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AAA 2022 Legislative Priorities

Written by Shawn Baird on . Posted in Balance Billing, Cost Data Collection, Government Affairs, Legislative, Medicaid.

Yesterday, the American Ambulance Association Board of Directors approved the Association’s advocacy priorities for 2022. Our key initiatives reflect the challenges we face this year, including short-sighted threats to EMS balance billing, a worsening workforce shortage, the expiration of the temporary Medicare increases, and potential sequestration cuts.

We also continue to fight for you as you care for people first on the frontlines of the COVID-19 pandemic. We will sustain our efforts at securing additional funding for ground ambulance services to help address the increased costs of providing medical care and transport during the Public Health Emergency.

To achieve our collective goals, the AAA Board will need to mobilize the full voice of influence of the EMS community this year. If you have not already sent an email using the AAA advocacy system to your members of Congress, please do so today!

Staff will be reaching out to you at key points later in the year about letter writing for specific individual policy requests. But it is important that they hear from you now on all the top issues for ground ambulance services.  They are:

Top AAA Advocacy Priorities for 2022

EMS Workforce Shortage

With the persistent shortage of ground ambulance service field personnel raising to a crisis level with the COVID-19 pandemic, the AAA moved the issue to a top policy priority. The AAA is currently working with key Congressional Committees of jurisdiction to hold hearings on the EMS workforce shortage. We are also developing legislation to specifically target increasing access for ground ambulance service organizations to federal programs and funding for the retention and training of health care personnel.

Balance Billing

The AAA successfully educated the Congress on the role of local government oversight and other unique characteristics of providing ground ambulance service organizations. As a result, the Congress directed the establishment of a Ground Ambulance and Balance Billing Advisory Committee to address the issue. The Committee is in the process of being formed and then has 180 days in which to make recommendations to the Congress. The AAA will be involved with the Committee and advocating that the Congress implement policies that meet the needs of our members.

Additional COVID-19 Financial Assistance

The AAA is advocating for additional financial assistance for ground ambulance service organizations to help address the increased costs of labor and other higher costs associated with providing health care during the COVID-19 pandemic.

Medicare Ambulance Relief

The temporary Medicare ambulance increases of 2% urban, 3% rural and the super rural bonus payment expire at the end of the year. The AAA will continue to push for passage of the provisions of the Preserving Access to Ground Ambulance Medical Services Act (S. 2037, H.R. 2454) before the provisions expire as well as for the adoption of language to ensure truly rural areas remain rural following changes to geographical designations based on the 2020 census.

Sequestration Cuts

The Congress delayed the additional 4% sequestration cut for only one yea. The AAA is working with other EMS and health care provider and supplier groups to permanently prevent the cut from going into effect as well as further extending the moratorium on the long-standing 2% cut.

Ambulance Cost Data Collection

With the 2-year delay of ambulance data collection due to the pandemic, the Medicare Payment Advisory Committee (MedPAC) will have little to no data to analyze in March 2023 in which to make recommendations to the Congress on Medicare ambulance payment policy and rates. The AAA is asking the Congress to push back the date of the MedPAC report and also expand the modified data collection timeline of two years to the intended four years.

On behalf of my fellow board members, I again thank you for your continued membership and participation. We look forward to serving you for many years to come.

We also encourage all of our AAA members to contact their members of Congress through our online advocacy tool. 

Should you have any questions regarding our advocacy priorities, please contact AAA Senior Vice President of Government Affairs Tristan North at tnorth@ambulance.org.

NHTSA Names New Office of EMS Director

Written by AAA Staff on . Posted in AAA HQ, News, Press, Regulatory.

From NHTSA on January 13, 2022

Long-time OEMS Staff member assumes leadership role

The National Highway Traffic Safety Administration (NHTSA) today announced that Gamunu Wijetunge, NRP, will assume the role of Director of the Office of EMS effective January, 29, 2022.

Gamunu “Gam” Wijetunge, who has worked within NHTSA’s Office of EMS for more than 20 years, is also a volunteer paramedic, fire captain and the president
of a volunteer rescue squad in Maryland. He will assume the director role — which is also responsible for the National 911 Program housed within the Office of EMS — following the retirement of Jon Krohmer, M.D., FACEP, FAEMS.

“For many years, Gam has been a leader within NHTSA’s Office of EMS, an
advocate for clinicians, and a trusted colleague for both Federal partners and Fire/EMS organizations,” said Dr. Krohmer. “His commitment to collaboration within the EMS community may be best illustrated through his stewardship of EMS Agenda 2050, which sets a clear path for the continued improvement of people-centered EMS systems for the next 30 years.”

Throughout his tenure at NHTSA, Gam has played an integral collaborative role in the development of EMS systems nationwide. These include leading efforts to:

  • Develop evidence-based guidelines and tackle EMS system improvement issues
  • Address recruiting, retention, clinician safety and other EMS workforce topics
  • Improve national EMS preparedness through coordination with other Federal agencies
  • Facilitate consensus and collaboration within leadership and working groups of the Federal Interagency Committee on EMS (FICEMS).

“I am thrilled to continue the office’s collaborative work side-by-side with our Federal partners, EMS stakeholders nationwide, and my colleagues at NHTSA,” said Gam. “I look forward to continuing Jon’s good work to support state, regional and local EMS and 911 agencies as we strive to advance our people-centered EMS and 911 systems.”

Wijetunge has a Bachelors’ Degree in Emergency Health Services from the University of Maryland, Baltimore County and a Master of Public Management from the University of Maryland, College Park. He has several professional affiliations and has been recognized repeatedly for outstanding performance and federal service, including most recently the HHS/ASPR COVID-19 Pandemic Civilian Service Medal in 2021.

HRSA Federal Office of Rural Health Policy Updates

Written by AAA Staff on . Posted in Operations, Patient Care, Regulatory.

From HRSA’s Federal Office of Rural Health Policy

What’s New

HRSA Rural Public Health Workforce Training Network Program – applications due March 18.  HRSA anticipates awards for more than 30 community-based organizations that will join an effort to train and place public health professionals in rural and tribal areas.  Eligible applicants include minority-serving institutions of higher education, Critical Access Hospitals, community health centers, nursing homes, Rural Health Clinics, substance use providers, and state or local workforce development boards.  Each grantee will receive approximately $1.5 million for a three-year project.  FORHP will hold a webinar for applicants on Wednesday, January 5 at 1:00 pm ET.  For those unable to view online, see the Events section below for dial-in information.

HRSA Rural Residency Planning and Development (RRPD) Program  – deadline extended until January 11. The Health Resources and Services Administration (HRSA) revised the program sustainability requirements and extended the deadline for RRPD grant applications. Applicants should review the changes and can resubmit their applications if needed. HRSA will only review your last submitted application. This program aims to increase opportunities for physicians to train in rural residencies. A total of $10.5 million will develop 14 new rural residency programs accredited by the Accreditation Council on Graduate Medical Education (ACGME). Eligible applicants include rural hospitals, GME consortiums, and tribal organizations. For questions, email RuralResidency@hrsa.gov.

HRSA Small Health Care Provider Quality Improvement Program Funding Opportunity – applications due March 21. HRSA will be making approximately 40 awards of up to $200,000 each to support the planning and implementation of quality improvement activities in rural communities. Applicants must be rural domestic public or private nonprofit entities with demonstrated experience serving, or the capacity to serve, rural underserved populations in a HRSA-designated rural area. FORHP will hold a technical assistance webinar for applicants via Zoom on Wednesday, January 26, 2022 from 2-3 p.m. ET. A recording will be available for those who cannot attend.

Share Your Experiences on Rural Emergency Preparedness and Response. The Rural Health Information Hub (RHIhub)  wants to hear about how rural communities, health care facilities, public health departments, first responders, tribes, rural serving organizations, and others have had to adapt, collaborate, and innovate in the face of disasters and public health emergencies. They are looking for examples of lessons learned, successes, challenges, or other helpful information to highlight related to emergency preparedness, response, and recovery for a variety of disasters. Examples will be shared in an emergency preparedness toolkit on the RHIhub website.

Spread the Word About Vaccine Boosters. The U.S. Department of Health & Human Services released new resources – posters, flyers, videos, and talking points – to help promote the extra protection from COVID-19 boosters.  All vaccinated adults aged 18+ are eligible for a booster.  Search by zip code to find nearby locations providing adult and pediatric vaccines and boosters for COVID-19 and the flu at vaccines.gov.

Ongoing: HRSA Payment Program for RHC Buprenorphine-Trained Providers.  In June 2021, HRSA launched an effort to improve access to substance use disorder treatment by paying for providers who are waivered to prescribe buprenorphine, a medication used to treat opioid use disorder.  Rural Health Clinics (RHCs) still have the opportunity to apply for a $3,000 payment on behalf of each provider who trained to obtain the waiver necessary to prescribe buprenorphine after January 1, 2019.  Approximately $1.5 million in program funding remains available for RHCs and will be paid on a first-come, first-served basis until funds are exhausted.  Send questions to DATA2000WaiverPayments@hrsa.gov. There is ongoing availability of a free online course for waiver eligibility training from the American Osteopathic Academy of Addiction Medicine and the Providers Clinical Support System.

COVID-19 Resources

NARHC Assistance with Federal Programs for COVID-19 Testing, Vaccine Distribution, and Provider Relief Fund. The National Association of Rural Health Clinics (NARHC) has background information and guidelines in its collection of technical assistance webinars for all COVID-related programs designated for Rural Health Clinics.

Federal Office of Rural Health Policy Resources for COVID-19.  A set of Frequently Asked Questions (FAQs) from our grantees and stakeholders.

Rural Health Clinic Vaccine Distribution (RHCVD) Program.  Under the program, Medicare-certified RHCs will receive direct COVID-19 vaccines in addition to their normal jurisdictions’ weekly allocation.  Contact RHCVaxDistribution@hrsa.gov for more information.

Community Toolkit for Addressing Health Misinformation. The new resource asks for participation from individuals, teachers, school administrators, librarians, faith leaders, and health care professionals to understand, identify, and stop the spread of misinformation.  The toolkit includes common types of misinformation and a checklist to help evaluate the accuracy of health-related content.

Online Resource for Licensure of Health Professionals.  As telehealth usage increased during the pandemic, FORHP funded new work with the Association of State and Provincial Psychology Boards to reduce the burden of multi-state licensure.  The site provides up-to-date information on emergency regulation and licensing in each state for psychologists, occupational therapists, physical therapists assistants, and social workers.

HRSA COVID-19 Coverage Assistance Fund.  HRSA will provide claims reimbursement at the national Medicare rate for eligible health care providers administering vaccines to underinsured individuals.

HHS Facts About COVID Care for the Uninsured. The U.S. Department of Health & Human Services (HHS) helps uninsured individuals find no-cost COVID-19 testing, treatment, and vaccines.  The HRSA Uninsured Program provides claims reimbursement to health care providers generally at Medicare rates for testing, treating, and administering vaccines to uninsured individuals, including undocumented immigrants.  There are at-a-glance fact sheets for providers and for patients in English and Spanish.

CDC COVID-19 Updates.  The Centers for Disease Control and Prevention (CDC) provides daily updates and guidance, including a section specific to rural health care, COVID-19 Vaccination Trainings for new and experienced providers, and Tips for Talking with Patients about COVID-19 Vaccination.

HHS/DoD National Emergency Tele-Critical Care Network.  A joint program of the U.S. Department of Health & Human Services (HHS) and the U.S. Department of Defense (DoD) is available at no cost to hospitals caring for COVID-19 patients and struggling with access to enough critical care physicians, nurses, respiratory therapists, and other specialized clinical experts. Teams of critical care clinicians are available to deliver virtual care through telemedicine platforms, such as an app on a mobile device. Hear from participating clinicians, and email to learn more and sign up.

Mobilizing Health Care Workforce via Telehealth.  ProviderBridge.org was created by the Federation of State Medical Boards through the CARES Act and the FORHP-supported Licensure Portability Grant Program. The site provides up-to-date information on emergency regulation and licensing by state as well as a provider portal to connect volunteer health care professionals to state agencies and health care entities.

New: Reaching Farm Communities for Vaccine Confidence.  The AgriSafe Network is a nonprofit organization that provides information and training on injury and disease related to agriculture.  Their health professionals and educators created a social media toolkit that aims to provide clear messages about COVID-19 vaccination for agriculture, forestry, and fishing workers.

Funding and Opportunities

SAMHSA Grants for Rural Emergency Medical Services Training – February 14.  The Substance Abuse and Mental Health Services Administration (SAMHSA) will make 27 awards of up to $200,000 each to recruit and train emergency medical services (EMS) personnel with a focus on mental and substance use disorders.  Eligible applicants are rural EMS agencies operated by a local or tribal government and non-profit EMS agencies.

Policy Updates

Send questions to ruralpolicy@hrsa.gov.

Medicare Rule Adds 1,000 Physician Residency Slots and Other GME Policies.  Last week, the Centers for Medicare & Medicaid Services (CMS) finalized several graduate medical education (GME) proposals that will enhance the health care workforce and fund additional medical residency positions in hospitals serving rural and underserved communities.  This Fiscal Year 2022 Medicare Inpatient Hospital Payment Final Rule adds 1,000 new Medicare-funded residency positions prioritizing hospitals that serve areas with the greatest needs. It also allows new opportunities for rural teaching hospitals participating in an accredited rural training track to increase their full time equivalent (FTE) caps.  The rule also allows hospitals beginning a new medical residency training program to reset their FTE caps and per-resident amounts under qualifying circumstances.  Rural hospitals seeking a cap reset must start new residency training programs by December 2025.  Finally, CMS seeks comments on alternative methods to prioritize additional FTE resident cap slots and the review process to determine eligibility for per resident amounts or FTE cap resets in specified situations.

CMS Suspends Enforcement of Vaccine Mandate While Court Ordered Injunctions Remain in Effect (pdf). This month, CMS issued a memo to State Survey Agency Directors indicating that the agency will not enforce the new rule stipulating vaccination for health care workers in certified Medicare/Medicaid providers and suppliers (including nursing facilities, hospitals, dialysis facilities and all other provider types covered by the rule). Health care facilities may voluntarily choose to comply with the Interim Final Rule at this time.

Learning Events and Technical Assistance

Assistance for Rural Public Health Workforce Funding Applications – Wednesday, January 5 at 1:00 pm ET.  FORHP will hold a one-hour webinar via Zoom for those applying for the Rural Public Health Workforce Training Network Program.  Applications are due March 18th for the grant that will invest $48 million to place newly trained public health professionals in rural areas.  To dial in:  1-833-568-8864; Participant Code: 86083981. Contact RPHWTNP@hrsa.gov for more information or a recording of the webinar.

Resource of the Week

Federally Qualified Health Centers and the Health Center Program. This recently updated topic guide at the Rural Health Information Hub includes new FAQs on Medicare reimbursement for telehealth services, insight on financial and operational performances of health centers, and the differences between a Federally Qualified Health Center and a Rural Health Clinic.

Approaching Deadlines

Last Day for RHCs to Spend COVID-19 Testing Funds – December 31

Department of Labor Stand Down Grants for Veterans Services – December 31

USDA Guaranteed Loans for Rural Rental Housing – December 31

COVID-19 Extension for Medicare Graduate Medical Education (GME) Affiliation Agreement  – January 1

Treasury Department New Markets Tax Credit Program – January 3

CDC Grants for New Investigators/Research for Interpersonal Violence Impacting Children/Youth – January 4

HRSA Family-to-Family Health Information Centers (F2F HICs)  – January 5

NIHB/CDC Building Capacity for Tribal Infection Control – January 7

Nominations Sought for Indigenous Health Equity Committee – extended to January 7

NIH Research for AI/AN End-of-Life Care – January 8

Burroughs Wellcome Fund Seed Grants for Climate Change and Health – January 10

USDA Farm to School Grants – January 10

HHS Grants for Family Planning Services – January 11

HRSA Rural Residency Planning and Development (RRPD) Program – extended to January 11

HRSA Nurse Corps Loan Repayment Program – January 13

HRSA Nurse Faculty Loan Program – January 13

HRSA Rural Communities Opioid Response Program – Implementation – January 13

SAMHSA Grants for Rural Emergency Medical Services Training – February 14

CDC Research on Telehealth Strategies for PrEP and ART – January 18

Comments Requested: DEA Regulation of Telepharmacy Practice – January 18

NIH Researching Behavioral Risk Factors for Cancer in Rural Populations – January 18

Department of Labor YouthBuild Program – January 21

CDC Centers for Agricultural Safety and Health – January 24

ACL Empowering Communities for Chronic Disease Self-Management – January 25

ACL Empowering Communities to Deliver and Sustain Falls Prevention Programs – January 25

CDC Seeking Public Input on Work-Related Stress for Health Workers – Extended to January 25

HRSA Delta Region Rural Health Workforce Training Program – January 25

CDC Cancer Prevention and Control for State, Territorial, and Tribal Organizations – January 26

HRSA Access to HIV Services for Women and Children – January 28

HRSA Rural Health Network Development Planning Program – January 28

HHS COVID-19 and Health Equity Impact Fellowship – extended to January 31

HHS Technology Challenge for Racial Equity in Postpartum Care – January 31

HRSA Centers of Excellence for Training Minorities in Health Professions – January 31

SAMHSA-American Psychiatric Association Diversity Leadership Fellowship – January 31

HRSA Leadership Education in Adolescent Health – February 1

Indian Health Service Forensic Healthcare Services for Domestic Violence Prevention – February 2

Indian Health Service Substance Abuse and Suicide Prevention Program – February 2

Indian Health Service Zero Suicide Initiative – February 2

National Health Service Corps Loan Repayment Programs – Extended to February 3

CDC Research to Prevent Firearm-Related Violence and Injuries – February 4

RWJF Summer Health Professions Education Program for Underrepresented Minorities – February 5

HRSA Predoctoral Training in Public Health Dentistry and Dental Hygiene – February 7

SAMHSA Harm Reduction Program – February 7

VA Supportive Services for Veteran Families – February 7

USDA Farm and Food Worker Relief Grants – February 8

IHS Tribal Self-Governance Negotiation – February 10

IHS Tribal Self-Governance Planning – February 10

CDC Strengthening Infection Prevention – February 11

CDC Evaluating Substance Use Prevention Incorporating ACEs Prevention – February 22

HRSA Mobile Health Training – Nurse Education, Practice, Quality and Retention – February 22

USDA Rural eConnectivity Broadband Loan and Grant Program – February 22

Rural Communities Opioid Response Program-Behavioral Health Care Technical Assistance (RCORP-BHCTA) – March 9

HRSA Rural Public Health Workforce Training Network Program – March 18

HRSA Small Health Care Provider Quality Improvement Program – March 21

FCC/USAC Rural Health Care Connect Fund – April 1

FCC/USAC Telecommunications Program – April 1

USDA Local Food Purchase Assistance Program – April 5

Ongoing Opportunities

CFPB Rental Assistance Finder

HHS/DoD National Emergency Tele-Critical Care Network

Extended Public Comment Period for FCC’s COVID-19 Telehealth Program

FCC Emergency Broadband for Individuals and Households

FEMA COVID-19 Funeral Assistance

HRSA Payment Program for Buprenorphine-Trained Clinicians – Until Funds Run Out

AgriSafe Nurse Scholar Program – March 2022

AHRQ Health Services Research Demonstration and Dissemination Grants – September 2022

AHRQ Research to Improve Patient Transitions through HIT – December 2022

American Indian Public Health Resource Center Technical Assistance

ASA Rural Access to Anesthesia Care Scholarship

Burroughs Wellcome Fund Seed Grants for Climate Change and Health – Quarterly through August 2023

CDC Direct Assistance to State, Tribal, Local, and Territorial Health Agencies

CDC Training Pediatric Medical Providers to Recognize ACEs

Delta Region Community Health Systems Development Program

Department of Commerce American Rescue Plan Funding for Indigenous Communities – September 2022

Department of Commerce: Economic Development Assistance Programs

Department of Labor Dislocated Worker Grants

DRA Technical Assistance for Delta Region Community Health Systems Development

EPA Drinking Water State Revolving Fund

FEMA/SAMHSA Crisis Counseling Assistance and Training Program (CCP)

GPHC & RWJF: Rapid Cycle Research and Evaluation Grants for Cross-Sector Alignment

HRSA Technical Assistance for Look-Alike Initial Designation for the Health Center Program

Housing Assistance Council: Housing Loans for Low-Income Rural Communities

HUD Hospital Mortgage Insurance Program

IHS Tribal Forensic Healthcare Training

IHS/DOD Medical Supplies and Equipment for Tribes (Project TRANSAM)

NARHC Certified Rural Health Clinic Professional Course

NIH Project Talk Initiative Host Site Applications

NIH Dissemination and Implementation Research in Health – May 2022

NIH Practice-Based Research for Primary Care Suicide Prevention – June 2022

NIH Research – Alcohol and Other Substance Use – Various Dates Through August 2022

NIH Research: Intervening with Cancer Caregivers to Improve Patient Outcomes – September 8, 2022

NIH Research on Minority Health/Health Disparities – September 8, 2022

NIH Research on Palliative Care in Home/Community Settings – September 8, 2022

NIH Intervention Research to Improve Native American Health – Various Dates Until September 2023

NIH Researching the Role of Work in Health Disparities – Various Dates Until September 2024

NIH Special Interest Research – Pandemic Impact on Vulnerable Children and Youth – May 2024

Nominations for Federal Advisory Commission on HIV, Viral Hepatitis, and Sexually Transmitted Diseases

Nominations for National Advisory Committee on Migrant Health

Primary Care Development Corporation Community Investment Loans

Rural Graduate Medical Education Planning and Development

RWJF Investigator-Initiated Research to Build a Culture of Health

RWJF Pioneering Ideas Brief Proposals

SBA Guaranteed Loans for Small Business

Southeast Rural Community Assistance Loans

Tribal Grant Writing Training

USDA Community Facilities Program

USDA Community Food Projects Technical Assistance

USDA Drinking Water and Waste Disposal for Rural and Native Alaskan Villages

USDA Economic Impact Initiative Grants

USDA Emergency Community Water Assistance Grants

USDA Healthy Food Financing Initiative Technical Assistance

USDA Intermediary Relending Program

USDA Rural Business Development Grants

USDA Rural Business Investment Program

USDA Rural Energy Savings Program

USDA SEARCH – Special Evaluation Assistance for Rural Communities and Households (for Water/Waste Projects)

USDA Summer Food Program

USDA Technical Assistance for Healthy Food Financing Initiative

USDA Telecommunications Infrastructure Loans

USDA Funding for Rural Water and Waste Disposal Projects

USDOT Rural Opportunities to Use Transportation for Economic Success (R.O.U.T.E.S)

The Announcements from the Federal Office of Rural Health Policy are distributed weekly. To receive these updates, send an email with “Subscribe” in the subject line.

 

Application Period Extended for FY 2021 Assistance to Firefighters Grant (AFG) Program

Written by Meghan Winesett on . Posted in Executive, News, Uncategorized.

Please see the below notice from FEMA on the extension of the Assistance to Firefighter Grant (AFG) Program:

“FEMA has been working with the General Services Administration to resolve interface issues related to SAM.gov that were affecting some applicants’ ability to begin inputting their federal fiscal year (FY) 2021 Assistance to Firefighters Grant (AFG) Program applications into the FEMA GO System. Specifically, this issue included applicants that received error messages stating their organizations were not found and that their Unique Entity Identifier (UEI)/Electronic Funds Transfer (EFT) combination did not exist despite the applicants’ SAM.gov accounts being fully active.

As this issue is ongoing, the FY 2021 AFG Program application period will remain open until January 21, 2022 5:00 p.m. ET. All applicants will automatically be granted this extension. This ensures that applicants affected by the UEI/EFT issue will have sufficient time to complete the online application. The extension to the application period will not affect the award timeline. In the meantime, FEMA continues to strongly encourage applicants to review the FY 2021 AFG Program Notice of Funding Opportunity and the associated tools posted on the FEMA website here: FY 2021 Assistance to Firefighters Grant (AFG) Application Guidance Materials | FEMA.gov. In preparation for application submission, applicants may also draft their narratives separately and cut and paste them into the appropriate areas of FEMA GO once the SAM.gov interface issue is resolved. The questions that are asked in the narrative section may be found in the FY 2021 AFG Program Narrative Get Ready Guide.

Fire Grants Help Desk: If you have questions about the NOFO or application process, call or email the Fire Grants Help Desk. The toll-free number is 1-866-274-0960; the e-mail address for questions is firegrants@fema.dhs.gov.The Fire Grants Help Desk is open Monday – Friday, 8 a.m. – 4:30 p.m. ET. “

 

5th Circuit Lifts Injunction on CMS Mandatory Vaccine Requirement for Half of U.S.

Written by Scott Moore on . Posted in Executive, Human Resources, Judicial.

On December 15, 2021, the United States Court of Appeals for the Fifth Circuit issued a ruling which modifies an earlier court national injunction related to the CMS mandatory vaccination rules.  In the latest ruling, the court upheld the injunction issued by the United States District Court for the Eastern District of Missouri as it applied to the fourteen (14) plaintiff states, Louisiana, Montana, Arizona, Alabama, Georgia, Idaho, Indiana, Mississippi, Oklahoma, South Carolina, Utah, West Virginia, Kentucky, and Ohio.  However, it overturned the lower court’s expansion of that injunction to other, non-plaintiff states, in the injunction.  Meaning that between the 5th and 8th Circuit Court rulings, the CMS mandatory vaccination injunction only applies to the following 24 states:

5th Circuit Plaintiffs: Louisiana, Montana, Arizona, Alabama, Georgia, Idaho, Indiana, Mississippi, Oklahoma, South Carolina, Utah, West Virginia, Kentucky, Ohio

8th Circuit Plaintiffs: Missouri, Nebraska, Arkansas, Kansas, Iowa, Wyoming, Alaska, South Dakota, North Dakota and New Hampshire.

States not covered by the CMS mandatory vaccination injunction:

California, Colorado, Connecticut, Delaware, Florida, Hawaii, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Jersey, New Mexico, New York, North Carolina, Oregon, Pennsylvania, Rhode Island, Tennessee, Texas, Vermont, Virginia, Washington, and Wisconsin

This decision, follows another mandatory vaccine related decision issued by the United States Court of Appeals for the Eleventh Circuit which criticized the Louisiana court for expanding the CMS vaccine mandate nationwide given that a Florida District Court had already refused to issue an injunction and because it felt that it was likely that the mandate was likely authorized under current CMS rules.

What does this mean for employers?

If you are an employer in one of the states not covered by an injunction, you should consult with any covered healthcare facility that your organization performs services under contract. These covered healthcare facilities will be required to mandate vaccination for their staff and for any contractor staff that interacts with their employees or patients.  Additionally, they will be seeking proof that your staff is vaccinated against COVID-19, unless they have a protected medical or religious accommodation.

Employers should have already taken the initial steps toward compliance with the CMS mandatory vaccination rules, including having a list of all employees with their vaccination status.  Additionally, employers should have an established policy related to mandatory vaccination and a procedure for requesting and processing an exception/accommodation requests. Lastly, healthcare institutions may independently institute mandatory vaccination rules for their employees and can require this of anyone entering their facility, including EMS staff.

We will continue to keep you post as these cases proceed through the legal system. These facilities may still independently require your staff to be vaccinated. If your organization has questions or need assistance deciphering or preparing for these requirements, please contact the AAA by emailing hello@ambulance.org.

 

 

 

HRSA Announces Distribution of Phase 4 General Distribution Funds

Written by Brian Werfel on . Posted in Executive, Government Affairs, Uncategorized.

The Health Resources & Services Administration (HRSA) has announced that it will begin distributing Phase 4 General Distribution Payments on Thursday, December 16, 2021.  According to HRSA, approximately 75% of all Phase 4 applications have now been processed.  HRSA indicated that the remaining 25% of applications require additional review under its risk mitigation and cost containment safeguards.

HRSA further indicated that it began distributing American Rescue Plan (ARP) Rural Payments on November 23, 2021.  As of December 14, 2021, HRSA has indicated that it has processed approximately 96% of ARP applications.  The ARP allocated a total of $8.5 billion to health care providers who serve rural Medicare, Medicaid and CHIP patients.  HRSA indicated that it will distribute $7.5 billion of these funds in its initial distribution.

To the extent a provider was determined to be eligible for either a Phase 4 payment or an ARP Rural Payment, the provider will receive both an email notification and a paper letter with additional details on these payments.  This will include the individual amounts attributed to any subsidiary TINs submitted as part of their application.  To the extent HRSA determined that you were not eligible for a Phase 4 payment, the email notice will provide an explanation for why you were determined to be ineligible.  These email notices will be sent to the email address provided in the Phase 4 application.  Providers selected for additional review will receive email notification as soon as HRSA completes its review process, which it indicated would be completed in “early 2022.”

AAA members are encouraged to look for this email.  If you have not received an email notification, we would suggest that you check your spam filter, as several of our members have indicated that the email was flagged as “spam” by their email system. 

TODAY | CCIIO Open Door Forum No Surprises Act

Written by AAA Staff on . Posted in Finance, Legislative, Regulatory.

Centers for Medicare & Medicaid Services Center for Consumer Information and Insurance Oversight

Special Open Door Forum: Provider Requirements under the No Surprises Act
Wednesday December 8, 2021 | 2:00-3:00 pm Eastern Time
Conference Call Only
Participant Dial-In Number: 1-888-455-1397
Conference ID #: 8604468

 

The Center for Consumer Information and Insurance Oversight (CCIIO) and the CMS Office of Communication will host an orientation to provider requirements under the No Surprises Act.

Starting January 1, 2022, consumers will have new billing protections when getting emergency care, non-emergency care from out-of-network providers at in-network facilities, and air ambulance services from out-of-network providers. Through new rules aimed to protect consumers, excessive out-of-pocket costs will be restricted, and emergency services must continue to be covered without any prior authorization, and regardless of whether or not a provider or facility is in-network.

On July 1, 2021, the “Requirements Related to Surprise Billing; Part I,” interim final rule was issued to restrict surprise billing for patients in job-based and individual health plans who get emergency care, non-emergency care from out-of-network providers at in-network facilities, and air ambulance services from out-of-network providers.

On September 30, 2021, a second interim final rule was issued and is open for public comment. The “Requirements Related to Surprise Billing; Part II” rule provides additional protections against surprise medical bills, including:

  • Establishing an independent dispute resolution process to determine out-of-network payment amounts between providers (including air ambulance providers) or facilities and health plans.
  • Requiring good-faith estimates of medical items or services for uninsured (or self-paying) individuals.
  • Establishing a patient-provider dispute resolution process for uninsured (or self-paying) individuals to determine payment amounts due to a provider or facility under certain circumstances.
  • Providing a way to appeal certain health plan decisions.

Together, these lay the groundwork to provide consumers with protection against surprise billing, starting in 2022. Learn more about how these rules help consumers.

Here is the link to our No Surprises page that has the slides: https://www.cms.gov/nosurprises/Policies-and-Resources/Provider-requirements-and-resources

We look forward to your participation.

Special Open Door Participation Instructions:

Participant Dial-In Number: 1-888-455-1397

Conference ID #: 8604468

Note: TTY Communications Relay Services are available for the Hearing Impaired. For TTY services dial 7-1-1 or 1-800-855-2880. A Relay Communications Assistant will help. 

A transcript and audio recording of this Special ODF will be posted to the Podcast and Transcripts website at https://www.cms.gov/Outreach-and-Education/Outreach/OpenDoorForums/PodcastAndTranscripts.html for downloading.

For automatic emails of Open Door Forum schedule updates (E-Mailing list subscriptions) and to view Frequently Asked Questions please visit our website at http://www.cms.gov/OpenDoorForums/.

Thank you for your interest in CMS Open Door Forums.

Assistance to Firefighters Grant Program- Non Affiliated EMS Organizations Are Eligible

Written by Meghan Winesett on . Posted in Government Affairs, News.

The Federal Emergency Management Agency (FEMA) Assistance to Firefighters Grant Program (AFG) applications are open. The goal of the grant program is to assist fire departments and non-affiliated emergency medical service organizations in meeting their needs to serve their communities. The grant assists these organizations in obtaining equipment, protective gear, emergency vehicles, training and other resources. Non-affiliated EMS organizations including non-hospital based (private or public) nonprofit, or governmental organizations are eligible to apply. Applications close on Friday, December 17, 2021 at 5pm ET.

Eligible organizations can review the help documents linked below:

If you need assistance in completing your grant application or have any questions you can call or email the Fire Grants Help Desk at 1-866-274-0960 or firegrants@fema.dhs.gov Monday-Friday from 8am-4:30pm ET.

CMS | Ambulance Open Door Forum Dec 9

Written by AAA Staff on . Posted in ET3, Regulatory.

The next CMS Ambulance Open Door Forum scheduled for:

Date:  Thursday, December 9, 2021

Start Time:  2:00pm-3:00pm PM Eastern Time (ET);

Please dial-in at least 15 minutes before call start time.

To participate by phone:

Dial: 1-888-455-1397 & Reference Conference Passcode: 8604468

Conference Leaders: Jill Darling, Maria Durham

**This Agenda is Subject to Change**

  1. Opening Remarks

Chair- Maria Durham, Director, Division of Data Analysis and Market Based Pricing

Moderator – Jill Darling (Office of Communications)

Announcements & Updates

  1. Emergency Triage, Treat, and Transport (ET3) Model Update
  2. Upcoming Implementation Dates of the Repetitive, Scheduled Non-Emergent Ambulance Transport Prior Authorization Model
  3. Ground Ambulance & Patient Billing Advisory Committee Member Nomination Period
  1. CY 2022 Ambulance Inflation Factor (AIF) Change Request 12488, Transmittal 11044
  2. Medicare Ground Ambulance Data Collection System CY 2022 Physician Fee Schedule Final Rule

III. Open Q&A

**DATE IS SUBJECT TO CHANGE**

Next Ambulance Open Door Forum: TBA

ODF email: AMBULANCEODF@cms.hhs.gov

———————————————————————

This Open Door Forum is open to everyone, but if you are a member of the Press, you may listen in but please refrain from asking questions during the Q & A portion of the call. If you have inquiries, please contact CMS at Press@cms.hhs.gov. Thank you.

Open Door Participation Instructions:

This call will be Conference Call Only.

To participate by phone:

Dial: 1-888-455-1397 & Reference Conference Passcode: 8604468

Persons participating by phone do not need to RSVP. TTY Communications Relay Services are available for the Hearing Impaired.  For TTY services dial 7-1-1 or 1-800-855-2880. A Relay Communications Assistant will help.

Instant Replay: 1-800-856-2271; Conference Passcode: No Passcode needed

Instant Replay is an audio recording of this call that can be accessed by dialing 1-800-856-2271 and entering the Conference Passcode beginning 1 hours after the call has ended. The recording is available until December 11, 2021, 11:59PM ET.

For ODF schedule updates and E-Mailing List registration, visit our website at http://www.cms.gov/OpenDoorForums/.

Were you unable to attend the recent Ambulance ODF call? We encourage you to visit our CMS Podcasts and Transcript webpage where you can listen and view the most recent Ambulance ODF call. Please allow up to three weeks to get both the audio and transcript posted to: https://www.cms.gov/Outreach-and-Education/Outreach/OpenDoorForums/PodcastAndTranscripts.html.

CMS provides free auxiliary aids and services including information in accessible formats. Click here for more information. This will point partners to our CMS.gov version of the “Accessibility & Nondiscrimination notice” page. Thank you.

CCIIO Open Door Forum No Surprises Act

Written by AAA Staff on . Posted in Finance, Legislative, Regulatory.

From CMS on December 3, 2021

Centers for Medicare & Medicaid Services Center for Consumer Information and Insurance Oversight

Special Open Door Forum: Provider Requirements under the No Surprises Act
Wednesday December 8, 2021 | 2:00-3:00 pm Eastern Time
Conference Call Only
Participant Dial-In Number: 1-888-455-1397
Conference ID #: 8604468

 

The Center for Consumer Information and Insurance Oversight (CCIIO) and the CMS Office of Communication will host an orientation to provider requirements under the No Surprises Act.

Starting January 1, 2022, consumers will have new billing protections when getting emergency care, non-emergency care from out-of-network providers at in-network facilities, and air ambulance services from out-of-network providers. Through new rules aimed to protect consumers, excessive out-of-pocket costs will be restricted, and emergency services must continue to be covered without any prior authorization, and regardless of whether or not a provider or facility is in-network.

On July 1, 2021, the “Requirements Related to Surprise Billing; Part I,” interim final rule was issued to restrict surprise billing for patients in job-based and individual health plans who get emergency care, non-emergency care from out-of-network providers at in-network facilities, and air ambulance services from out-of-network providers.

On September 30, 2021, a second interim final rule was issued and is open for public comment. The “Requirements Related to Surprise Billing; Part II” rule provides additional protections against surprise medical bills, including:

  • Establishing an independent dispute resolution process to determine out-of-network payment amounts between providers (including air ambulance providers) or facilities and health plans.
  • Requiring good-faith estimates of medical items or services for uninsured (or self-paying) individuals.
  • Establishing a patient-provider dispute resolution process for uninsured (or self-paying) individuals to determine payment amounts due to a provider or facility under certain circumstances.
  • Providing a way to appeal certain health plan decisions.

Together, these lay the groundwork to provide consumers with protection against surprise billing, starting in 2022. Learn more about how these rules help consumers.

Here is the link to our No Surprises page that has the slides: https://www.cms.gov/nosurprises/Policies-and-Resources/Provider-requirements-and-resources

We look forward to your participation.

Special Open Door Participation Instructions:

Participant Dial-In Number: 1-888-455-1397

Conference ID #: 8604468

Note: TTY Communications Relay Services are available for the Hearing Impaired. For TTY services dial 7-1-1 or 1-800-855-2880. A Relay Communications Assistant will help. 

A transcript and audio recording of this Special ODF will be posted to the Podcast and Transcripts website at https://www.cms.gov/Outreach-and-Education/Outreach/OpenDoorForums/PodcastAndTranscripts.html for downloading.

For automatic emails of Open Door Forum schedule updates (E-Mailing list subscriptions) and to view Frequently Asked Questions please visit our website at http://www.cms.gov/OpenDoorForums/.

Thank you for your interest in CMS Open Door Forums.

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