Veterans Administration Issues Interim Final Rule Expanding Coverage of Ambulance Services under Millennium Bill On January 9, 2018, the Department of Veterans Affairs issued an interim final rule that would amend its policy for payment of Millennium Bill claims. The Millennium Bill authorizes the Veterans Administration (VA) to pay for emergency care provided to veterans in non-VA facilities — including emergency ambulance transportation — provided the veteran has no other health insurance that would cover the costs of such emergency care. These changes were necessitated, in part, by a recent decision of the U.S. Court of Appeals for Veterans’ Appeals (Staab v. McDonald, 28 Vet. App. 50, 2016). The two major changes being made by the interim final rule are: (1) the expansion of payment eligibility to include veterans who received partial payment or reimbursement from a health plan for their non-VA emergency care and (2) the expansion of payment eligibility for emergency transportation associated with a veteran’s receipt of emergency treatment in a non-VA facility. These changes went into effect on January 9, 2018. Relevant Background 38 U.S.C. §1725 authorizes the VA to reimburse veterans for the costs of emergency treatment for non-service connected conditions furnished in a non-VA (more…)
On March 9, 2017, Rep. Mike Coffman [R-CO-6] reintroduced the Veterans Reimbursement for Emergency Ambulance Services Act (H.R. 1445). The VREASA (Veterans Reimbursement for Emergency Ambulance Services Act) would provide veterans with reimbursement for emergency ambulance services when a Prudent Layperson would have a reasonable expectation that a delay in seeking immediate medical attention will jeopardize the life or health of the veteran. Currently, prior to reimbursement, the Department of Veterans Affairs (VA) requires all medical records be provided, including the records of treatment after the emergency service has taken place. Should those records show that it was not a life threatening emergency or a false alarm, the claim for reimbursement is denied. The veteran is stuck with the bill. Medicare, Medicaid, and other major payers adhere to the “prudent layperson” standard for the reimbursement of emergency ambulance services. The VA is the only major payer to not follow this standard. It is time we ensure our veterans are not stuck with the bill for their emergency ambulance service. AAA Member, American Medical Response and their VP Federal Reimbursement & Regulatory Affairs, Deb Gault, have been working with Rep. Coffman’s office to get this bill reintroduced.
The House VA Committee hearing started at 7:30 p.m., but it was well-attended and lasted until 10 p.m. The witnesses included Senator John McCain (R-AZ), VA Secretary David Shulkin, and representatives of the VA Office of Inspector General and the Government Accountability Office. Senator McCain and Secretary Shulkin were both warmly welcomed by Members of the Committee on a bipartisan basis. Chairman Roe (R-TN) emphasized the need to act quickly to extend the authorization for the Veterans Choice Program, which expires on August 7. To that end, the House VA Committee is voting today on a bill to eliminate the sunset of the program’s authorization. In addition, the Committee will consider broader legislation later this year to make comprehensive reforms to the Choice Program. He noted that the VA has additional funds available but will not be able to spend them once the authorization expires. A copy of Chairman Roe’s opening statement is available here. Secretary Shulkin testified in support of extending the Choice Program, and he clarified that the VA was not seeking additional funding – just the authority to spend funds already obligated. He noted that the VA already is being forced to deny Choice Program coverage to...
Last month I suggested that many of our states are the incubators for employment legislation and that ambulance services need to keep an eye on legislation at the local level and get involved if the legislation effects your business. The leader in employment legislation from a state perspective is California. This article highlights several pieces of legislation that were filed this year that will impact employers. As I have stated several times in prior posts, webinars, and live sessions, the “Ban the Box” movement is growing momentum. California has introduced a bill that will extent current “Ban the Box” protections applicable to State and City employers to private employers. This would prohibit inquiries about a candidate’s criminal history until after a conditional offer of employment was made. This is just one of the bills that were introduced. The other include, Right to Work, Veteran’s Preference, and Employees and dependents Reproductive Health protections. In addition, Assemblyman Freddie Rodriguez introduced legislation that may drastically impact private EMS providers and how they operate their service. Last December the Department of Labor released final rule revising the claims procedure requirements for disability benefit plans under the Employee Retirement Income Security Act (ERISA). The new rules are (more…)
Asbel Montes, AAA Payment Reform Committee co-chair and all-around reimbursement expert, recently developed some great quick tips on billing the US Department of Veterans Affairs for ambulance services. Do you have a process in place to identify when a transported individual is a veteran being carried to a non-VA facility? In an emergency condition, it may prove very beneficial for you to have a consistent process within your billing department to ensure that you can identify these patients in order to maximize reimbursement, while also avoid billing the patient inappropriately… READ MORE► Read Asbel’s full article over on www.reimbursementanswers.com, or learn more in person at the upcoming June 9 AAA Regional Workshop in the San Francisco area!
On March 3, 2016, Congressman Charles W. Boustany, Jr., MD, republican representative of Louisana’s 3rd district, introduced the Timely Payment for Veterans’ Emergency Care Act. According to data obtained by Boustany from the VA’s Chief Business Office, the VA has a nationwide emergency claims payment backlog of over $788 million. When the VA fails to pay these medical bills on time, veterans’ credit ratings are put at risk. Read more about Representative Boustany’s proposed solution on his website.