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 during the public health emergency (PHE).

The AAA has highlighted the increased costs, uncompensated care and lost revenue related to COVID-19 and hope to see ambulance-specific funding in the Senate’s 4^th stimulus package.

Expand Public Safety Officer Benefits (PSOB)

Since the beginning of the pandemic, the AAA has advocated to add COVID-19 as an infectious disease under the Public Safety Officers’ Benefit (PSOB) and extend coverage during the pandemic to paramedics and EMTs employed by a private ambulance service who die from COVID-19.

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.

On May 22, the AAA received a written response from the DOJ denying any expansion of the PSOB program stating that 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.

To push for a legislative fix, AAA Staff and consultants have continued to advocate that all paramedics and EMTs be covered by the program regardless of their employer.

Expansion of Treatment in Place

The AAA has sent several letters asking the Centers for Medicare and Medicaid Services (CMS) to reimburse ground ambulance service providers and suppliers for performing protocol-driven treatments in place during the PHE.

This coverage will help limit the spread of COVID-19 by keeping patients with mild cases of COVID-19 at home and out of overcrowded hospitals or other facilities where they could expose others to the virus. With mostly positive response on our proposed regulatory fixes, the AAA will continue to follow up and address any roadblocks to full coverage of Treatment in Place.

Allow Private For-Profit EMS Providers to Apply Directly for FEMA Grants

The AAA has long advocated to allow private for-profit EMS agencies to apply directly to the Federal Emergency Management Agency (FEMA) for Public Assistance program grants during the PHE and waive the matching requirement for emergency response providers. During the COVID-19 pandemic, it is more necessary than ever that EMS agencies receive the funding the deserve for their role in the COVID-19 response. This will allow all EMS agencies to apply for financial assistance and for state and local governments to focus their limited resources on directly combating the pandemic.

We have been met with positive response from key Senators serving on Committees and Subcommittees of jurisdiction.

Other Legislation

The AAA was pleased to see the introduction of the Pandemic Responder Service Award Act (S. 3763) by Sen. Casey (D-PA) which provides front-line healthcare workers with awards up to $10,000 based on days of eligible service during the PHE. In the case of any qualified health care worker who was hospitalized or died as a result of contracting COVID–19, the award would be the full $10,000. This bill specifically includes private for-profit ambulance service providers, in a well-needed recognition of the work they provide on the frontlines of COVID-19. The AA will continue to work with Sen. Casey’s office as well as push for the inclusion of private for-profit providers in the House companion bill.

The AAA is also pleased to announce the introduction of H.R. 7292 by Rep. Marcy Kaptur (OH-09) which would provide forgiveness of certain accelerated and advanced payments under Medicare parts A and B. While the funding provided by the CARES Act was critical at keeping ambulance service providers operating, the Medicare Accelerated and Advanced Payment Program has the potential to cripple health care providers in the near future as Medicare payments are withheld until those advanced payments are repaid. H.R. 7292 would forgive the repayments and help ensure financial stability for ambulance service providers across the country.

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.