Medicare Extender Update

As president of your association, keeping you informed of our advocacy efforts is one of my top priorities. In keeping with this approach, I would like to share with you an update on the American Ambulance Association’s latest efforts on Capitol Hill. The temporary Medicare ambulance increases are currently scheduled to expire on December 31, 2017. And once again, Congress is waiting until the last minute to extend them. Thankfully, a long-term solution is on the horizon. The House and Senate are in the process of negotiating the details of a Medicare provider extender package including our ambulance provisions. The House and Senate positions both include a five-year extension of the 2% urban, 3% rural, and super rural increases. Where their positions differ reflects the respective preferences of the Senate Finance and House Ways and Means Committees on how best to collect cost data from ambulance services suppliers and providers. The Senate position is based on a Senate Finance Committee Discussion Draft from October 26 which includes the five-year extension of the increases as well as a data collection system based on the one from the Medicare Ambulance Access, Fraud Prevention and Reform Act (S. 967). The provision would direct...

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Summary of December 2017 Ambulance Open Door Forum

On December 14, 2017, CMS held its latest Open Door Forum. As usual, it started with a few announcements, as follows: Ambulance Inflation Factor – CMS announced that it had published Transmittal 3893 on October 27, 2017, which sets forth the Ambulance Inflation Factor (AIF) for calendar year 2018. In that Transmittal, CMS indicated that the CY 2018 AIF would be 1.1%. This is based on an increase in the CPI-U of 1.6%, and a multi-factor productivity adjustment of 0.5%. Expiration of Temporary Adjustments – CMS indicated that the current temporary adjustments for urban (2%), rural (3%) and super rural ground ambulance transports are set to expire on December 31, 2017. CMS also indicated that they were aware of proposed legislation that would extend these adjustments for 2018 and beyond, but that they have yet to be enacted into law. CY 2018 Public Use File – CMS indicated that the Public Use File on its website has been updated to include Medicare allowables for 2018. CMS made a point of noting that the 2018 rates do not include the temporary adjustments, as they are set to expire on December 31, 2017. Prior Authorization Demonstration Project – CMS indicated that it...

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Act Now: Support 5 Year Medicare Add-on Extension

Take Action for Permanent Medicare Ambulance Relief Ask your Senators and Representatives to Support Medicare Ambulance Relief! The temporary Medicare ambulance increases of 2% urban, 3% rural and 22.6% to the base rate in super rural areas are scheduled to expire on December 31 of this year. That is just one month away! Please write your members of Congress today in support of a 5-year extension of the increases. Writing to your members of Congress only takes 2 clicks, follow these simple steps: 1. Enter contact information below (required by Congressional offices) and click “Submit” 2. On the next page you’ll see the letter to your Representative (Message 1) and the letter(s) to your Senators  (Message 2) – click “Submit Messages” Feel free to personalize your letter(s) before submitting them. Over the past 15 years, the AAA has lead efforts on Capitol Hill to establish the increases and ensure they do not expire.  Thanks to the work of our champions and supporters on Capitol Hill, there are provisions in both the House and Senate for a five-year extension of the Medicare ambulance increases.  However, passage of these provisions is in no way certain.  Your members of Congress need to hear that the (more…)

Senate Committee Draft Package with 5-year Ambulance Extender

Senate Committee Releases Draft Package with 5-year Ambulance Extender The Senate Finance Committee has released a discussion draft of its Medicare provider extender package. A five-year extension of the temporary Medicare ambulance add-ons and a modified version of the cost data collection provision from the Medicare Ambulance Access, Fraud Prevention and Reform Act (S. 967) are included in the package. The ambulance provisions being part of the package marks significant progress in the Senate toward a long-term extension of the add-ons and a model cost data collection system. A five-year extension of the 2% urban and 3% increases and the super rural bonus payment would provide approximately $1 billion in desperately needed Medicare relief for our industry. Having the increases in place for five years would give ambulance service suppliers and providers greater funding stability and help with long-term budgeting. There are now proposals in both the House and Senate with Committee backing which reflect a five-year extension of the add-ons. The five-year extension reflects the efforts of our champions in the Senate on S. 967. The cost data collection system is also from S. 967 with modifications. Instead of a random sampling of ambulance service providers and suppliers a (more…)

House Committee Passes Medicare Ambulance Relief Bill

House Committee Passes Medicare Ambulance Relief Bill On Wednesday, the House Ways and Means Committee voted out favorably an amendment in the nature of a substitute to the Comprehensive Operations, Sustainability, ant Transport Act of 2017 (HR 3729) by Congressman Nunes (R-CA) and Sewell (D-AL). H.R. 3729 would extend for five years the Medicare ambulance add-on payments of 2% urban, 3% rural and the super rural bonus. The legislation would also implement cost reporting for ambulance service suppliers. H.R. 3729 is a revised version of the Ambulance Medicare Budget and Operations Act  (HR 3236)introduced by Congressmen Nunes (R-CA), Upton (R-MI) and Welch (D-VT). While the AAA supports H.R. 3236, there were several changes made in H.R. 3729  that are concerning to the AAA. In particular, the addition of an offset which would implement an additional 13%* cut to BLS nonemergency transports to and from dialysis centers and a change in the penalty for not filing a time, complete and accurate cost report.  The AAA has therefore taken a neutral position on H.R. 3729 as we work with the House Ways and Means Committee and Congressmen Nunes and Sewell on modifications to the bill. This week, AAA Board Members and Volunteer Leaders were in DC and met with both sponsors (more…)

Summary of September 2017 Ambulance Open Door Forum

On September 14, 2017, CMS held its latest Open Door Forum. As usual, it started with a few announcements, as follows: “Locality” Rule – On 6/16/17 CMS issued Transmittal 236, to amend the Benefit Policy Manual, Chapter 10, section 10.3.5 to give Medicare Administrative Contractors discretion to determine the “locality”. This is for the issue of the nearest appropriate facility. ALS Assessment – The same Transmittal also amended section 30.1.1 to indicate that if an ALS assessment is performed, then the ALS emergency base rate shall be paid, even if there is no ALS intervention. Multiple Patient Transports – On 9/1/17, CMS issued Transmittal 3855 to restore to its Claims Processing Manual, Chapter 15, section 30.1.2 instructions for multiple patients transported in the same vehicle. This is not a change in policy. The section was inadvertently omitted from the Internet Only Manual. Temporary Adjustments – The 2%, 3% and 22.6% temporary adjustments for ground ambulance transports originating in urban, rural and super-rural areas will expire 12/31/17, unless legislation is enacted. Later on the call, they indicated that they are aware of a legislative initiative in Congress that includes this issue (S.967, H.R. 3236).        Following these announcements, a Q &...

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 VIDEO: Support Sustainable EMS Funding

EMS needs your support to survive! Learn from American Emergency Vehicles founder Mark Van Arnam what you can do to advocate for sustainable funding for ambulance services, then visit the AAA Advocacy page to reach out to your elected officials. (AAA is deeply grateful to REV Group, Inc. for developing this video.)

House Introduces H.R. 3236 – Write to Your Reps!

Take Action for Extending Medicare Ambulance Relief Ask your Representatives to Support H.R. 3236 – The Ambulance Medicare Budget and Operations Act of 2017 The current 33-month extension of the Medicare add-on payments is set to expire at the end of December 2017. Losing these add-on payments would be a devastating blow to ambulance services across the country. It is crucial that the payments be extended as we push for a long-term solution. H.R. 3236 introduced by Reps. Nunes, Upton, and Welch would extend the current temporary Medicare add-ons for five years. More details about the Bill can be found below. Let your Representative know that you support H.R. 3236 — Here are three quick and easy ways to get involved! Writing to your members of Congress only takes 2 clicks, follow these simple steps: 1. Enter contact information below (required by Congressional offices) and click “Submit” 2. On the next page you’ll see the letter to your Representative (Message 1) and the letter(s) to your Senators  (Message 2) – click “Submit Messages” Feel free to personalize your letter(s) before submitting them. Active on Social Media? Tweet at your Representative asking for their support of H.R. 3236! Authorize Your Account Enter Contact Information Tweet! (Tweet will be (more…)