Federal District Court Judge Strikes Down the ACA

On December 14, 2018, a federal district court judge for the Northern District of Texas issued a ruling striking down the Affordable Care Act (ACA) on the grounds that the Individual Mandate was unconstitutional, and that the rest of the law cannot withstand constitutional scrutiny without the Individual Mandate. District Court Judge Reed O’Connor’s decision relates to a lawsuit filed earlier this year by 20 states and two individuals. The plaintiffs argued that the Tax Cuts and Jobs Act of 2017 — which amended the Individual Mandate to eliminate the penalty on individuals that failed to purchase qualifying insurance effect January 1, 2019 — rendered the Individual Mandate unconstitutional. The plaintiffs further argued that the Individual Mandate was inseverable from the rest of the ACA, and, therefore, that the entire ACA should be struck down. The defendants in this case were the United States of America, the U.S. Department of Health and Human Services (HHS), Alex Azar, in his capacity as the Secretary of HHS, and David J. Kautter, in his capacity as the Acting Commissioner of the Internal Revenue Service (IRS). 16 states and the District of Columbia intervened as additional defendants. In order to properly understand the district (more…)

CMS Extends Moratorium on Non-Emergency Ground Services

CMS Extends Temporary Moratorium on Non-Emergency Ground Ambulance Services in New Jersey and Pennsylvania On January 30, 2018, the Centers for Medicare & Medicaid Services (CMS) issued a notice in the Federal Register extending the temporary moratoria on the enrollment of new Medicare Part B non-emergency ground ambulance providers and suppliers in the states of New Jersey and Pennsylvania. The extended moratoria will run through July 29, 2018. Section 6401(a) of the Affordable Care Act granted CMS the authority to impose temporary moratoria on the enrollment of new Medicare providers and suppliers to the extent doing so was necessary to combat fraud or abuse. On July 31, 2013, CMS used this new authority to impose a moratorium on the enrollment of new ambulance providers in Houston, Texas and the surrounding counties. On February 4, 2014, CMS imposed a second moratorium on newly enrolling ambulance providers in the Philadelphia metropolitan areas. These moratoriums were subsequently extended on August 1, 2014, February 2, 2015, July 28, 2015, and February 2, 2016. On August 3, 2016, CMS announced changes to the moratoria on the enrollment of new ground ambulance suppliers. Specifically, CMS announced that: (1) the enrollment moratoria would be lifted for the...

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Is the TX Moratorium Ending?

Is CMS Ending the Temporary Moratorium on Enrollment of New Non-Emergency Ground Ambulance Providers in Texas? On September 2, 2017, the Centers for Medicare and Medicaid Services (CMS) posted a notice on its website that it was lifting the temporary moratorium on the enrollment of new Part B non-emergency ambulance suppliers in Texas, effective September 1, 2017.  CMS indicated that the lifting of this temporary moratorium was intended to aid in the disaster response to Hurricane Harvey. For reasons I will discuss in greater detail below, this explanation has struck a number of commentators as curious.  These commentators have speculated that this may notice may foretell a permanent elimination of the enrollment moratorium for non-emergency ground ambulance providers in Texas. Background on Temporary Moratorium on New Enrollments in Texas The Affordable Care Act granted CMS several new tools to combat fraud, waste, and abuse in the Medicare, Medicaid, and Children’s Health Insurance Programs.  This included Section 6401(a), which granted the CMS Secretary the authority to impose temporary moratoria on the enrollment of new Medicare, Medicaid, or CHIP providers to the extent the Secretary determined that doing was necessary to prevent fraud and abuse. The implementation of the first enrollment moratorium...

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CMS Lifts Moratorium Enrollment Non-Emergency Providers (TX)

In order to assist with the disaster response to Hurricane Harvey, CMS has announced that it has lifted the temporary moratorium on the enrollment of new Part B non-emergency ambulance suppliers in Texas, effective September 1, 2017. The lifting of this moratorium applies to new enrollments in Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP). CMS indicated that it will publish a notice in the Federal Register to formally announce the lifting of the moratorium. As a result, Part B ambulance suppliers that are not otherwise already enrolled as non-emergency ambulance provider in the State of Texas will be permitted to enroll in the Medicare Program. The lifting of the moratorium will also permit companies that are already enrolled as non-emergency ambulance suppliers to add additional practice locations throughout the state. CMS has indicated that both new enrollments and changes in enrollment to add additional practice locations will be subject to “high” screening under 42 C.F.R. §424.518(c)(3)(iii).

CMS Extends Moratorium on Non-Emergency Ground Ambulance

CMS Extends Temporary Moratorium on Non-Emergency Ground Ambulance Services in New Jersey, Pennsylvania, and Texas On July 28, 2017, the Centers for Medicare & Medicaid Services (CMS) issued a notice in the Federal Register extending the temporary moratoria on the enrollment of new Medicare Part B non-emergency ground ambulance providers and suppliers in the states of New Jersey, Pennsylvania, and Texas. The extended moratoria will run through January 29, 2018. Section 6401(a) of the Affordable Care Act granted CMS the authority to impose temporary moratoria on the enrollment of new Medicare providers and suppliers to the extent doing so was necessary to combat fraud or abuse. On July 31, 2013, CMS used this new authority to impose a moratorium on the enrollment of new ambulance providers in Houston, Texas and the surrounding counties. On February 4, 2014, CMS imposed a second moratorium on newly enrolling ambulance providers in the Philadelphia metropolitan areas. On August 3, 2016, CMS announced changes to the moratoria on the enrollment of new ground ambulance suppliers. Specifically, CMS announced that: (1) the enrollment moratoria would be lifted for the enrollment of new emergency ambulance providers and supplier and (2) the enrollment moratoria on non-emergency ambulance services...

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Alabama Governor Signs REPLICA Compact

Governor Kay Ivey recently signed into law Alabama’s REPLICA legislation, HB250. Alabama joins ten other states—Colorado, Texas, Virginia, Idaho, Kansas, Tennessee, Utah, Wyoming, Mississippi, and Georgia—in this forward-thinking interstate compact. REPLICA, the Recognition of EMS Personnel Licensure Interstate Compact,  recognizes the day-to-day movement of EMS personnel across state lines. It extends the privilege to practice under authorized circumstances to EMS personnel based on their home state license, as well as allows for the rapid exchange of licensure history between Compact member states.. Learn more about how REPLICA participation can help your state at http://www.emsreplica.org.

Congressman Kenny Marchant to Receive AAA Legislative Honor

Congressman Kenny Marchant to Receive AAA Legislative Recognition Award For Immediate Release Contact: Amanda Riordan ariordan@ambulance.org 703-610-0264 Washington, DC – The American Ambulance Association (AAA) will honor Congressman Kenny Marchant of Texas with a Legislative Recognition Award in appreciation of his advocacy for emergency medical services. Congressman Marchant will be presented this award in June in Washington, DC by AAA’s Texas Stars of Life—EMS personnel selected for their excellence and dedication. This year’s Stars from the Lone Star State are Chris Eachen of Paramedics Plus; Cindy Hitchcock of American Medical Response; Rhonda Dees-Lockwood, and Sloane Brown of Acadian Ambulance Service; and Thomas Faticone, Daniel Dormady, and Elizabeth Roden of MedStar Mobile Healthcare. Congressman Marchant was selected for the Legislative Recognition Award for his support of the Medicare ambulance temporary add-on increases and the super rural bonus payment. AAA President Mark Postma notes, “Congressman Marchant has been a trusted advocate for health care and emergency medical services, both in Texas and across our country.” Elected to the U.S. House of Representatives in 2004, Congressman Marchant represents Texas’s 24th congressional district. Congressman Marchant serves on the House Ways and Means Committee Subcommittees on Health and Tax Policy, as well as on the (more…)

REPLICA Compact Enacted

REPLICA Meets Goal, Interstate Compact Becomes Official May 8, 2017 For Immediate Release Contact: Sue Prentiss 603-381-9195 prentiss@emsreplica.org May 8, 2017 (Falls Church, VA). With the 10th member state enactment, the Recognition of Emergency Medical Services Licensure Interstate Compact (REPLICA) has become official. Governor Nathan Deal of Georgia signed Senate Bill 109 on today activating the nation’s first EMS licensure compact. States that have passed REPLICA to date include: Colorado, Texas, Kansas, Virginia, Tennessee, Idaho, Utah, Mississippi, Wyoming and Georgia. Released in 2014, REPLICA’s model legislation creates a formal pathway for the licensed individual to provide pre-hospital care across state lines under authorized circumstances. According to Keith Wages, president of the National Association of State EMS Officials (NASEMSO), “REPLICA represents a collective, nationwide effort to address the problems faced by responders when needing to cross state borders in the line of their duties.” Wages highlighted the compact’s abilities to “increase access to healthcare, reduce regulatory barriers for EMS responders, and place an umbrella of quality over cross border practice not previously seen in the EMS profession.” Wages also noted that the partnership with the National Registry of Emergency Medical Technicians (NREMT) has been essential during the advocacy and implementation phases. (more…)