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OMB PHE Update | May 11

Written by AAA Staff on . Posted in Executive, Government Affairs, Legislative, Regulatory.

January 30, 2023
(House Rules)

STATEMENT OF ADMINISTRATION POLICY
H.R. 382 – A bill to terminate the public health emergency
declared with respect to COVID-19
(Rep. Guthrie, R-KY, and 19 cosponsors)

H.J. Res. 7 – A joint resolution relating to a national emergency
declared by the President on March 13, 2020
(Rep. Gosar, R-AZ, and 51 cosponsors)
The COVID-19 national emergency and public health emergency (PHE) were declared by the Trump Administration in 2020.  They are currently set to expire on March 1 and April 11, respectively.  At present, the Administration’s plan is to extend the emergency declarations to May 11, and then end both emergencies on that date.  This wind-down would align with the Administration’s previous commitments to give at least 60 days’ notice prior to termination of the PHE.

To be clear, continuation of these emergency declarations until May 11 does not impose any restriction at all on individual conduct with regard to COVID-19.  They do not impose mask mandates or vaccine mandates.  They do not restrict school or business operations.  They do not require the use of any medicines or tests in response to cases of COVID-19.

However, ending these emergency declarations in the manner contemplated by H.R. 382 and H.J. Res. 7 would have two highly significant impacts on our nation’s health system and government operations.

First, an abrupt end to the emergency declarations would create wide-ranging chaos and uncertainty throughout the health care system — for states, for hospitals and doctors’ offices, and, most importantly, for tens of millions of Americans.  During the PHE, the Medicaid program has operated under special rules to provide extra funding to states to ensure that tens of millions of vulnerable Americans kept their Medicaid coverage during a global pandemic.  In December, Congress enacted an orderly wind-down of these rules to ensure that patients did not lose access to care unpredictably and that state budgets don’t face a radical cliff.  If the PHE were suddenly terminated, it would sow confusion and chaos into this critical wind-down.  Due to this uncertainty, tens of millions of Americans could be at risk of abruptly losing their health insurance, and states could be at risk of losing billions of dollars in funding.  Additionally, hospitals and nursing homes that have relied on flexibilities enabled by the emergency declarations will be plunged into chaos without adequate time to retrain staff and establish new billing processes, likely leading to disruptions in care and payment delays, and many facilities around the country will experience revenue losses.  Finally, millions of patients, including many of our nation’s veterans, who rely on telehealth would suddenly be unable to access critical clinical services and medications.  The most acutely impacted would be individuals with behavioral health needs and rural patients.

Second, the end of the public health emergency will end the Title 42 policy at the border.  While the Administration has attempted to terminate the Title 42 policy and continues to support an orderly lifting of those restrictions, Title 42 remains in place because of orders issued by the Supreme Court and a district court in Louisiana.  Enactment of H.R. 382 would lift Title 42 immediately, and result in a substantial additional inflow of migrants at the Southwest border.  The number of migrants crossing the border has been cut in half, approximately, since the Administration put in place a plan in early January to deter irregular migration from Venezuela, Cuba, Nicaragua, and Haiti.  The Administration supports an orderly, predictable wind-down of Title 42, with sufficient time to put alternative policies in place.  But if H.R. 382 becomes law and the Title 42 restrictions end precipitously, Congress will effectively be requiring the Administration to allow thousands of migrants per day into the country immediately without the necessary policies in place.

The Administration strongly opposes enactment of H.R. 382 and H.J. Res. 7, which would be a grave disservice to the American people.
* * * * * * *

 

This statement is online here: https://www.whitehouse.gov/wp-content/uploads/2023/01/SAP-H.R.-382-H.J.-Res.-7.pdf

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Rest in Peace, Jacob Dindinger

Written by AAA Staff on . Posted in News, Press.

From Global Medical Response

It is with a heavy heart that we inform you that Jacob’s family made the decision to remove him from life support. This decision did not come easy; it came after many tests and conversations and much consideration to his condition. Jacob fought hard, but unfortunately the injuries he sustained were so damaging, he was not able to survive them.

Jacob made such a big impact in our community with each interaction he had. He was dedicated and driven to succeed and continually looking for his next accomplishment. To Jacob, failure was a setback, but it didn’t stop him from working harder to succeed. His family meant everything to him, and the smiles we have seen in recent photos show the love he had for his family and friends. He made an even bigger impact on our family here at AMR and we feel like we are all better people after being touched by Jacob and his family.

These past two weeks have been difficult for the entire GMR family. We appreciate all the support you have given to our local teams as well as the family. CISM teams have been working in Arizona to help our teams there, and GMR Life teams have been offering support across all our operations. I encourage you to reach out to them and to our HR teams, and to use EAP resources.

When final arrangements have been made, we will notify our local teams.

If you would like to help the family, a Go Fund Me account has been established.

Thank you,

Glenn Kasprzyk, Southwest Region President
Jackie Evans, Regional Director
Global Medical Response

40 Under 40: Adam Stockton (Maricopa Ambulance – Phoenix, AZ)

Written by American Ambulance Association on . Posted in 40 Under 40.

40 Under 40 nominees were selected based on their contributions to the American Ambulance Association, their employer, state ambulance association, other professional associations, and/or the EMS profession.
____

Adam Stockton
Director of EMS Operations, West Valley
Maricopa Ambulance (Member of the Priority Ambulance family of companies)
Phoenix, Arizona

____

Nominated by: Amanda Jennings (Priority Ambulance – Knoxville, TN)
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Biography:

Adam joined the Maricopa Ambulance team in 2016 when the company started up in Maricopa County, Arizona. As the company grew, Adam quickly advanced from Paramedic Supervisor to EMS Director in less than two years due to his talent and commitment to serving his communities. Adam Stockton currently serves as EMS Director for the 9-1-1 service areas of Glendale and Goodyear where he was instrumental in the implementation and optimization of those systems in 2019.

Adam served as the lead supervisor for the City of Scottsdale during the startup of the city’s 9-1-1 EMS system and was instrumental in the startup of the City of Surprise backup 9-1-1 service.

Adam’s interest and dedication to EMS stems from his father who has been a Paramedic in the Avondale/Goodyear areas in Central Arizona for 25 years.

Adam is an Arizona native who resides in Litchfield Park with his wife and two children.
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Reason for Nomination:

Adam Stockton’s accelerated growth trajectory within Maricopa Ambulance is evidence of his career potential to be a leader in the EMS industry. From day one, Adam’s dedication and talent was recognized by top leadership and promoted at the organization. Advancing from field employee to senior management in less than two years, Adam has risen to and exceed every challenge presented to him.

Adam Stockton was a member of the original team of employees that started up Maricopa Ambulance, an ambulance service created in 2016 to provide choice to medical facilities in Arizona’s most populous county. Starting as a Paramedic, Adam was promoted to Field Supervisor and them to Director of EMS for the West Valley 9-1-1 operations.

Adam was involved during the implementation and operation of three separate municipal contracts in the West Valley. Adam now oversees a 9-1-1 service area with 15 ambulances and more than 105 employees. Through these West Valley 9-1-1 operations, Maricopa Ambulance now provides 9-1-1 service to more than 460,000 residents.

Priority Ambulance West Regional President says of Adam:

“Adam exemplifies accountable leadership. He is not afraid of making decisions and has grown tremendously across multiple functional areas in the last year.”

Maricopa Ambulance Director of New Business Development says of Adam:

“When a new Director of EMS, West Valley position needed to be filled, it was clear it required an individual who would be diligent, accountable, and demand excellence from the workforce, while representing Maricopa Ambulance in a professional manner. It did not take long to realize Adam was the person best-suited to fill this position. The respect, trust and confidence these fire departments have in Adam speak volumes and are a direct result of his hard work and commitment to delivering the highest level of patient care and customer service.”

Adam was selected for the 2020 class of the Priority Ambulance Leadership Foundation’s EMS Leadership of Tomorrow program, a year-long accelerated EMS executive course.

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View all of the 2020 Mobile Healthcare 40 Under 40 Honorees

House Holds Hearing on Veterans Choice Program

Written by Todd Tuten on . Posted in Government Affairs, Legislative, News, Veterans Affairs.

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 veterans whose episodes of care would extend beyond the August 7 expiration date (e.g., pregnancy).

Secretary Shulkin also urged Congress to support the VA’s efforts to bring appointment scheduling in-house for care coordination purposes. However, the VA OIG witness noted challenges in records going out to community-based providers and coming back to the VA. The GAO witness also underscored the need for the VA to have better systems in place in order to effectively coordinate care, which will take time to procure and implement. Rep. Brownley (D-CA) echoed that point, calling the VA’s information technology systems a “Model T in a Tesla world.” Rep. Esty (D-CT) also urged improvements in the VA’s information systems and expressed concern that veterans are being improperly billed.

Other Members, including Rep. Wenstrup (R-OH) and Rep. Poliquin (R-ME), raised concerns about continuing delays in the processing of claims and payments to providers. Secretary Shulkin agreed that providers deserve to be paid for their services, noting his own experience as a physician in the private sector. He acknowledged that the VA is not processing enough claims electronically today, and he advised that he plans to pursue options outside the VA for systems procurement going forward.

Many Members also raised serious concerns about treatment of PTSD and mental health conditions for veterans, including Rep. Wenstrup (R-OH), Rep. O’Rourke (D-TX), Rep. Sablan (D-MP), Rep. Banks (R-IN), Rep. Rutherford (R-FL) and Rep. Takano (D-CA). Rep. O’Rourke emphasized that suicide among veterans is the most serious crisis, and Secretary Shulkin agreed that it is his number one priority. The Secretary announced that the VA will begin providing urgent mental health care that also will include individuals other than those service members who were honorably discharged. He added that the VA needs 1,000 more mental health providers, as well as telemental health services, and is looking to expand community partnerships to address suicide.

Rep. Banks noted interest among Indiana veterans in greater access to alternative treatments for PTSD and traumatic brain injury. Secretary Shulkin underscored that he is “most concerned about areas like PTSD, where we do not have effective treatments.” He also advised that the VA has established an “Office of Compassionate Innovation” (separate from the VA’s Center for Innovation), which will focus on finding new approaches to health and physical wellness and explore alternative treatment options for veterans when traditional methods fall short.

Rep. Wenstrup inquired about the VA’s GME and residency programs, as well as its associations with academic institutions. Secretary Shulkin responded that the VA is “doubling down” on partnerships with academic medical institutions.

Chairman Roe concluded his remarks by emphasizing the need to extend the Choice Program authorization soon and to consolidate the VA’s community-based care programs. He also expressed support for the VA’s decision to stop developing its own information technology internally.

Medicaid Waivers to End Coverage of Non-Emergency Transportation

Written by David Werfel on . Posted in Medicaid, Medicare, Reimbursement.

By David M. Werfel, Esq | AAA Medicare Consultant
Updated February 16, 2016

Federal law requires that state Medicaid programs cover necessary transportation to and from health care providers in order to ensure access to care. However, as a result of Medicaid expansion under the Affordable Care Act and cost increases, recently, a few states have asked CMS to waive the requirement for non-emergency transportation so they can end coverage of non-emergency transportation.

CMS granted waivers to Iowa and Indiana. Pennsylvania received permission, but the subsequent change in the governor’s office altered the state’s expansion plans and state officials ultimately chose not to use it. Arizona has a pending request to provide prior authorization.

When Iowa was granted the waiver, a beneficiary survey was conducted to determine the impact on access to care. The survey found some beneficiaries with incomes under the poverty level did not have transportation to or from a healthcare visit. Other beneficiaries said a lack of transportation could prevent them from getting a physical exam in the coming year. However, CMS stated the cases of negative impact were not statistically significant enough to discontinue the waiver.

As a result of the complaints, Sen. Ron Wyden (D-OR) and Sen. Frank Pallone, (D-NJ) asked the Government Accountability Office to investigate the impact of these waivers. The report is not expected in the near future. However, when issued, it could embolden other states to seek a waiver.

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