The 2022 Human Resources Toolkit includes the addition of numerous practice notes intended to provide EMS leaders with a more practical understanding of the legal principles that necessitate much of the language found in many of the sample policies in the HR Manual. Additionally, the practice notes provide suggestions for EMS agencies to better insulate the organization from legal liability.
The American Ambulance Association seeks member organization employees and consultants with grant-writing expertise who may be interested in writing or presenting to ambulance services. Ideally, we would like to develop a one-hour webinar for members that includes tips for finding and winning grants of all kinds ( Assistance to Firefighter Grants, SAMHSA/ SIREN Act, local, non-profit, etc). If you may be interested, please contact ariordan@ambulance.org! Thank you for your support and participation.
“Locality” Rule – MAC Discretion – Since the inception of the CMS Internet Only Manual (in 2003), the Benefit Policy Manual 100-02, Chapter 10, section 10.3.5 has always defined “Locality” as:
The term “Locality” with respect to ambulance service means the service area surrounding the institution to which individuals normally travel or are expected to travel to receive hospital or skilled nursing services.
An example is then listed to indicate that the ambulance transportation to either of two large metropolitan hospitals that regularly provide services to the small community where the emergency arose would be covered destinations.
On June 16, 2017, CMS issued Transmittal 236 to add the following at the end of the paragraph before the example:
The MAC’s have the discretion to define locality in their service areas.
Effectively, there is no change as Carriers and Intermediaries (now MACs) have always had discretion to determine the “locality” around each facility. Often, they did this with mileage edits, e.g. in an urban area, they may have set a parameter of 15 miles, but in a rural area, they have allowed a much larger area. Nevertheless, it is a good time to ask your MAC for their definitions of the localities in their service area or the mileage edits that they use.
A copy of the Transmittal can be obtained at: https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R236BP.pdf
ALS Assessment
The same Transmittal made two changes to the CMS definition of “ALS Assessment”, as listed in the Benefit Policy Manual, 100-02, Chapter 10, section 30.1.1, as follows:
1. Assuming the ALS assessment is performed and meets the definition, this section now states that the services provided by the supplier or provider “shall” be covered at the ALS emergency level. Previously, the definition indicated the services “may” be covered at the ALS emergency level. This change was needed as some MACs thought they did not have to pay ALS emergency when the ALS assessment is performed in accordance with the definition.
2. The other change was to add to the end of the paragraph “and all other coverage requirements are met”. In other words, aside from providing the ALS assessment in accordance with the definition, there must also be ambulance transportation, the origin/destination requirements are met, the provider/supplier must meet all vehicle and crew requirements, transportation was medically necessary, the ALS assessment was medically necessary, etc.
The effective date for the changes noted above is September 18, 2017.
Introducing the AAA’s newest member benefit, StateTrack, powered by CQ Roll Call. StateTrack will give AAA members the ability to easily track crucial legislation and regulations in one state or all of them as well as the Federal Government.
StateTrack will show you a map of the entire United States. Click on the state you are interested in tracking and you will see a list of all regulations and legislation impacting the following areas:
► Affordable Care Act
► Ambulance
► Community Paramedicine
► EMT
► Medicaid
► Medicare
► Mobile Integrated Health
► Paramedic
Click on the key words above to narrow down your search to only legislation and regulations that contain those terms.
Please contact Aidan Camas at acamas@ambulance.org if you have any questions.
Enhance employee health and engagement by making sure your workforce is aware of the LifeWorks Employee Assistance and Wellness Program. The LifeWorks program is centered around helping your employees achieve work-life balance, improving their productivity and well-being.
We all face challenges in life. From finding answers to parenting questions or managing personal finances, to getting help with a relationship or taking care of health issues, LifeWorks offers around the clock fast, free, confidential help.
AAA understands that your people are your most valuable asset. Make sure your employees are aware of this resource for fast, confidential help with family, work, money, health and work-life balance issues. Share AAA’s EAP with your team.
Share Lifeworks with Your Team Today!
Most of us find our jobs stressful at times. Often these feelings are temporary, but sometimes negative emotions linger and may begin to affect your job performance, your relations with others, or even your health and well-being. Learning to manage challenging emotions at work takes effort, but the payoff is big. When we deal with problems before they overwhelm us, we can contribute more to our team and gain a greater sense of control and effectiveness — both at work and outside of work. You can take steps to become more aware of your emotions and to manage them more effectively. If you are feeling stressed at work, the following tips can help you cope:
For support and more ideas on managing stress and other emotions at work, get in touch with LifeWorks—call to speak with a caring, professional consultant anytime, 24/7. LifeWorks is completely confidential and it’s provided to you at no cost. You can also go to www.lifeworks.com to explore our online resources—short videos, podcasts, and a wide range of articles including:
Call LifeWorks at 888-267-8126 or visit www.lifeworks.com (username: theaaa; password: lifeworks)