2017 AAA Legislative Awards

The American Ambulance Association is proud to announce the winners of the 2017 AAA Legislative Awards, in recognition of their strong advocacy for emergency medical services. Each legislator was chosen for their ongoing service to the ambulance services of the United States. 2017 AAA Legislator of the Year Senator Susan Collins (R-ME) – Press Release, Facebook Post, Twitter Post 2017 AAA Legislative Recognition Award Recipients Senators Sen. Richard Burr (R-NC) – Press Release Sen. Bill Cassidy (R-LA) – Press Release Sen. Orrin Hatch (R-UT) – Press Release Sen. Patrick Leahy (D-VT) – Press Release Sen. Pat Roberts (R-KS) – Press Release Sen. Charles Schumer (D-NY) – Press Release Sen. Debbie Stabenow (D-MI) – Press Release Sen. Jon Tester (D-MT) Sen. Ron Wyden (D-OR) – Press Release Representatives Rep. Kevin Brady (R-TX) – Press Release Rep. Mike Coffman (R-CO) – Press Release Rep. Gregg Harper (R-MS) Rep. Richard Hudson (R-NC) – Press Release Rep. Kenny Marchant (R-TX) Rep. Markwayne Mullin (R-OK) Rep. Richard Neal (D-MA) Rep. Devin Nunes (R-CA) – Press Release Rep. Erik Paulsen (R-MN) Rep. Peter Roskam (R-IL) – Press Release Rep. Mike Thompson (D-CA) Rep. Pat Tiberi (R-OH) – Press Release Rep. Fred Upton (R-MI) Rep. Greg Walden (R-OR) Rep. Peter Welch (D-VT)...

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The Future of Prior Authorization

In May 2014, CMS announced the creation of a three-year demonstration project that calls for the prior authorization of repetitive scheduled non-emergency ambulance transports. The demonstration project was first implemented in the states of New Jersey, Pennsylvania, and South Carolina. These states were selected based on their higher-than-average utilization rates for repetitive ground ambulance transportation. For example, in a June 2013 report to Congress, the Medicare Payment Advisory Commission (MedPAC) cited these states as having particular high utilization rates for dialysis transports. Prior authorization went live in these states on December 15, 2014. Congress Acts to Expand the Prior Authorization Regime On April 16, 2015, President Barack Obama signed into law the Medicare Access and CHIP Reauthorization Act of 2015. Section 515 of that law required CMS to expand the demonstration program into five additional states (Delaware, Maryland, North Carolina, Virginia, and West Virginia) and the District of Columbia on or before January 1, 2016. The law further instructed CMS to expand the prior authorization regime to the rest of the country beginning no earlier than January 1, 2017. However, the national expansion was conditioned on CMS determining that the demonstration project has been effective in reducing Medicare expenditures without...

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Van Arnam Retires From AEV, Will Head CAAS GVS

Mark Van Arnam, founder and CEO of American Emergency Vehicles, has announced his retirement from the North Carolina based manufacturer of ambulances. “It is extremely difficult to leave AEV,” stated Van Arnam. “But, the company is performing well, and is run by a strong team.” Mark has been in the ambulance business for over 45 years, and is looking forward to some new challenges. First on his list of projects is the implementation of the new Ground Vehicle Standard (GVS v.1.0), scheduled to be published in February by the Commission on Accreditation for Ambulance Services (CAAS). “Our broad based GVS committee spent over two years developing this new consensus standard for ambulances,” stated Van Arnam, who served as Vice Chair of the Committee. “We are very proud of our document, and anxious to roll it out as a successor to the KKK-A-1822 standard which the US Government will sunset in the near future.” CAAS is an ANSI accredited organization that defines the “gold standard” for operations in the medical transportation industry. “CAAS is very excited about the Ground Vehicle Standard project,” stated Mark Postma, CAAS Chair. “We have now created the gold standard for emergency medical vehicles, intended for use by all types of providers in the broad spectrum (more…)

Palmetto Announces Prior Authorization Workshops

Palmetto GBA asked AAA to share the following announcement with our members.   Repetitive Scheduled Non-Emergent Ambulance Transportation Documentation Requirements—North Carolina Palmetto GBA will hold Repetitive Scheduled Non-Emergent Ambulance Transportation Prior Authorization Demonstration face-to-face workshops in North Carolina for ambulance providers providing repetitive scheduled non-emergent transports to familiarize them with The Centers for Medicare & Medicaid Services (CMS) demonstration currently going on in South Carolina. These workshops are designed to familiarize providers, whose ambulances are garaged in potential demonstration expansion states, with demonstration requirements including the process of submitting a prior authorization request, billing for repetitive scheduled non-emergent ambulance transports under the repetitive scheduled non-emergent transportation demonstration, as well as common errors identified during the demonstration in South Carolina. Each event will include a question and answer period at the end of the formal presentation. Background Information The purpose of the current prior authorization demonstration is to ensure that beneficiaries continue to receive medically necessary care while reducing expenditures and minimizing the risk of improper payments to protect the Medicare Trust Fund by granting provisional affirmation for a service prior to submission of the claim. Prior authorization allows providers and suppliers to address issues with claims prior to rendering services (more…)

Summary of CMS Ambulance Open Door Forum of November 5, 2015

By David M. Werfel, Esq. | Updated November 6, 2015 On November 5, 2015, the Centers for Medicare and Medicaid Services (CMS) conducted its latest Ambulance Open Door Forum.  As usual, CMS started with announcements, which were as follows: As required under the Medicare Access and CHIP Reauthorization Act (HR 2), the pilot program for prior authorization for non-emergency repetitive patients will be expanded to Delaware, the District of Columbia, Maryland, North Carolina, Virginia and West Virginia, effective January 1, 2016.  A Special Open Door Forum on the topic will be held by CMS on November 10, 2015 from 12:30 to 1:30 pm. (Link to PDF). Payment Policies On October 30, CMS released the final rule on changes in CY 2016 to the Medicare ambulance fee schedule.  The final rule will be published in the Federal Register on November 16, 2015.  The rule finalizes the following: The 2% urban, 3% rural and 22.6% super rural adjustments have been extended through December 31, 2017. Urban/Rural Designations – CMS will continue in 2016 and thereafter with the current geographic designations of urban and rural that were implemented on January 1, 2015. CMS also stated the Agency is further reviewing those zip codes...

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Prior Auth Expansion to MD, DE, DC, NC, VA, WV

CMS Announces Expansion of Prior Authorization Program for Repetitive Scheduled Non-Emergent Ambulance Transports October 26, 2015 CMS has announced that consistent with the requirements of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), it will expand the current prior authorization demonstration program for repetitive scheduled non-emergent ambulance transports beginning on January 1, 2016, to Maryland, Delaware, the District of Columbia, North Carolina, Virginia, and West Virginia. The current demonstration program is operating in three states (New Jersey, Pennsylvania, and South Carolina). The demonstration seeks “to test whether prior authorization helps reduce expenditures, while maintaining or improving quality of care, using the established prior authorization process for repetitive scheduled non-emergent ambulance transport to reduce utilization of services that do not comply with Medicare policy.” The Agency reiterates that the prior authorization process does not create new clinical documentation requirements. Requesting a prior authorization is not mandatory, but CMS encourages ambulance services to submit a request for prior authorization to their MACs along with the relevant documentation to support coverage. If an ambulance service does not request prior authorization, by the fourth round-trip in a 30-day period, the claims will be stopped for pre-payment review. To be approved, the request...

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Novitas Issues Guidance for Ambulance Providers, Facilities and Beneficiaries Regarding Expansion of Prior Authorization Project for Repetitive Patients

September 17, 2015 Novitas Solutions, Inc. (Novitas) recently issued a series of guidance documents on the expansion of the prior authorization demonstration project for repetitive scheduled non-emergency ambulance transports. This demonstration project is currently operating in the states of New Jersey, Pennsylvania, and South Carolina. The Medicare Access and CHIP Reauthorization Act of 2015 (Pub. Law 114-10), enacted on April 16, 2015, requires that this program be expanded into the remaining states of MAC Regions L (Delaware, Maryland, and the District of Columbia) and M (North Carolina, Virginia, and West Virginia), effective January 1, 2016. The program will be further expanded to cover all remaining states starting on January 1, 2017. Novitas is the Medicare Administrative Contractor for MAC Region L, and therefore will be responsible for implementing this program in Delaware, Maryland and the District of Columbia. These guidance documents are intended to educate ambulance services, health care professionals and facilities, and beneficiaries located in these states on the programs requirements. Guidance Document for Ambulance Services On August 17, 2015, Novitas issued a “Dear Ambulance Company” letter that provides guidance to ambulance companies on how the program will operate. As noted in the letter, participation is voluntary. However, ambulance services...

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