2018 National and State-Specific Medicare Data

The American Ambulance Association is pleased to announce the publication of its 2018 Medicare Payment Data Report. This report is based on the “Early Edition” of the 2018 Part B National Summary Data File (previously known as the Bess Report). The report consists of an overview of total Medicare spending nationwide, and then a separate breakdown of Medicare spending in each of the 50 states, the District of Columbia, and the various other U.S. Territories. For each jurisdiction, the report contains two charts: the first reflects data for all ambulance services, with the second limited to dialysis transports. Each chart is further broken down by HCPCS code. The charts provide information on the total number of allows services and the total Medicare payments for CYs 2017 and 2018. Percentage changes will allow members to view payment trends over the past year. Questions? Contact Brian Werfel at bwerfel@aol.com.  ...

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CMS Announces 2019 Ambulance Inflation Factor

On November 30, 2018, CMS issued Transmittal 4172 (Change Request 11031), which announced the Medicare Ambulance Inflation Factor (AIF) for calendar year 2019. 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 2018, the federal Bureau of Labor Statistics (BLS) has calculated that the CPI-U has increased 2.9%. CMS further indicated that the CY 2019 MFP will be 0.6%. Accordingly, CMS indicated that the Ambulance Inflation Factor for calendar year 2019 will be 2.3%....

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 Mid-Term Election Analysis Webinar

Join AAA Government Affairs Committee Chair, Jamie Pafford-Gresham, AAA SVP of Government Affairs, Tristan North, AAA Senior Manager of Federal Affairs, Ruth Hazdovac, and Manager of State & Federal Government Affairs, Aidan Camas, as they provide a brief re-cap of the recent mid-term elections. This pre-recorded webinar provides an update on federal and state election results, and how they may impact our industry. We review possible leadership changes in the House & Senate as well as on key committees of jurisdiction over ambulance related legislation. The webinar also provides a brief look ahead into AAA legislative priorities for 2019. If you have any questions about material covered on the presentation, please email Aidan Camas at acamas@ambulance.org. ►Watch the video on Youtube here...

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Mid-term Election Analysis

As a result of Tuesdays’ elections, Democrats will control the U.S. House of Representatives next Congress and Republicans will have a larger majority in the United States Senate. Presently, Democrats have gained a net of 30 seats in the House with Republicans netting two seats in the Senate. Democrats needed to capture 23 seats from Republicans to gain the majority. There are still several races in the House and Senate to be called which will likely add to those totals. Akin Gump, the lobbying firm for the AAA, has put together a synopsis of the election results as of this morning and a slide deck on historical trends and the outcome of races called so far. Key supporters of the industry who will not be returning next Congress include Representatives Peter Roskam (R-IL), Mike Coffman (R-CO) and Erik Paulsen (R-MN). All three members have been supportive of ambulance initiatives with Roskam in his position as Chair of the House Ways and Means Health Subcommittee and Paulsen as a member of the Subcommittee. Coffman sponsored legislation to apply the prudent layperson definition to emergency ambulance services provided to veterans. In late breaking news, the Senate race in Montana was called in favor for (more…)

CMS Launches Outreach Effort to Ambulance Providers & Suppliers

As part of the Bipartisan Budget Act of 2018 (BBA 2018), the Congress instructed CMS to develop a cost collection system to collect cost and revenue data related to the provision of ambulance services. Ambulance services are defined by federal law to include all levels of emergency and non-emergency services.  CMS is in the first phase of this process. The Congress instructed the Agency to engage with stakeholders before specifying through notice and comment rulemaking the data collection system. By law, CMS is required to specify the final system by December 31, 2019. CMS must also identify the first group of providers and suppliers selected for the first representative sample by that date as well. It appears that the goal is to have the contractor develop a proposal before the 2019 rulemaking cycle which will begin next summer. To engage with the stakeholders, CMS, through its contractor the RAND Corporation, is reaching out providers and suppliers to learn more about the costs and revenues associated with providing ambulance services. During the American Ambulance Association’s annual meeting earlier this month, CMS through the RAND Corporation, convened a focus group where they selected several AAA members who were able to talk directly (more…)

LifeWorks October Feature: Work-Life Balance and Productivity

October Feature: Work-Life Balance and Productivity Ten Tips for Fitting Work and Life Together Would you like to move beyond feeling stressed or overwhelmed by your personal and work responsibilities? Or learn how to achieve personal and professional success on your own terms? “Knowing how to manage the way work and life fit together is a modern skill set we all need to succeed,” says Cali Williams Yost, an internationally recognized flexible workplace strategist and author of the books Tweak It: Make What Matters to You Happen Every Day and Work+Life: Finding the Fit That’s Right for You. Here are Yost’s 10 strategies: Remember that work-life fit is unique for each of us. “Simply put, there is no work-life balance or perfect 5050 split between your work and your personal life,” Yost says. “If you do happen to hit a balance, you can’t maintain it because your realities are always changing, personally and professionally.” There’s also no “right way” to achieve a good work-life fit. Your goal is to find your unique, ever-changing fit, the way your work and personal realities fit together day-to-day and at major life transitions. Don’t compare yourself to others. Find the fit that’s right for...

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Narberth Ambulance Overcomes Major Hurdles In Its Billing System

Pennsylvania EMS Provider Achieves Major Billing Milestones Through Payor Logic Partnership and ESO Integration The Volunteer Medical Service Corps of Narberth was established in 1944 by residents of Narberth Borough, a suburb of Philadelphia, to provide transportation and first aid for soldiers returning from World War II via Philadelphia’s ports. The organization, now known as Narberth Ambulance, has expanded over the past 70 years from a small station with two ambulances to a full-fledged EMS service that makes nearly 10,000 trips annually, employs 33 full-time staff, 44 part time employees, and 80 volunteers. Narberth covers four Philadelphia area communities with two stations, seven ambulances, two responder vehicles and one mass casualty/rehab bus. While Narberth Ambulance has seen tremendous growth and success throughout its history, recent times have brought new challenges. Changing technology in the healthcare industry paired with declining reimbursement over the past several years left Narberth, like many other EMS services, facing issues with its billing system and claims processing. These complications made claims longer to work and payment harder to collect. At the height of this problem, Narberth’s billing team needed from five to ten business days to process a claim. The Issue at Hand According to Meg...

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2018 AMBY Award Winners Announced

The American Ambulance Association is proud to announce the recipients of the 2018 AMBY Awards. The AMBYs highlight excellence in EMS and the ingenuity and entrepreneurial spirit that epitomize AAA members. The mission of the awards is to showcase creativity and innovation in the ambulance industry by fostering a culture of collaboration, cooperation and a passion for excellence in patient care. This year’s awards will be presented at the Annual Conference & Trade Show Awards Reception on September 7, 2018. Please join us in congratulating our 2018 winners! Clinical Outcome Program Medic Ambulance Service, Inc. | Vallejo, CA Community Impact Program NorthStar EMS, Inc. | Tuscaloosa, AL Employee Programs Hall Ambulance Service, Inc. | Bakersfield, CA Innovation in EMS Priority Ambulance | Knoxville, TN Mercy Ambulance Service, Inc. | Savannah, GA Public Relations Campaign MEDIC EMS Agency | Charlotte, NC Hall Ambulance Service, Inc. | Bakersfield, CA Quality Improvement Program Sunstar Paramedics | Largo, FL Patient and Employee Safety Program Priority Ambulance | Knoxville, TN Once again, join us in celebrating the 2018 winners! Learn more about the AMBYs.  

2018 AAA Award Winners Announced

The American Ambulance Association is proud to announce this year’s award winners. Awards will be presented at the AAA Annual Conference & Trade Show Membership Meeting on Friday, September 7, 2018. Please join us in congratulating this year’s winners! J. Walter Schaeffer Award Dale Berry The J. Walter Schaeffer Award is given annually to an individual whose work in EMS has contributed positively to the advancement of the industry as a whole. Dale has achieved this through his many years of commitment and service to the ambulance industry. Robert L. Forbuss Lifetime Achievement Award The Honorable Harvey Hall The Robert L. Forbuss Lifetime Achievement Award is named in honor of the first Executive Director of the American Ambulance Association. It recognizes a volunteer leader who has made a significant long-term impact on the association. your decades of service, commitment, and dedication to the private ambulance industry, the AAA, and its members. The Honorable Harvey Hall has achieved this through his decades of service and dedication to the private ambulance industry, the AAA, and its members. President’s Award Jonathan Washko These awards are bestowed by the President to volunteer leaders who have shown commitment to the advancement of the AAA, above and beyond (more…)

Talking Medicare: DOJ Settlement Highlights Importance of Exclusion Testing

Talking Medicare: Recent DOJ Settlement Highlights Importance of Exclusion Testing On July 17, 2018, the U.S. Attorney for the District of Maine issued a press release on a settlement that had been reached with an ambulance service in Maine. As a result of this settlement, the ambulance service agreed to pay $16,776.74 to resolve allegations that it had submitted false claims to the Medicare and Maine Medicare Programs. While the Department of Justice’s press release referred to the matter as a civil health care fraud, that headline is somewhat misleading. The ambulance service was not alleged to “up-coded” its claims or to have billed for patients that did not require ambulance transportation. Rather, the ambulance service was accused of using monies paid to it by these federal health care programs to pay the salary and benefits of a woman hired to assist the company’s billing manager. The woman, who was not identified in news reports, had previously been excluded from participation in federal health care programs after surrendering her license as a pharmacy technician after being found to have inappropriately diverted certain controlled substances. The ambulance service apparently failed to conduct an exclusion test on this individual prior to placing...

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CMS Extends Moratorium on Non-Emergency Ground Services

CMS Extends Temporary Moratorium on Non-Emergency Ground Ambulance Services in New Jersey and Pennsylvania The Centers for Medicare & Medicaid Services (CMS) has announced that it intends to extend the temporary moratoria on the enrollment of new Medicare Part B non-emergency ground ambulance providers and suppliers in the states of New Jersey and Pennsylvania.  The extended moratoria will run through January 29, 2019.  Notice of the extension of the temporary moratorium will appear in the Federal Register on August 2, 2018. Section 6401(a) of the Affordable Care Act granted CMS the authority to impose temporary moratoria on the enrollment of new Medicare providers and suppliers to the extent doing so was necessary to combat fraud or abuse.  On July 31, 2013, CMS used this new authority to impose a moratorium on the enrollment of new ambulance providers in Houston, Texas and the surrounding counties.  On February 4, 2014, CMS imposed a second moratorium on newly enrolling ambulance providers in the Philadelphia metropolitan areas.  These moratoriums were subsequently extended on August 1, 2014, February 2, 2015, July 28, 2015, and February 2, 2016. On August 3, 2016, CMS announced changes to the moratoria on the enrollment of new ground ambulance suppliers. ...

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Notice of Proposed Change to OSHA Injury Reporting

Notice of Proposed Change to OSHA Electronic Injury Reporting Regulations The Occupational Safety and Health Administration (OSHA) announced on July 27, 2018 that it has published a Notice of Proposed Rulemaking (NPRM) that would change the Electronic Injury Reporting Regulations (29 CFR Part 1904) for employers with 250 or more employees. OSHA is proposing this change due to a heightened concern that employee Personally Identifiable Information may be at risk of disclosure through the Freedom of Information Act (FOIA). Currently, all EMS employers must submit their annual injury and illness data to OSHA through the Injury Tracking Application (ITA). Historically, employers were required to track all workplace injuries and illnesses and maintain records of those incidents in the workplace on the OSHA Form 300, 301, and 300A. Each year, employers are required to post a Summary of Workplace Injuries and Illnesses on the Form 300A from February 1st through April 30th. In May 2016, OSHA amended the regulations requiring all employers to submit their Form 300A Summary electronically through the Injury Tracking Application (ITA). Employers with 250 or more employees were required to electronically report all injury and illness data from Forms 300, 301, and 300A each year. Initially OSHA...

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 Sharing Patient Stories

  EMTs, Paramedics, and Dispatchers touch lives every day. However, ambulance services aren’t always sure how best to showcase their value. Learn how Robert Lawrence of PatientCare Logistics Solutions – Alameda Co. and Matt Zavadsky of MedStar Mobile Healthcare share their teams’ impact with patient stories. #SupportEMS...

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NEW! AAA PreCon Workshop on Mandatory Cost Data Collection

AAA is excited to announce that this year we will be holding a full day pre-conference workshop at the AAA Annual Conference & Trade Show! Join industry experts Rebecca Williamson, Angie McLain, Asbel Montes, Kathy Lester, Scott Moore, and Brian Werfel to learn what the new cost data collection mandates will require and how you and your service can get ahead of the game and prepare for these changes. Mandatory Cost Data Collection: When Is It Happening & How to Prepare September 5, 2018 | 9:00 AM – 4:00 PM | MGM Grand, Las Vegas $75 for Annual Conference attendees | $250 workshop-only 2018 federal legislation expanded Medicare cost reporting to ambulance services, although with some important differences from other Medicare reporters. Failure to meet these new reporting requirements could lead to significant sanctions including loss of Medicare revenue. In this session, we will review how we got to where we are, what the new mandates will require based on current regulations, and how best to prepare yourself and your service for the phase-in. To register, simply add the workshop to your cart when completing your Annual Conference registration. Register for Annual and the Workshop► Register only for the workshop (more…)

Massachusetts Legislative Update

Last week the Senate passed a measure (HB 4640) that would raise the Massachusetts Minimum Wage to $15.00 per hour incrementally over the next five years. The Bill would also phase out the time and a half pay that some retail establishments who currently must pay employees who work on Sundays and certain holidays and establishes a permanent tax holiday. Governor Baker and Massachusetts law makers were eager to move this initiative in an effort to block a ballot initiative. The Bill would also establish a paid family and medical leave program for workers. The paid leave program will be funded by a new .63% payroll tax with contributions from both employers and employees. Businesses with fewer than 25 employees will not have to contribute to the fund. The program would go into effect on January 1, 2021 and would provide for up to 12 weeks of paid family leave, 20 weeks of medical leave, up to a total of 26 weeks in a year. Workers on leave would be paid a portion of their weekly wage with the average cost being $4.25 per employee per week. The Bill has been sent to Governor Baker’s office for consideration but will...

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Nominations Open – AAA Board of Directors!

Call For Nominations Now Open! In accordance with the Bylaws of the American Ambulance Association, it is time to call for members in good standing that wish to serve on the Board of Directors. The AAA is now seeking candidates for the following positions: President-Elect Treasurer-at-Large Secretary Region I Director (CT, MA, ME, NH, NJ, NY, RI & VT) Region II Director (AL, DE, DC, FL, GA, MD, MS, NC, PA, SC, VA, WV) Region III Director (IL, IN, KY, MI, OH, TN WI) Region IV Director (AR, IA, KS, LA, MN, MO, OK, ND, NE, SD, TX) Region V Director (AK, AZ, CA, CO, HI, ID, MT, NM, NV, OR, UT, WA, WY Individuals who wish to be considered for an elected position as President-Elect, Treasurer-at-Large, or Secretary must meet the following criteria: 1. Be an employee of and the designated representative of an Active member of the AAA, in good standing; 2. Be ready to devote time and effort to matters which concern the Board of Directors and to actively participate in all Board activities; 3. Be prepared to assist other AAA members with concerns and problems which relate to the ambulance industry and the workings of the AAA; and, 4. Understand that these positions (more…)

ACA Affordability Adjustment

The Internal Revenue Service (IRS) announced on May 21, 2018 that it would be increasing the employee shared responsibility premium percentage under the ACA for 2019. Today, employers are compliant with the ACA if their health plans provide “essential health benefits” that are “affordable” for employees. The “affordability” requirement states that an employer’s health plan premium cost for employees must not exceed 9.56% of household income for the lowest cost, self-only plan. The IRS is adjusting that rate based upon inflation to 9.86% for 2019. With the average cost of health insurance single premium increasing 4% in 2017, this is a bit of relief as employers struggle with maintaining the affordability requirement....

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