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Tag: Senator Bernie Sanders (I–VT)

EMS ROCS Act Reintroduced in House and Senate

Senator Peter Welch (D-VT) and Senator Bernie Sanders (I-VT), alongside Representative Becca Balint (D-VT), have reintroduced the Emergency Medical Services Reimbursement for On-scene Care and Support (EMS ROCS) Act (S. 3730 / H.R. 7277). The bipartisan, bicameral legislation would require Medicare to reimburse EMS providers for medically necessary care delivered on scene, even when a patient is not transported to a hospital.

Under current Medicare policy, EMS agencies generally receive payment only when a patient is transported, despite the fact that EMS clinicians increasingly provide definitive assessment, stabilization, and treatment on scene. This issue is particularly acute in rural communities, where transport times are long, hospital access is limited, and Medicare beneficiaries account for a significant portion of EMS patients. As a result, EMS agencies are often delivering critical care without reimbursement.

Supporters argue that the EMS ROCS Act would modernize Medicare payment policy to better reflect contemporary EMS practice, support appropriate treatment-in-place, and reduce unnecessary hospital transports. The legislation is intended to help stabilize EMS agencies facing rising costs, workforce shortages, and growing volumes of non-transport care, challenges that have forced some rural providers to reduce services or shut down entirely.

The bill has multiple Senate cosponsors and is endorsed by the American Ambulance Association, the National Association of Emergency Medical Technicians (NAEMT), the National Rural Health Association, and the Vermont Ambulance Association, all of which emphasize that fair reimbursement for on-scene care is essential to preserving access to emergency medical services, particularly in rural and underserved communities.

Medicare Ambulance Relief Bill introduced in Senate

Yesterday, Senators Catherine Cortez Masto (D-NV) and Susan Collins (R-ME) introduced the Protecting Access to Ground Ambulance Medical Services Act of 2021 (S. 2037). Senators Cortez Masto and Collins were joined by Senators Debbie Stabenow (D-MI), Bill Cassidy (R-LA), Patrick Leahy (D-VT) and Bernie Sanders (D-VT) as primary cosponsors and leads on the legislation.

S. 2037 is identical to H.R. 2454 by Representatives Terri Sewell (D-AL), Devin Nunes (R-CA), Peter Welch (D-VT) and Markwayne Mullin (R-OK) and would extend the temporary Medicare ground ambulance increases of 2% urban, 3% rural and the super rural bonus payment for five years. The increases are currently scheduled to expire on December 31, 2022. The five-year extension would allow for the increases to remain in place during the two-year delay on ambulance data collection due to the COVID-19 public health emergency, an analysis of the data by MedPAC and subsequent action by the Congress to reform the Medicare ambulance fee schedule.

The legislation would also help ensure that rural zip codes in large urban counties remain rural following geographical changes under the fee schedule as a result of the 2020 census data. The current definition using rural urban commuting areas (RUCA) in Goldsmith Modification areas would be modified for zip codes with 1,000 people or less per square mile would also be rural. Ground ambulance service providers and suppliers could also petition the Centers for Medicare and Medicaid Services (CMS) to make the argument that a specific zip code should be rural. It is vital that this provision be implemented before CMS makes changes from the 2020 census data which will likely occur in 2023.

The AAA has been leading the effort on the legislation with the support of the International Association of Fire Chiefs, International Association of Fire Fighters, National Association of EMTs, National Rural Health Association and the National Volunteer Fire Council.

The AAA will be launching a Call to Action shortly requesting AAA members to ask their Senators to cosponsor S. 2037, and reach out to their Representatives to cosponsor H.R. 2454 if they have not already done so.

We greatly appreciate the leadership of Senators Cortez Masto, Collins, Stabenow, Cassidy, Leahy, and Sanders on this vitally important legislation.

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