIVE AND THEIR WEBFORM ADDRESS: CLICK HERE and enter your zip code to find the online contact form of your Representative.

4. SEND LETTERS TO MEMBERS: Follow the webform link into your Internet browser and you will be directed to the webpage for contacting your member of Congress. Fill in your contact information, cut and paste your letter into the comments box and hit submit.

In addition to advocating for Congress to include funding specifically for ground ambulance services in the next COVID-19 economic relief package, the AAA is pressing for the Department of Health and Human Services to allocate more funding to EMS under the $75 billion already appropriated to the PHSSEF through the Paycheck Protection Program and Health Care Assistance Act.

The AAA will continue to fight for our members as your operation and paramedic and EMTs are on the front lines of combating the Coronavirus.