Permanent Medicare Ambulance Relief Bill Introduced in House

Moments ago, Congresswoman Terri Sewell (D-AL) and Congressman Devin Nunes (R-CA) introduced the Medicare Ambulance Access, Fraud Prevention, and Reform Act of 2019 (H.R. 4938). Congressmen Peter Welch, (D-VT), Markwayne Mullin (R-OK), and Earl Blumenauer (D-OR) are original cosponsors of the legislation. Thank you to the bill sponsors for their continued support! H.R. 4938 would help stabilize current and future Medicare reimbursement of ambulance services and set the stage for future reform of the Medicare ambulance fee schedule. If passed, this bill would: Make Medicare Add-ons Permanent – Current temporary 2 percent urban, 3 percent rural, and super rural bonus payments would be made permanent. Expand Prior Authorization Pilot Program Nationwide – To address fraud and abuse with the transportation of dialysis patients by ambulance, the bill expands the Centers for Medicare & Medicaid Services (CMS) national prior authorization program for repetitive non-emergency basic life support (BLS) dialysis transports. CMS has not yet exercised its authority to expand this successful pilot program nationwide. While CMS is considering exercising its authority to extend the program nationwide in a recent proposed rule, it has not made a final determination yet. Provide Regulatory Relief – Amend requirements under the 855 form to make (more…)

Update on AAA Legislative Priorities

The American Ambulance Association has been working hard to accomplish the legislative goals of the membership in the 116th Congress. The AAA would like to take this opportunity to provide an update on what we have accomplished thus far in the 116th Congress. Balance/Surprise Billing Balance/surprise billing is a hot button issue that recently came into the spotlight at the start of the 116th Congress. With the President’s announcement calling for Congress to pass legislation that would end surprise billing for patients, there has been an increase in Congressional action on the issue including introduced legislation, discussion drafts and hearings in all committees of jurisdiction. The AAA has been working tirelessly with the Congressional committees of jurisdiction to educate Members and staff on the unique characteristics of EMS systems and that it would be inappropriate to apply the same restrictions on balanced billing to ground ambulance services. The AAA has formed a working group comprised of AAA member volunteers that have worked on policy and messaging on balance billing. The working group has submitted comments to the Energy and Commerce Committee and Senate HELP committees advocating that the ambulance industry is unique from other stakeholders, and as such, should be looked (more…)

2019 AAA Legislative Awards

The American Ambulance Association is proud to announce the winners of the 2019 AAA Legislative Awards, in recognition of their strong advocacy for emergency medical services. Each legislator was chosen for their ongoing dedication to the ambulance services across the United States. 2019 AAA Legislator of the Year Representative Terri Sewell (D-AL) 2019 AAA Legislative Recognition Award Recipients Senators Senator Bill Cassidy, M.D. Senator Susan M. Collins Senator Chuck Grassley Senator Doug Jones Senator Patrick J. Leahy Senator Pat Roberts Senator Charles E. Schumer Senator Debbie Stabenow Senator Jon Tester Senator John Thune Senator Ron Wyden Representatives Representative Earl Blumenauer Representative Rosa DeLauro Representative Debbie Dingell Representative Richard Hudson Representative Darin LaHood Representative Markwayne Mullin Representative Richard E. Neal Representative Devin Nunes Representative Steve Scalise Representative Scott Tipton Representative Fred Upton Representative Greg Walden Representative Peter Welch Representative Lee Zeldin

House Introduces NEATSA Act Companion Bill (H.R. 3021)

House Introduces NEATSA Act Companion Bill (H.R. 3021) The American Ambulance Association (AAA) is pleased to announce that, Congressman Darin LaHood (R-IL) and Congresswoman Terri Sewell (D-AL) have introduced H.R. 3021 the “Non-Emergency Ambulance Transportation Sustainability and Accountability Act of 2019” or “NEATSA Act.” Last year, Congress included in the Bipartisan Budget Act of 2018 an offset to cover the cost of the 5 year extension of the add-ons. The offset cuts reimbursement for BLS non-emergency transports to and from dialysis centers by an additional 13%. This is on top of the preexisting 10% reduction. This legislation would restructure the offset so that a majority of the additional reduction would be focused on those ambulance service agencies in which 50% or more of their volume are repetitive BLS non-emergency transports to and from dialysis centers. H.R. 3021 is the reintroduction of H.R.6269 from last Congress. This legislation serves as a companion bill to the Senate version, S. 228 by Senator Cassidy (R-LA) and Senator Jones (D-AL) which was introduced in January 2019. The additional cut went into effect on October 1, 2018 and has since negatively impacted AAA members. As such, the AAA is grateful for the support of Congressman LaHood...

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Senate Introduces S. 228

Last year, Congress included in the Bipartisan Budget Act of 2018 an offset to cover the cost of the 5 year extension of the add-ons. The offset cuts reimbursement for BLS nonemergency transports to and from dialysis centers by an additional 13%. This is on top of the preexisting 10% reduction. The AAA is pleased to announce that Senators Bill Cassidy (R-LA) and Doug Jones (D-AL) have recently introduced S. 228 which would restructure the offset so that a majority of the additional reduction would be focused on those ambulance service agencies in which 50% or more of their volume are repetitive BLS nonemergency transports to and from dialysis centers. S. 228 is the reintroduction of S. 3619 from last Congress which served as a companion bill to the House version, the NEATSA Act (H.R.6269), by Congressman LaHood (R-IL) and Congresswoman Sewell (D-AL) which was introduced in June 2018. AAA staff and volunteer leaders are working to get a House version of this legislation reintroduced shortly. The additional cut went into effect on October 1, 2018 and negatively impacted AAA members. The AAA is working to help pass this legislation and we will keep members updated as this legislation moves through (more…)

Senate Introduces NEATSA Act Companion Bill (S. 3619)

Earlier this year, Congress included in the Bipartisan Budget Act of 2018 an offset to go along with the extension of the add-ons that will cut reimbursement for BLS nonemergency transports to and from dialysis centers by an additional 13%. This will be on top of the existing 10% reduction. Senators Bill Cassidy (R-LA) and Doug Jones (D-AL) just introduced S. 3619 which would restructure the offset so that a majority of the additional reduction would be focused on those ambulance service agencies in which 50% or more of their volume are repetitive BLS nonemergency transports to and from dialysis centers. S. 3619 will serve as a companion Bill to the House version, the NEATSA Act (H.R.6269) by Congressman LaHood (R-IL) and Congresswoman Sewell (D-AL) which was introduced in June 2018. The additional cut went into effect on October 1 and impacted AAA members and the AAA are working to get this legislation passed. The AAA will be sure to keep members updated as this legislation moves through Congress. Questions?: Contact Us If you have questions about the legislation or regulatory initiatives being undertaken by the AAA, please do not hesitate to contact a member of the AAA Government Affairs (more…)

Talking Medicare: CMS Implements Further Dialysis Cuts

Talking Medicare: CMS Implements Further Cuts in Reimbursement for Dialysis Services; Medicare Payment Data Shows Continued Reduction in Overall Spending on Dialysis Transports, but Net Increase in Dialysis Payments in Prior Authorization States On October 1, 2018, CMS implemented an additional thirteen (13%) cut in reimbursement for non-emergency BLS transports to and from dialysis. This cut in reimbursement was mandated by Section 53108 of the Bipartisan Budget Act of 2018. This on top of a ten (10%) cut in reimbursement for dialysis transports that went into effect on October 1, 2013. As a result, BLS non-emergency ambulance transports to and from dialysis that occur on or after October 1, 2018 will be reimbursed at 77% of the applicable Medicare allowable. The payment reduction is partially the result of the reduction in the amounts paid for dialysis services. However, it is also reflective of an overall decline in the number of approved dialysis transports. For this, we can look primarily to the impact of a four-year demonstration project that requires prior authorization of dialysis transports in 8 states and the District of Columbia. As a reminder, the original prior authorization states were selected based on higher-than-average utilization rates and high rates of...

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