Rural Health Day Advocacy Update

Happy National Rural Health Day! Thank you to all of the ambulance service providers who work hard providing life-saving treatment in rural areas every day. In part of our ongoing advocacy efforts, the AAA sent a letter today to the Rural Caucuses in the United States Senate and House of Representatives. Addressed to leadership of the caucuses, Sen. Pat Roberts (R-KS), Sen. Heidi Heitkamp (D-ND), Rep. Adrian Smith (R-NE), and Rep. Tim Walz (D-MN), this in-depth letter highlights the critical work that our members do every day around the country and raises important issues affecting the industry. Issues covered in the letter include: Stabilizing the Ambulance Fee Schedule Make the add-ons permanent and build them into the base rate Use new data from the ambulance cost collection program to ensure reimbursement is adequate going forward New data should be used to assess the problems with the current ZIP-code methodology for determining rural and super-rural services Ambulance Fee Schedule Reform Proposed alternative models for rural ambulance services Encouraging Congress to look at alternative destination options for ambulance service providers Recognizing Ambulance Services as Providers of Health Care Moving non-fire-based ambulance services from suppliers to providers under Medicare The letter also highlights...

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Government Affairs Update

Government Affairs Update: What We’re Working On The AAA continues to press policy initiatives with Congress and the Administration that are important to our members. While not as high-profile as our successful efforts earlier this year on the five-year extension of the Medicare ambulance add-ons, the AAA is working hard on ambulance legislation and regulations that impact the EMS industry and ambulance services across the country. Here is a snapshot of those current efforts. Over the next month, we will be providing weekly in-depth updates highlighting these issues. Ambulance Cost Data Collection System The AAA was successful in getting our preferred language of an ambulance cost data collection system using a survey and random sample methodology included with the extension of the add-ons in the Bipartisan Budget Act of 2018. However, that was just the first key step in the process. We now need to ensure that CMS gets the details right as the agency develops the structural specifics and data elements for the system. It is critical that the system is designed in a way that ambulance service suppliers and providers will submit the most accurate data possible. The data will ultimately provide the information necessary for Congress, the...

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CMS Non-Emergency Ambulance Transport Open Door Forum 7/26

CMS Issues Data Elements and Templates for Non-Emergency Ambulance Transports (NEAT): Open Door Forum for Thursday, July 26, 2018 Just Announced As part of its Patients Over Paperwork Project, the Centers for Medicare & Medicaid Services (CMS) Provider Compliance Group (PCG) has been hosting quarterly listening sessions and reviewing the Request for Information submissions. The American Ambulance Association has been actively engaged in these efforts, highlighting the recommendations we submitted to CMS and the House Ways & Means Committee last year. These recommendations included suggestions as to how CMS could streamline regulatory requirements to eliminate duplicative requirements and reduce regulatory burdens.  In addition to these efforts, CMS has been working to standardize documentation data elements and establish templates that providers and suppliers can use to help make the current documentation processes less burdensome as well. On July 24, CMS released draft documentation-related clinical data elements and clinical templates that could be used for the Physician Certification Statement, Progress Notes, and Prior Authorization requests. View the Documents. These documents are not intended to change current law. CMS also announced yesterday that it will discuss the templates on a Special Open Door Forum which is scheduled for July 26 at 2-3 pm ET. ...

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White House Memorandum on 2-for-1 Regulatory Order

On January 30, 2017, the Trump administration published Executive Order 13771 “Reducing Regulation and Controlling Regulatory Costs” which requires federal agencies to identify two rules for elimination for each new regulation issued. On April 5, 2017, the White House released a memorandum providing additional guidance on the implementation of Executive Order 13771. This memo supplements Office of Management and Budget (OMB) interim guidance issued on February 2, clarifies how agencies can comply with the order and explains which new regulations must be offset. The memo also notes that federal spending regulatory actions that cause only income transfers between taxpayers and beneficiaries (such as regulations associated with Medicare spending), and those that establish new fees or penalties without imposing any new costs, do not need to be offset. The AAA will continue to monitor this executive order and keep you informed. Read the full Memorandum...

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AAA Issues Response to GAO Claims Report

On May 13, the Government Accountability Office (GAO) issued a report entitled “Claim Review Programs Could Be Improved with Additional Prepayment Reviews and Better Data“. In the report, the GAO recommended that CMS be provided legislative authority to allow Recovery Auditors to use prepayment claims reviews to address improper Medicare payments. CMS fortunately disagreed with the GAO on the recommendation and cited better options such as prior authorization to address potentially improper payments. The AAA has now issued a Formal Statement in response to the GAO report noting the problems with prepayment claims review for ambulance services and promoting the better alternative of prior authorization for nonemergency BLS transports of dialysis patients. The statement is in follow up to our Member Advisory providing an in-depth review of the report. Please feel free to share the statement if you receive questions about the report. On June 26, 2015, the AAA had participated in a conference call with the GAO officials conducting the report in which AAA representatives had pushed for recommendations in line with our statement. The AAA will continue to advocate for policies to address improper payments that address the issue but are also the least burdensome to AAA members (more…)

FLSA – New Overtime Rule Takes Effect December 2016

Last October, the American Ambulance Association published an article notifying its members about the proposed changes to the Fair Labor Standards Act (FLSA). Employers have been waiting anxiously for the Final Regulation to be published. On May 17, 2016, the White House published a Fact Sheet regarding changes to the Regulations that will become effective December 1, 2016. As a result, overtime protections are being extended to 4.2 million workers who are currently exempt. The new rule, which will be published May 18, 2016 will bring the first updates to the FLSA since 2004. There will be significant changes, including increasing the threshold salaries levels for both the standard and highly compensated employees (HCE) and includes regular automatic adjustments to those levels every three years thereafter. The impetus of the changes to the law were prompted by President Obama in March 2014 when he directed the Secretary of Labor to Update and Modernize Overtime Regulations for the Fair Labor Standards Act (FLSA). The FLSA provides basic rights and wage protections for American workers, including Federal minimum wage and overtime requirements. Specifically the memorandum stated that the “regulations regarding exemptions from the Act’s overtime requirement, particularly for executive, administrative, and professional...

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