KFF 2020 Employer Health Benefits Survey

From the Kaiser Family Foundation on October 8

This annual survey of employers provides a detailed look at trends in employer-sponsored health coverage, including premiums, employee contributions, cost-sharing provisions, offer rates, wellness programs, and employer practices. The 2020 survey included 1,765 interviews with non-federal public and private firms.

Annual premiums for employer-sponsored family health coverage reached $21,342 this year, up 4% from last year, with workers on average paying $5,588 toward the cost of their coverage. The average deductible among covered workers in a plan with a general annual deductible is $1,644 for single coverage. Fifty-five percent of small firms and 99% of large firms offer health benefits to at least some of their workers, with an overall offer rate of 56%.

Survey results are released in several formats, including a full report with downloadable tables on a variety of topics, a summary of findings, and an article published in the journal Health Affairs.

CMS Ambulance Open Door Forum Oct 22

From CMS on October 16

Open Door Participation Instructions:

October 22, 1:00–2:30 on ET

This call will be Conference Call Only.

To participate by phone:

Dial: 1-888-455-1397 & Reference Conference Passcode: 9375124

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: 1-866-448-2572; Conference Passcode: No Passcode needed

Instant Replay is an audio recording of this call that can be accessed by dialing 1-866-448-2572 and entering the Conference Passcode beginning 1 hours after the call has ended. The recording is available until October 24, 11:59PM ET.

The next CMS Ambulance Open Door Forum is scheduled for:

Date:  Thursday October 22, 2020

Start Time:  1:00pm-2:30pm PM Eastern Time (ET);

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

Conference Leaders: Jill Darling, Susanne Seagrave

**This Agenda is Subject to Change**

1. Opening Remarks

  • Acting Chair- Susanne Seagrave, Acting Director, Division of Data Analysis and Market-Based Pricing (Center for Medicare)
  • Moderator – Jill Darling (Office of Communications)

2. Announcements & Updates

3. 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.

 

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.

 

Rural Healthcare Grants from HRSA FORH

From the HRSA Federal Office of Rural Health Policy

The Health Resources and Services Administration’s Federal Office of Rural Health Policy has released the Notice of Funding Opportunity (NOFO) for the Rural Health Care Services Outreach Program (Outreach) (HRSA-21-027).  HRSA plans to award 60 grants to rural communities as part of this funding opportunity.

Review the Funding Opportunity

The Outreach Program administered by HRSA’s FORHP focuses on expanding the delivery of health care services to include new and enhanced services exclusively in rural communities. Applicants are required to deliver health care services through a consortium of at least three health care provider organizations, use an evidence-based or promising practice model to inform their approach, and demonstrate health outcomes and sustainability by the end of the four-year performance period.

In addition to funding Outreach programs through the regular Outreach track, in FY 21, FORHP will also afford applicants a unique opportunity to take part in a national effort that targets rural health disparities through a second track called the “Healthy Rural Hometown Initiative.” This initiative was created through the HHS Rural Task Force and driven by findings from a report published by the Centers of Disease Control and Prevention (CDC) that noted that the number of preventable death from the five leading cause of death in rural areas was higher than those in urban areas. Unfortunately, these findings echo earlier CDC research on the rural disparities in avoidable or excess death in 2017.

The Healthy Rural Hometown Initiative (HRHI) is an effort that seeks to address the underlying factors that are driving growing rural health disparities related to the five leading causes of avoidable death (heart disease, cancer, unintentional injury/substance use, chronic lower respiratory disease, and stroke). The goal of the HRHI track is to demonstrate the collective impact of projects that better manage conditions, address risk factors and focus on prevention that relate to the leading causes of death in rural communities. This track should be a good fit for applicants who want to identify and bridge the gap between the social determinants of health and other systemic issues that contribute to achieving health equity with regards to excess death in rural communities. Furthermore, this is a rural-specific and community-based approach to addressing these disparities and represents a new and more targeted strategy given the enduring health gaps between rural and urban populations.

Of the successful 60 award recipients, HRSA aims to award approximately 45 to regular Outreach track applicants and at least 15 to HRHI applicants for a ceiling amount of up to $200,000 (Regular Outreach) or $250,000 (HRHI) total cost (includes both direct and indirect, facilities and administrative costs) per year (and final numbers will be subject to how applicants score). 

The HRHI is part of an ongoing multi-year effort by FORHP to highlight how rural community health efforts can improve health at the local level. We are encouraging rural health stakeholders to join us in this broader effort while also taking on the challenge of addressing these long-standing rural health disparities related to the five leading causes of death.    

NOTE: The eligibility criteria for this program has changed and now includes all domestic public and private, nonprofit and for-profit entities with demonstrated experience serving, or the capacity to serve, rural underserved populations. Urban-based organizations applying as the lead applicant should ensure there is a high degree of rural control in the project. The applicant organization must represent a network that includes at least three or more health care provider organizations and, at least 66% (or two-thirds) of consortium members must be located in a HRSA-designated rural area.

Please review the guidance in its entirety for more information about eligibility criteria and specific program requirements. Visit www.grants.gov to review the Outreach NOFO and apply. Learn about the Outreach Program.

A webinar for applicants is scheduled on Tuesday October 13, from 3-4:30 p.m., EST. A recording will be made available for those who cannot attend.

For more information about this funding opportunity, contact the Program Coordinator, Alexa Ofori, at RuralOutreachProgram@hrsa.gov.

Newsmax | Will Trump Get Ambulance Services Needed Pay From Government?

By John Gizzi via Newsmax.com

Although President Donald Trump promised Newsmax earlier this month that he would “certainly look into it,” several ambulance professionals and their representatives have since told us they have seen none of the operating funds in question from the Department of Health and Human Services.

Continue Reading on Newsmax.com

Preliminary Calculation of 2020 Ambulance Inflation Update

Section 1834(l)(3)(B) of the Social Security Act mandates that the Medicare Ambulance Fee Schedule be updated each year to reflect inflation.  This update is referred to as the “Ambulance Inflation Factor” or “AIF”.

The AIF is calculated by measuring the increase in the consumer price index for all urban consumers (CPI-U) for the 12-month period ending with June of the previous year.  Starting in calendar year 2011, the change in the CPI-U is now reduced by a so-called “productivity adjustment”, which is equal to the 10-year moving average of changes in the economy-wide private nonfarm business multi-factor productivity index (MFP).  The MFP reduction may result in a negative AIF for any calendar year.  The resulting AIF is then added to the conversion factor used to calculate Medicare payments under the Ambulance Fee Schedule.

For the 12-month period ending in June 2020, the federal Bureau of Labor Statistics (BLS) has calculated that the CPI-U has increased by 0.646%.

Cautionary Note Regarding CPI-U.  Members should be advised that the BLS’ calculations of the CPI-U are preliminary, and may be subject to later adjustment.  Therefore, it is possible that these numbers may change.

CMS has yet to release its estimate for the MFP for calendar year 2021.  Since its inception, this number has fluctuated between 0.3% and 1.2%.  For calendar year 2020, the MFP was 0.7%.  Under normal circumstances, it would be reasonable to expect the 2021 MFP to be within a percentage point or two of the 2020 MFP.  However, the economic impact of the COVID-19 pandemic makes predictions on the MFP difficult at this point.

Accordingly, the AAA is not in a position to confidently project the 2021 Ambulance Inflation Factor at this point in time.  However, the relative low increase in the CPI-U strongly suggests that the 2021 Ambulance Inflation Factor will be significantly lower than last year’s increase of 0.9%.

The AAA will notify members once CMS issues a transmittal setting forth the official 2021 Ambulance Inflation Factor.

 

 

President Trump Engages on Ambulance Relief during Press Conference

Letter from AAA President Aarron Reinert
August 5, 2020

At last night’s White House press conference with President Trump, a reporter asked the President about the need for ambulance services to be fully reimbursed for their work related to the COVID-19 public health emergency. President Trump responded that ambulance services are doing an incredible job which is a very tough and dangerous one. The President stated he would look into the issue. The fact that the President of the United States was engaged in a public dialogue about the need for our work to be fully reimbursed is a significant development.

To view the YouTube clip of the ambulance dialogue during the press conference, please click here. The dialogue begins at 1:05:40.

The AAA continues to elevate the profile of the need for ambulance service providers to receive additional funding under the Provider Relief Fund. While we are extremely grateful for the relief we have received thus far, it represents only a small portion of the total $2.89 billion we need to offset the impact of being front line health care responders during the COVID-19 public health emergency.

We are directly requesting the Department of Health and Human Services (HHS) to distribute a portion of the funds remaining in the Provider Relief Fund to ambulance services. We are also advocating for Congress to include in the economic stimulus package currently being developed an allocation of more funds for ambulance service providers.

The AAA will continue to fight for our members and the financial relief necessary to combat the pandemic and maintain a strong EMS infrastructure for the future.

If you have not already done so, I ask that you write your members of Congress using the AAA’s new online letter writing tool about the need for more financial relief.

Thank you.

Aarron Reinert
President
American Ambulance Association

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.

 

hippa

HHS | Post-Payment Notice of Reporting Requirements

From HHS on July 20, 2020

General and Targeted Distribution Post-Payment Notice of Reporting Requirements

July 20, 2020

Purpose

The purpose of this notice is to inform Provider Relief Fund (PRF) recipients that received one or more payments exceeding $10,000 in the aggregate from the PRF of the timing of future reporting requirements. Detailed instructions regarding these reports will be released by August 17, 2020.

Overview

Congress appropriated funding to reimburse eligible health care providers for health care related expenses or lost revenues attributable to coronavirus. The Health Resources and Services Administration (HRSA) is administering the distribution of payments under the PRF program, funded through appropriations in the Coronavirus Aid, Relief, and Economic Security (CARES) Act (P.L. 116-136) and the Paycheck Protection Program and Health Care Enhancement Act (P.L. 116-139). Each recipient of a payment from the PRF that used any part of that payment agreed to a set of Terms and Conditions (T&Cs) which, among other obligations, require each recipient to submit reports to the Department of Health and Human Services (HHS). The reports shall be in such form, with such content, as specified by the Secretary of HHS in future program instructions directed to all recipients. HHS will be releasing detailed reporting instructions by August 17, 2020.

These reporting instructions will provide directions on reporting obligations applicable to any provider that received a payment from the following CARES Act/PRF distributions:

General Distributions:
  • Initial Medicare Distribution
  • Additional Medicare Distribution
  •  Medicaid, Dental & CHIP Distribution
Targeted Distributions:
  • High Impact Area Distribution
  •  Rural Distribution
  •  Skilled Nursing Facilities Distribution
  •  Indian Health Service Distribution
  •  Safety Net Hospital Distribution

The reports will allow providers to demonstrate compliance with the T&Cs, including use of funds for allowable purposes, for each PRF payment. HRSA plans to provide recipients with Question and Answer (Q&A) Sessions via Webinar in advance of the submission deadline. Additional details will follow regarding the Q&A Sessions.

Notice on Timing of Reports

The reporting system will become available to recipients for reporting on October 1, 2020.

  • All recipients must report within 45 days of the end of calendar year 2020 on their expenditures through the period ending December 31, 2020.
  •  Recipients who have expended funds in full prior to December 31, 2020 may submit a single final report at any time during the window that begins October 1, 2020, but no later than February 15, 2021.
  •  Recipients with funds unexpended after December 31, 2020, must submit a second and final report no later than July 31, 2021.
  •  Detailed PRF reporting instructions and a data collection template with the necessary data elements will be available through the HRSA website by August 17, 2020.

 

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.

CMS Announces Resumption of Program Integrity Functions

On July 7, 2020, CMS updated its Coronavirus Disease 2019 (COVID-19) Provider Burden Relief Frequently Asked Questions (FAQs).  As part of this update, CMS indicated that it would resume several program integrity functions, starting on August 3, 2020.  This includes pre-payment and post-payment medical reviews by its Medicare Administrative Contractors (MACs), the Supplemental Medical Review Contractor (SMRC), and the Recovery Audit Contractors (RACs).  This also includes the resumption of the Prior Authorization Model for scheduled, repetitive non-emergency ambulance transports.  These programs had been suspended by CMS in March in response to the COVID-19 pandemic.

Resumption of Medicare Fee-For-Service Medical Reviews

 CMS suspended most Medicare FFS medical reviews on March 30, 2020.  This included pre-payment medical reviews conducted by its MACs under the Targeted Probe and Educate program, as well as post-payment reviews by its MACs, the SMRC, and the RACs.  CMS indicated that, given the importance of medical review activities to CMS’ program integrity efforts, it expects to discontinue its “enforcement discretion” beginning on August 3, 2020.

CMS indicated that providers selected for review should discuss any COVID-related hardships that might affect the provider’s ability to respond to the audit in a timely fashion with their contractor.

CMS further indicated that its contractors will be required to consider any waivers and flexibilities in place at the time of the dates of service of claims selected for future review.

Resumption of Prior Authorization Model

 Under the Repetitive, Scheduled, Non-Emergent Ambulance Transport Prior Authorization Model, ground ambulance providers in affected states are required to seek and obtain prior authorization for the transportation of repetitive patients beyond the third round-trip in a 30-day period.  The Prior Authorization Model is currently in place in Delaware, Maryland, New Jersey, North Carolina, Pennsylvania, South Carolina, Virginia, West Virginia, and the District of Columbia.

On March 29, 2020, CMS suspended certain claims processing requirements under the Prior Authorization Model.  During this “pause,” claims for repetitive, scheduled, non-emergency transports were not be stopped for pre-payment review to the extent prior authorization had not been requested prior to the fourth round trip in a 30-day period.  However, CMS continued to permit ambulance providers to submit prior authorization requests to their MACs.

CMS indicated that full model operations and pre-payment review would resume for repetitive, scheduled non-emergent ambulance transportation submitted in the model states on or after August 3, 2020.  CMS stated that the MACs will be required to conduct postpayment review on claims that were subject to the model, and which were submitted and paid during the pause.  CMS further indicated that it would work with the affected providers to develop a schedule for postpayment reviews that does not significantly increase the burden on providers.

CMS stated that claims that received a provision affirmation prior authorization review decision, and which were submitted with an affirmed Unique Tracking Number (UTN) will continue to be excluded from most future medical review.

CNBC | Why Ambulance Rides Are So Expensive In The United States

Thank you to American Ambulance Association Payment Reform Chair Asbel Montes for eloquently representing the EMS perspective on surprise coverage in this video from CNBC:


It’s an open secret in America that calling for an ambulance can be a financial gamble because of surprise bills. There’s no way for patients to know how much an ambulance will cost before they get inside the vehicle, and the final bill can be thousands of dollars. Here’s why ambulances are so expensive in the United States and what can be done to change it.

Stat | Treatment in Place

From Stat on June 29, 2020 by Hanan Cohen of Empress EMS and Patient Care EMS Solutions

Medicare shouldn’t make ground ambulance services take a financial hit for providing at-home care

Ever since the coronavirus pandemic began sweeping across the U.S., ambulance crews have been treating some patients at home rather than risking a hospital surge — and aren’t getting paid for it. At a time when ambulance services are on the frontlines of care, not just transport, Medicare is treating ambulances like expensive taxicabs.

Treating people in place — at the scene of a medical emergency, which can include the home, a long-term care facility, or other location — has become the expected standard of care, especially during the pandemic. Some states even mandate it. But the Centers for Medicare and Medicaid Services, which oversees Medicare payments, refuses to pay companies for the cost of providing medically necessary health care services if the patient is not transported to a hospital or other designated destination.

As a result, ground ambulance organizations that are fighting the Covid-19 pandemic on the frontlines by treating people with everything from low blood sugar to dehydration are taking a massive financial hit. And it’s coming at the worst time.

Continue reading►

HHS HRSA Provider Relief Fund Webinars

CARES Act Provider Relief Fund

The Provider Relief Funds supports American families, workers, and the heroic healthcare providers in the battle against the COVID-19 outbreak. HHS is distributing $175 billion to hospitals and healthcare providers on the front lines of the coronavirus response.

HHS expects to distribute $15 billion to eligible Medicaid and CHIP providers through the Provider Relief Fund. Join our webcast to learn more about the application process. Please pre-register to reserve a spot on your preferred date:

Updated CMS FAQs on the Ambulance Data Collection

Updated CMS FAQs on the Ambulance Data Collection System and Reporting Requirement Delay

As we recently reported, CMS announced that it will be delaying the implementation of the statutorily mandated ambulance data collection system.  CMS has released a new set of Frequently Asked Questions (FAQs) clarifying the delay.  In sum, ambulance organizations selected to provide cost data for 2020 will now be required to report 2021 data in Year 2.  CMS will also add a new set of ambulance organizations for Year 2 reporting as well.  This means that twice as many ambulance organizations will be reporting 2021 data in Year 2 and there will be no data reported for 2020.  Any organization selected that does not report data will be subject to the 10 percent penalty, unless an exception applies.  In addition to addressing concerns about reporting during the pandemic, the FAQs suggest that CMS is concerned that 2020 data “may not be reflective of typical costs and revenue associated with providing ground ambulance services.”

The complete list of these questions, as well as previous ambulance FAQs for COVID-19 on Medicare Fee-for-Service (FFS) Billing can be found here.  The new data collections are below.

Data Collection and Reporting Requirements for the Medicare Ground Ambulance Data Collection System

 1. Question: CMS requires selected ground ambulance organizations to collect cost, revenue, utilization, and other information through the Medicare Ground Ambulance Data Collection System. The collected information will be provided to MedPAC, which is required to submit a report to Congress on the adequacy of Medicare payment rates for ground ambulance services and geographic variations in the cost of furnishing such services. Will the data collection and reporting requirements for the Medicare Ground Ambulance Data Collection System be delayed due to COVID-19?

Answer: Yes. CMS has issued a blanket waiver: https://www.cms.gov/files/document/summary-covid-19-emergency-declaration- waivers.pdf due to the PHE for the COVID-19 pandemic. CMS is modifying the data collection period and data reporting period, as defined at 42 CFR §414.626(a), for ground ambulance organizations that were selected by CMS to collect data beginning between January 1, 2020, and December 31, 2020 (Year 1).

Under this modification, these ground ambulance organizations can select a new data collection period that begins between January 1, 2021, and December 31, 2021; collect the necessary data during their selected data collection period; and submit the data during the data reporting period that corresponds to their selected data collection period.

CMS is modifying this data collection and reporting period to increase flexibilities for ground ambulance organizations that would otherwise be required to collect data in 2020–2021 so that they can focus on their operations in support of patient care.

As a result of this modification, ground ambulance organizations selected for year 1 data collection and reporting will collect and report data during the same period of time that will apply to ground ambulance organizations selected by CMS under §414.626(c) to collect data beginning between January 1, 2021, and December 31, 2021 (year 2) for purposes of complying with the data reporting requirements described at §414.626.

For additional information on the Medicare Ground Ambulance Data Collection System, please visit the Ambulances Services Center website at

https://www.cms.gov/Center/Provider-Type/Ambulances-Services-Center.

New: 6/16/20

2. Question: Will the 10 percent payment reduction still apply to ground ambulance organizations that are now required to collect and report data under the modified data collection and reporting period but do not sufficiently report the required data?

Answer: Yes. The 10 percent payment reduction described at 42 CFR §414.610(c)(9) will still apply if a ground ambulance organization is selected to collect and report data under the modified data collection and reporting timeframe, but does not sufficiently submit the required data according to the modified timeframe and is not granted a hardship exemption. The payment reduction will be applied to payments made under the Medicare Part B Ambulance Fee Schedule for services furnished during the calendar year that begins following the date that CMS provides written notification that the ground ambulance organization did not submit the required data.

New: 6/16/20

3. Question: The modification states that the ground ambulance organizations that were selected by CMS to collect data beginning between January 1, 2020, and December 31, 2020 (year 1) can select a new continuous 12-month data collection period that begins between January 1, 2021, and December 31, 2021. Do the ground ambulance organizations that were selected in year 1 have an option to continue with their current data collection period that started in early 2020 or choose to select a new data collection period starting in 2021?

Answer: No. The ground ambulance organizations that were selected for year 1 do not have an option and must select a new data collection period that begins in 2021. CMS cannot permit this option because the data collected in 2020 during the PHE may not be reflective of typical costs and revenue associated with providing ground ambulance services. New: 6/16/20

4. Question: Does the guidance mean that there will be no data reporting in 2021 and that both the ground ambulance organizations that were selected for year 1 and the ground ambulance organizations that will be selected for year 2 will collect and report data during the same time periods?

Answer: Yes. Under the modification, ground ambulance organizations that are selected for year 1 will not collect data in 2020. These ground ambulance organizations will select a new data collection period that begins in 2021 and must submit a completed Medicare Ground Ambulance Data Collection Instrument during the data reporting period that corresponds to their selected data collection period. As a result of the modification, year 1 and year 2 selected ground ambulance organizations will collect and report data during the same time periods. New: 6/16/20

URGENT – CALL TO ACTION

Contact Your Senators Today on Ambulance Specific Funding!

The U.S. Senate is currently developing its next economic relief package to address the impact of COVID-19. The House had passed its version, the HEROES Act, which includes $100 billion for health care providers. While our members would likely be eligible for a portion of those funds, it is vital that the final package passed by Congress allocate funds specifically for ground ambulance services.

Please contact your Senators 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 today!

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

  1. USE LETTER TEMPLATE: CLICK HERE to access a draft letter. Please customize your letter including the cities and towns you serve, if you are sending to the office of a Senator or Representative and any additional details as to services you are providing during the COVID-19 outbreak and the financial impact on your operation.
  1. LOOK UP YOUR MEMBERS OF CONGRESS AND THEIR WEBFORM ADDRESS: CLICK HERE to access a list of the webform addresses of your Members of Congress.
  1. SEND LETTERS TO MEMBERS: Cut and paste 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 the Senate, as well as the House, 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.

HHS Posts FAQ on Healthcare COVID-19 Relief Fund

Earlier today, the Department of Health and Human Services (HHS) posted a revised set of frequently asked questions (FAQs) regarding the terms and details of payments distributed under the Public Health and Social Services Emergency Fund to Medicare providers including ground ambulance service providers and suppliers. The updated FAQs cover a range of topics regarding the acceptance of funds, revenue data submission and eligibility criteria.

Download FAQ

CMS Modifies the Cost Data Collection System Year 1 Data Collection

CMS has issued a blanket waiver modifying the data collection period for the ground ambulance services that were selected to report in Year 1.  Under the current law, these organizations would have been required to collect data beginning January 1, 2020, and through December 31, 2020.  The waiver allows these organizations to select a new continuous 12-month data collection period that begins between January 1, 2021 and ends December 31, 2021.  This modification means that such organizations will collect and report data during the same time period as the ground organizations that CMS will select for Year 2 of the cost collection program.

From the summary of the waiver, it appears that organizations will have the choice of submitting data in Year 1 or Year 2.  CMS has not moved the timeline for any other data collection year, so there is the potential for a substantial number of organizations to report in Year 2, which would increase the amount of data available.

The AAA has supported the data collection system to make sure that CMS and the Congress have valid and reliable data to support maintaining the geographic add-ons to the Medicare Ambulance Fee Schedule and to support efforts to address the chronic underfunding of the Medicare Ambulance Fee Schedule.

The complete FAQ is below and also available at: https://www.cms.gov/files/document/summary-covid-19-emergency-declaration-waivers.pdf (on page 29).

“CMS is modifying the data collection period and data reporting period, as defined at 42 CFR § 414.626(a), for ground ambulance organizations (as defined at 42 CFR § 414.605) that were selected by CMS under 42 CFR § 414.626(c) to collect data beginning between January 1, 2020 and December 31, 2020 (year 1) for purposes of complying with the data reporting requirements described at 42 CFR § 414.626. Under this modification, these ground ambulance organizations can select a new continuous 12-month data collection period that begins between January 1, 2021 and December 31, 2021, collect data necessary to complete the Medicare Ground Ambulance Data Collection Instrument during their selected data collection period, and submit a completed Medicare Ground Ambulance Data Collection Instrument during the data reporting period that corresponds to their selected data collection period. CMS is modifying this data collection and reporting period to increase flexibilities for ground ambulance organizations that would otherwise be required to collect data in 2020- 2021 so that they can focus on their operations and patient care.”

“As a result of this modification, ground ambulance organizations selected for year 1 data collection and reporting will collect and report data during the same period of time that will apply to ground ambulance organizations selected by CMS under 42 CFR § 414.626(c) to collect data beginning between January 1, 2021 and December 31, 2021 (year 2) for purposes of complying with the data reporting requirements described at 42 CFR § 414.626.”