Ambulance Ride-Along Toolkit

AAA ambulance emt member legislation

2018 Ride-Along Toolkit Now Available!

Educating your members of Congress about ambulance industry issues makes them much more likely to support your efforts.  An easy and effective way to educate them is to invite them to participate in a local Ambulance Ride-Along!

Congress is scheduled to adjourn on July 28 for their August congressional recess with members of Congress returning home to their districts and states.  This is the perfect opportunity for you to educate your members of Congress about those issues, in particular Medicare ambulance relief and reform, which are important to your operation. The most effective way to deliver these key messages is to host your member of Congress or their staff on a tour of your operation and an ambulance ride-along. If you cannot host a tour and ride-along, we strongly encourage you to arrange local meetings with your members of Congress during August. The AAA has made the process of arranging a ride-long or scheduling a meeting easy for you with our 2018 Congressional Ride-Along Toolkit.

Are you willing to host a Member of Congress at your service but unsure of how to set it up? Email Aidan Camas at acamas@ambulance.org and Aidan can help you set up a meeting.

Everything you need to arrange the ride-along or schedule a meeting is included in the Toolkit. Act now and invite your elected officials to join you on an Ambulance Ride-Along!

Court Decision Overpayment Determination Statistical Sampling

Maxmed is a home health agency. In 2011, Medicare reviewed a sample of 40 claims involving 22 Medicare beneficiaries and determined that all but one were not medically necessary. The sample was extrapolated to their universe of claims, resulting in an overpayment of $773,967. The Administrative Law Judge invalidated the extrapolation methodology, but the Medicare Appeals Council reversed and Maxmed appealed to Federal District Court, where it lost. Maxmed then appealed claiming:
  • the extrapolation was invalid because the contractor failed to document the random numbers used in the sample and how they were selected.
  • a valid random sample must be for claims that are “defined correctly and independent” and here the same Medicare beneficiary had multiple claims in the sample.
On June 22, 2017, the U.S. Court of Appeals, Fifth Circuit, found the extrapolation and sampling methodology used was proper. The decision, Maxmed Healthcare Inc. v. Price, is just the latest in a recent line of decisions making it harder and harder to challenge statistical sampling and extrapolation of overpayments.

Senate GOP Releases Revised BCRA

This afternoon Senate Republican leaders released the revised version of the Better Care Reconciliation Act (BCRA). Legislative language and section-by-section summaries are now available.. The material was provided by our team at Akin Gump. The AAA will continue to keep members up to date in regards to the Obamacare repeal and replacement efforts.

Better Care Reconciliation Act (BCRA) Revised Text
BCRA Section by Section Summary

Please contact info@ambulance.org if you have any questions.

Ford Issues Recall on Transit Vehicles

On June 28, the Ford Motor Company issued a safety recall and two safety compliance recalls for more than 400,000 transit vans and buses, police interceptors, and Ford Escapes. The recall comes after some of the vehicles have had issues with the driveshaft coupling.

“In the affected vehicles, continuing to operate a vehicle with a cracked flexible coupling may cause separation of the driveshaft, resulting in a loss of motive power while driving or unintended vehicle movement in park without the parking brake applied,” Ford said in a statement about the recall. “In addition, separation of the driveshaft from the transmission can result in secondary damage to surrounding components, including brake and fuel lines. A driveshaft separation may increase the risk of injury or crash.”

The affected vehicles were built between 2015-2017, and no known injuries or accidents have been associated with the issue.

Next Week: AAA Moving to Ambulance.org

The American Ambulance Association is excited to announce that next week, our primary website URL will move to www.ambulance.org. We are excited to offer our members this simple, clear, and easy-to-type online home.

While we do not expect any major technology difficulties during the changeover next week, we appreciate your patience with very short downtime, slight glitches, or slower loading times as we make the change.

Please be assured that the familiar www.ambulance.org URL will continue to work as well as it will redirect to our new www.ambulance.org home.

Please contact AAA staff should you have any questions.

EMS Education – A Look Forward

I have always believed EMS parallels the career trajectory of nursing. This is especially true when you look at the infancy of nursing—1750 to 1893—in what was a subservient apprenticeship with no didactic education. “Most nurses working in the States received on-the-job training in hospital diploma schools. Nursing students initially were unpaid, giving hospitals a source of free labor. This created what many nurse historians and policy analysts see as a system that continues to undervalue nursing’s contribution to acute care.” (History Lesson: Nursing Education has evolved over the decades, 2012, para. 5).

We reached a turning point in 1893 when the Columbian Exposition met, and although Ms. Florence Nightingale was unavailable to attend, she did have a paper presented at the exposition. In essence, the paper proved that a well-educated nursing workforce with standards of practice was needed to improve the health care of the United States.

This is exactly where EMS is now. Young enough to have moved through our growing pains of the late ’60s and early ’70s, but lucky enough to be in an age of extensive medical growth where all levels of providers are looking to enhance the care being provided.

So where do we go from here? We can choose to keep the status quo or we can move forward, hopefully, at a much greater speed than our nursing brothers and sisters. We should consider moving away from being governed by the Department of Transportation and the National Highway Traffic Safety Administration. A much more appropriate body is the Department of Health, which gives us the ability to stop thinking of our discipline as transport to the hospital, and more like bringing a hospital-like service to the to the sick and injured.

“EMS is a critical component of the nation’s healthcare system. Indeed, regardless of where they live, work or travel, people across the US rely on a sufficient, stable and well-trained workforce of EMS providers for help in everyday emergencies, large-scale incidents and natural disasters alike.” (“Education,” 2015, para. 1)

To get there, our education needs to reflect growth, and evidence-based medicine should be the law of the land. If this is proven to be effective, then let’s adopt it. If not, let’s stop teaching the worthless skills of yesterday, just as we have seen with the near extinction of the Long Spine Board. Let’s increase the minimum requirements for every level of provider. Let’s give Paramedics an associate’s degree, a diagnosis’s language, and a licensure, not a certification. Let’s all take the reins of our chosen career paths and have better continuing education that is challenging and accessible, and not an alphabet soup of certifications.

Yes, these are my musings about the future of EMS education. I know places that are very progressive in this country exist. I know there are protocol driven areas too. So let’s stop the segregation and become a health care group with a real mission, an everyday purpose. A place where we act as a group, not as individuals. A place where we treat our patients with the skill, compassion, and talent I know exists. Are you ready to join me?

Scott F. McConnell is Vice President of EMS Education for OnCourse Learning and one of the Founders of Distance CME. Since its inception in 2010, more than 10,000 learners worldwide have relied on Distance CME to recertify their credentials. Scott is a true believer in sharing not only his perspectives and experiences but also those of other providers in educational settings

References

Education. (2015). Retrieved from https://www.ems.gov/education.html

History Lesson: Nursing Education has evolved over the decades. (2012, November 12th, 2012). History Lesson: Nursing Education has evolved over the decades Blog post. Retrieved from https://www.nurse.com/blog/2012/11/12/history-lesson-nursing-education-has-evolved-over-the-decades-

 

CBO Estimates Senate Bill Would Leave 22M More Uninsured

From Akin Gump:

The Congressional Budget Office (CBO) this afternoon released its cost estimate of the Senate’s health care bill, the Better Care Reconciliation Act (BCRA), projecting that the legislation would increase the number of uninsured by 22 million in 2026 relative to the number under current law. This is slightly fewer than the number of uninsured estimated for the House-passed American Health Care Act (AHCA). CBO also estimates that the BCRA would reduce federal deficits by $321 billion over 10 years, $202 billion more than estimated net savings for the House bill.

According to the Senate Budget Committee, below is a brief summary of the changes that were made to the previous draft:

  • Conforming amendments to Sec. 106 – Changes made to better align the purposes of stability funding to the underlying CHIP statute.
  • Adds a new Sec. 206 – Starting in 2019, individuals who had a break in continuous insurance coverage for 63 days or more in the prior year will be subject to a six month waiting period before coverage begins.  Consumers will not have to pay premiums during the six month period.
  • Redesignates Secs. 206-208 to Secs. 207-209, to accommodate for the new Sec. 206 on continuous coverage.

Read the CBO report.

 

Medevac Ambulance Founder Passes Away

It is with great sadness that the American Ambulance Association has learned of the passing of Joe Dolphin, founder of Medevac Ambulance. We will be keeping Joe and his family in our thoughts during this time. A Celebration of Life service will be held on Friday, June 23 at St. Michael’s Church in Poway, Ca., at 10:30 a.m.

Obituary

In 1971, Joe Dolphin founded Medevac Ambulance, which would become the first US Ambulance company to go national.

Joseph’s parents, Carl and Mary Ellen founded the original Dolphin’s Ambulance Service in 1941. In the late 1960s, the founders were retiring, and their two sons were interested in different parts of the business. Joseph chose the ambulance business, and Patrick continued the Medical Equipment Rentals.

In the 1980s, Medevac operated in Central and Southern California including: San Diego County, Santa Clara County, San Mateo County, and Los Angeles County.

Medevac Mid-America was formed in 1981, when the company was awarded the Kansas City MO MAST contract. It was then purchased by Tom Little in 1988 after they lost the Kansas City MAST Contract. After the purchase by Little, the operation was renamed Medevac Medical Services, which was acquired by AMR in 1994.

San Mateo County: Medevac’s first 911 Contract was signed with San Mateo County in 1976. This operation closed in 1991 when they lost the 911 contract.

Santa Clara County: First Contracted with Medevac in 1978 for emergency ambulance service. The San Clara County Operations of Medevac were acquired by Paul Shirley of Pac Med Ambulance in 1989. (Vanguard was one of the 4 companies initially acquired in 1992 to form AMR) Vanguard had a long history, starting in 1963, as Santa Cruz Ambulance, then Pac Med in 1989, finally becoming Vanguard before the sale to AMR.

San Diego County: Medevac held the San Diego EMS Contract from 1978 to 1983.

Los Angeles County: The Medevac LA County Operations were purchased by Crippin Ambulance on October 1, 1992. This was the last remaining operation of Medevac.

About the Founder: Joe Dolphin was president and CEO of the San Diego-headquartered Medevac, Inc. He was appointed by Ronald Reagan to the California Emergency Medical Advisory Committee in 1974. He started the City of San Diego Paramedic Program in 1978. In 1981, Medevac was named as one of the nation’s 100 fastest growing private companies by INC. magazine. Medevac provided service in the following counties and cities: San Diego, San Francisco, San Mateo, Santa Clara, San Bernardino, Los Angeles, Kansas City, Missouri and Topeka, Kansas.

As the Republican nominee for California State Senate, 39th District, in 1996, Joe received more votes in his district (126,653) than Bob Dole did. In 1995, Dolphin was President of the Board of Governors of the California Community Colleges. In 1993, he served as the Foreman of San Diego County’s Grand Jury.

 

 

NHTSA and NASEMSO Host Panel on EMS Practices

The National Association of State EMS Officials (NASEMSO) and the National Highway Transportation Safety Administration (NHTSA) hosted a series of meetings for subject matter experts to discuss revisions to the National EMS Scope of Practice model. The experts reviewed the model’s practices, examined education and training procedures, and discussed what certification level, if any, is needed for specific treatments that are now widely-used among EMS professionals. The panel focused on five specific procedures that are commonly practiced: hemorrhage control, Naloxone use, CPAP use, therapeutic hypothermia in cardiac arrest, and pharmacological pain management.

Over the next several months, the panel will continue to examine information and recommend changes to the Scope of Practice model, with final recommendations tentatively set to be submitted in August 2018. For more information, please visit NASEMSO’s website.

 

 

OIG Releases SemiAnnual Report to Congress

The Office of the Inspector General of the Department of Health and Human Services (HHS-OIG) recently issued the “Measuring Compliance Program Effectiveness: A Resource Guide“. The Guide was developed by a group of HHS-OIG professionals who wanted to provide a set of metrics by which health care providers can measure the elements of their compliance program. The authors recognize that not all the metrics are applicable to all health care providers but intended to be used as a guide. The Guide was released on March 27.

You can also read the full “Semiannual Report to Congress (October 1, 2016 – March 31, 2017)“.

Alabama Governor Signs REPLICA Compact

Governor Kay Ivey recently signed into law Alabama’s REPLICA legislation, HB250. Alabama joins ten other states—Colorado, Texas, Virginia, Idaho, Kansas, Tennessee, Utah, Wyoming, Mississippi, and Georgia—in this forward-thinking interstate compact.

REPLICA, the Recognition of EMS Personnel Licensure Interstate Compact,  recognizes the day-to-day movement of EMS personnel across state lines. It extends the privilege to practice under authorized circumstances to EMS personnel based on their home state license, as well as allows for the rapid exchange of licensure history between Compact member states..

Learn more about how REPLICA participation can help your state at http://www.emsreplica.org.

EMS Week Contest Winners Announced

EMS professionals across the country recently celebrated EMS Week, held May 21-27, by hosting a variety of activities, memorials and both fun-filled and informative events. The AAA asked our members to tell us about some of their favorite ways they honored and celebrated their profession throughout the week, and we have selected three stories as our EMS Week contest winners. Here are some of the highlights:

LifeCare Medical Transports (Fredericksburg, VA): “This year’s EMS Week began with us honoring those who gave their lives so that others might live, at our National EMS Memorial Service. On Sunday, May 21, we co-hosted the EMS Service Cyclists for a dinner on their stop in Fredericksburg, VA. The remainder of the week consisted of fun yet educational online EMS Challenges each day, with participants being entered into raffles for great prizes. All employees received a letter from our leadership, as well as EMS gift bags.”

Armstrong Ambulance Service (Arlington, MA): “We love celebrating our employees every year with a week-long celebration of EMS Week. We annually begin the week with breakfast catered to the bases. This year, we brought carnival food trucks to the bases for a catered lunch of fair food favorites, including hot dogs, hamburgers, sausages and fried dough. On Friday, an ice cream truck visited the bases with sweet treats!

One of our favorite traditions is our EMS Week scavenger hunt. Field crews are given a list of tasks that allow them to interact with our community and that they must complete within 12 hours. The submissions are always hilarious! Throughout the week, we also hold various giveaways for local concerts, Red Sox games and gift certificates.”


McGregor Memorial EMS (Durham, NH): During the week, preschoolers and parents participated in the educational “Boo-Boo Bus” activity, in which children placed band-aids on teddy bears, and kids also participated in several coloring activities.

We also do “CPR on the Street,” in which we set up a tent and table with educational materials on CPR, and we have several mannequins that the public can use to learn “hands-only” CPR.

Finally, there is a volunteer-created place mat that we distributed to local restaurants. We distributed 600 place mats and crayons that were full of informational tidbits, as well as coloring areas and a maze puzzle.”

Thank you to all those who participated, and congratulations to our winners!

HHS to Administer $70 million in Funds to Combat Opioid Crisis

The Department of Health and Human Services (HHS) announced $70 million in grants to help communities and health care professionals combat the ongoing opioid crisis that is ravaging communities across the U.S. The majority of the money will be used to help prevent opioid-induced deaths and to provide treatment for people with opioid use disorders, including $28 million allotted for medication-based treatment. More than 33,000 lives were claimed in 2015 due to opioid overdoses.

$41.7 million of the funding is set to expand resources and training for first responders on how to use emergency treatments, such as Narcan, to help reverse and treat overdoses. In many cases, first responders are often the difference between life and death for opioid users who experience an overdose, so it is imperative health care professionals have access to the needed resources and training to help save lives. The additional funding aims to help paramedics, EMTs and other emergency service personnel gain access to much-needed resources.

“The grants we announce today clearly demonstrate our efforts to meet the opioid crisis with every tool at our disposal,” said Substance Abuse and Mental Health Services Administration Acting Deputy Assistant Secretary Kana Enomoto. “The evidence-based training, medication, and behavioral therapies provided here will save lives and help people with addictions start a path toward reaching their potential.”

In addition to the most recent grants, $485 million in grants were awarded in April to treat and prevent opioid abuse.

To read more about the grants, please visit the HHS web site.

In Memory of Lahiri Garcia & Paul Besaw (AMR Palm Beach/Broward)

The American Ambulance Association was deeply saddened to learn that Lahiri Garcia (51) and Paul Besaw (36) were killed on June 1 in the line of duty. Both were longstanding and respected team members at AMR Palm Beach/Broward County in Florida.

In an interview with WPTV, AMR Regional Director Bill Hall said, “The AMR family has lost two amazing people. They were dedicated husbands, fathers, friends and teammates. Our thoughts are with both families during this difficult time. Lahiri and Paul will be greatly missed. Garcia and Besaw were committed to caring for others, and together they had nearly 40 years of service for AMR and the community.”

“Thank you all for your kind thoughts and sentiments during the past few days. This week, we celebrate the lives of our fallen colleagues, Paul Besaw and Lahiri Garcia, who tragically lost their lives in an unfortunate ambulance accident last Thursday morning,” said Terance Ramotar, regional director of AMR. “These two gentleman have dedicated their lives to the EMS profession and we are preparing a tribute on Thursday to honor their service.”

A processional, followed by funeral services, is scheduled for Thursday, June 8, 2017, at Courtyard Gardens of Jupiter, FL, located at 1790 Indian Creek Drive West, Jupiter, FL. The staging will be on Indian Creek Drive West, and the processional will begin at approximately 9 a.m. The processional ends at Christ Fellowship Church (5343 Northlake Blvd, Palm Beach Gardens, FL), where formal funeral services for Besaw and Garcia are to be held.

The AAA extends its deepest condolences to the Garcia and Besaw families, as well as their friends and colleagues.

CSU Bakersfield Honors Harvey L. Hall with Honorary Doctorate

FOR IMMEDIATE RELEASE
Hall Ambulance News Release
Contact: Mark Corum, Director of Media Services
(661) 322-8741 | Cell (661) 334-0996
May 24, 2017

Hall Ambulance Service, Inc. Founder and President Harvey L. Hall was awarded an honorary Doctor of Humane Letters (L.H.D.) degree, conferred in the names of the California State University and California State University, Bakersfield (CSUB) at the spring 2017 commencement on May 19.  An honorary doctorate is CSUB’s highest honor.

The presentation was made by CSUB President Horace Mitchell, Ph.D., who stated, “Harvey Hall’s support for CSUB and our community is upfront and unwavering.  The criteria established for awarding the honorary doctorate include distinction in the nominee’s chosen field of endeavor, widely recognized eminence, and demonstrated values consistent with those of higher education and the highest ideals of the chosen field.  Harvey Hall embodies, exemplifies, and exceeds those criteria.”

Hall is a longtime supporter of CSUB.  In 2014, President Mitchell presented then-Mayor Hall with the CSUB President’s Award for his leadership, commitment, and service to the University and the community.  In 2010, the CSUB School of Business and Public Administration Executive Advisory Council honored then-Mayor Hall with the prestigious John Brock Community Service Award for his strong record of exemplary community engagement and service.

Widely esteemed as a pioneer of emergency medical transportation services in California, his Company, Hall Ambulance Service, Inc. is the 9-1-1 paramedic provider for 88% of Kern County’s population which includes the incorporated cities of Bakersfield, Arvin, Taft, Shafter, Wasco, Tehachapi, California City, and the communities of Lamont, Frazier Park, Mojave, Rosamond, and Boron.  Hall Critical Care Transport provides both ground and air CCT service from San Francisco, to San Diego.

The prestigious recognition was a cornerstone moment for Hall.  In his honorary doctorate statement, he remarked, “We all strive to make a difference in humanity but sometimes wonder about our individual contribution.  You never know what the catalyst will be that changes your life.  Mine came in 1960 in the form of a dare to go on an ambulance ride along.  From that moment forward, I made it my life’s work to respond to people in need and treat them with dignity and pride through exemplary service.”

His commitment carried on when Hall was entrusted by the people of Bakersfield to serve as their 25th mayor for 16-years—the longest in the city’s history.  Affectionately known as Mr. Bakersfield, he has been a leading advocate for quality of life, beautification, serving as a mayor for all of the people under the belief of building unity in our community.

During his tenure, Hall presented 1,836 proclamations, issued, 10,750 certificates of appreciation, welcomed new business with 958 ribbon cuttings and 91 ground breakings, delivered 981 speeches, 469 welcomes, including 452 foreign visitors.  “Nothing made me happier than to celebrate the accomplishments, celebrations, and achievements of Bakersfield’s residents,” Hall said.

His desire to be inclusive reached across borders and oceans through his work with the Bakersfield Sister City Project Corporation to establish relationships with Queretaro, Mexico; Bucheon, Republic of South Korea; and, Amritsar, India.

Hall’s commitment to Bakersfield’s youth was evidenced through the donation of his entire mayor’s salary to fund the Mayor Harvey L. Hall Scholarship Fund, which awarded $253,000 in financial aid to 297 students.

“I have devoted a lifetime to serving the people and city that I care so passionately about,” said Hall, “The conferment of this honorary degree from our state’s university system provides me clarity for a job well done.”

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EMS Week 2017

43rd Annual EMS Week
“Always In Service”

May 21–27, 2017

Each year, EMS Week celebrates the contributions of EMTs, Paramedics, Dispatchers, and other EMS professionals to their communities. Thank you for your service!

“The American Ambulance Association is committed to representing EMS across the United States. We work tirelessly to ensure that ambulance services receive sustainable levels of reimbursement, empowering them to continue to deliver the
highest quality patient care. EMS Strong offers AAA the opportunity to collaborate with other EMS-focused organizations to bring attention to our shared goals. Together, we are even stronger.”
Mark Postma
President, American Ambulance Association

AAA 2017 EMS Week Contest

The AAA wants to know what you are doing this EMS Week. Share the great events you have planned and be sure to tag the AAA in your EMS Week Social Media posts!

EMS Week Activity Survey

New for 2017, EMS Week is proud to announce themes for each day of the week.

  • Monday: “Education Day” to highlight both public education programs and EMS provider education
  • Tuesday:  “Safety Tuesday” to promote Safety for the EMS provider, the patient, and the public;
  • Wednesday: “EMS for Children Day” to highlight the special needs of caring for children;
  • Thursday: “Save-A-Life Day” to promote “Stop the Bleed” citizen bleeding control education, “Until Help Arrives” active bystander training, public CPR programs, and other related education programs;
  • Friday is “EMS Recognition Day” to recognize your local EMS heroes and those saves by the EMS system.

Learn more on the ACEP EMS Week page.

CMS – MLN Ambulance Transports Booklet

CMS has issued an MLN Ambulance Transports Booklet. The booklet (36 pages) can be downloaded here.

Download MLN Ambulance Transports Booklet

One section of the Booklet that you might want to keep handy involves Free-Standing Emergency Departments. Specifically, on page 15, CMS states the following:

Freestanding Emergency Department (ED)
If a freestanding ED is provider based (a department of the hospital), the ambulance transport from the freestanding ED to the hospital is not a separately payable service under Part B if the beneficiary is admitted as an inpatient prior to ambulance transport. For more information about criteria for coverage of ambulance transports separately payable under Part B or as a packaged hospital inpatient service under Part A, refer to Chapter 10, Section 10.3.3, of the Medicare Benefit Policy Manual.

This may be useful, along with the Manual section cited, when you have a free-standing ED that is part of a hospital and they call for transports to the main building for the patient to be admitted, but the hospital lists the time of admission as being prior to the time of your transport. When the hospital admits the patient prior to your transport, the hospital becomes responsible for the ambulance charges. It may be useful to show the hospital and ED the booklet and Manual section to prove to them that the hospital is responsible if the patient is admitted to the hospital prior to your transport.

REPLICA Compact Enacted

REPLICA Meets Goal, Interstate Compact Becomes Official

May 8, 2017
For Immediate Release
Contact:
Sue Prentiss
603-381-9195
prentiss@emsreplica.org

May 8, 2017 (Falls Church, VA). With the 10th member state enactment, the Recognition of
Emergency Medical Services Licensure Interstate Compact (REPLICA) has become official.
Governor Nathan Deal of Georgia signed Senate Bill 109 on today activating the nation’s first EMS
licensure compact. States that have passed REPLICA to date include: Colorado, Texas, Kansas,
Virginia, Tennessee, Idaho, Utah, Mississippi, Wyoming and Georgia.

Released in 2014, REPLICA’s model legislation creates a formal pathway for the licensed individual
to provide pre-hospital care across state lines under authorized circumstances. According to Keith
Wages, president of the National Association of State EMS Officials (NASEMSO), “REPLICA
represents a collective, nationwide effort to address the problems faced by responders when needing
to cross state borders in the line of their duties.” Wages highlighted the compact’s abilities to
“increase access to healthcare, reduce regulatory barriers for EMS responders, and place an
umbrella of quality over cross border practice not previously seen in the EMS profession.” Wages
also noted that the partnership with the National Registry of Emergency Medical Technicians
(NREMT) has been essential during the advocacy and implementation phases. “We are grateful for
their continued support and contributions.”

Through funding provided by the Department of Homeland Security (DHS), NASEMSO led 23 EMS,
fire, law enforcement organizations and associations as well as key federal partners in the design and
drafting of REPLICA. The National Registry of EMTs (NREMT) currently provides funding to finalize
the development of the Commission.

The compact calls for establishment of an Interstate Commission with each state that has passed
REPLICA holding a seat, as well as a national EMS personnel coordinated database. Member states
will be able to rapidly share personnel licensure information, develop policy focused only on cross
border EMS practice, and hold EMS personnel originating in other states accountable in an
unprecedented way. The National Registry of EMT’s (NREMT) has committed to the development
and hosting of the coordinated database.

Twelve national associations and organizations support REPLICA. Three states have REPLICA bills
under consideration in their legislative sessions. Learn more at www.emsreplica.org.

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EMS Week Activity Survey

EMS Week is May 19-25, 2019. The AAA wants to know how your organization is celebrating  this year! Please let us know what your organization has planned. Also, please be sure to tag the AAA is your EMS Week social media posts so we can “like” and “share” what your organization is doing! The best submissions will also be posted in the AAA weekly digest. Please email info@ambulance.org if you have any questions.

Write to Your Senators! Support S.967

Take Action for Permanent Medicare Ambulance Relief

Ask your Senators to Support S.967 – 2017 Medicare Ambulance Access, Fraud Prevention, and Reform Act

The current 33-month extension of the Medicare add-on payments is set to expire at the end of December 2017. Losing these add-on payments would be a devastating blow to ambulance services across the country. It is crucial that the payments be made permanent as we push for a long-term solution. More details about the Bill can be found below. Let your Senators know that you support S. 967 — Here are three quick and easy ways to get involved!

Writing to your members of Congress only takes 2 clicks, follow these simple steps:

1. Enter contact information below (required by Congressional offices) and click “Submit”
2. On the next page you’ll see the letter(s) to your Senators – click “Submit Messages”

Active on Social Media? Tweet at your Senators asking for their support of S. 967!

  • Authorize Your Account
  • Enter Contact Information
  • Tweet! (Tweet will be auto-generated with your Senators tagged)
Know your Senators’ Twitter accounts already? Tweet:
“#ambulance svs in your state need you, @[your Senators]! Please co-sponsor S. 967 to help us continue to provide quality #EMS!”


Post on Facebook why S. 967 is important! Be sure to tag your Senators and encourage others to share your post! Ask others to write letters of support as well! http://bit.ly/AAAbill

More About Our Bill S. 967, the 2017 Medicare Ambulance Access, Fraud Prevention, and Reform Act:
Permanent ambulance relief legislation has been introduced by Senators Stabenow, Roberts, Schumer, Collins, and Leahy (S. 967). This legislation will allow ambulance service providers to maintain high quality ambulance services and budget for the future.
Specifically, the bill:

  • Provides Medicare Ambulance Relief, by permanently incorporating the current temporary 2 percent urban, 3 percent rural, and super rural bonus payments into the Medicare ambulance fee schedule rates.
  • Requires the Centers for Medicare and Medicaid Services (CMS) to submit a report to Congress detailing the features of a reformed payment system for ambulance services under the Medicare program no later than July 1, 2019.
  • Modifies the process for the transport of dialysis patients by requiring the Department of Health and Human Services to establish a process for the prior authorization of coverage for such patients.
  • Treat ambulance services designated as “suppliers” as “providers” for certain purposes under Medicare.
  • Specifies CMS to work with stakeholders in the development of a data collection system for ambulance entities that defines the various types of ambulance entities as well as the relevant cost and data elements required for submission.