Tag: Texas

Status of the American Health Care Act

Today, citing “growing pains” of his Republican majority, Speaker Paul Ryan (R-WI), in consultation with President Donald Trump, determined not to proceed with a planned vote on the American Health Care Act (AHCA), which repealed and replaced important elements of the Affordable Care Act (ACA).  The Speaker indicated that the House Republican Caucus “came up short” in the number of votes needed for the bill.  House Republican Leadership had been moving AHCA through the Chamber at a rapid pace.  The bill was officially released on March 6, and had been changed several times to try to appease various conservative and moderate voting blocs within the Republican Caucus.  The Congressional Budget Office (CBO) originally estimated the bill would reduce federal deficits by $337 billion, and subsequently downgraded the deficit reduction to $150 billion based on additional substantive policy changes to the bill.  The CBO estimates the bill would have increased the country’s number of uninsured by about 24 million people.

In negotiating the provisions of AHCA, the House Republican Leadership had faced a constant seesaw, as efforts to appease one ideological bloc upset the other.  Ultimately, throughout the day in advance of the scheduled vote, an increasing number of moderate Republicans, including Appropriations Committee Chairman Rodney Frelinghuysen (R-NJ), announced they would vote against the bill.  As the moderates disappeared, not enough members of the conservative Freedom Caucus decided to support the bill.

As disarray in the House Republican Caucus occurred, there appeared to be a similar lack of consensus amongst their Republican colleagues on the Senate side.  While Senate Leadership had planned to move the bill directly to the Senate floor as fast as within a week of receipt from the House, there were a number of Senators from a range of political perspectives with serious concerns about the bill.  On one side of the Republican spectrum, Senators Rand Paul (KY), Mike Lee (UT) and Ted Cruz (TX) had planned to push the limits of what can be included in a reconciliation bill to make it more conservative. Senator Paul had advocated for repealing the ACA in full and dealing with the replacement later on. On the other side, more moderate or “purple state” Members like Senators Susan Collins (ME), Lisa Murkowski (AK), Rob Portman (OH), Cory Gardner (CO) and Dean Heller (NV) raised concerns about insurance affordability and the expedited rollback of Medicaid expansion in the House version of the bill. Other Senators who will likely play a prominent role in any further health reform developments include physician Senator Bill Cassidy (LA), and Senator Tom Cotton (AR), who advocated all along to slow the process down. Republicans can only lose two Senators and still pass any health reform bill, with the vote of Vice President Mike Pence breaking the tie.

As a next step, House and Senate Republican Leadership plan to take more time to develop consensus in any future approach to health reform.  How much time is unclear – but it seems unlikely the bill will be the legislative focus in the short term.  Instead, there will likely be a cooling-off period on health reform legislative activity, since the fundamental disagreements within the caucus are not easily fixed.  There will continue to be significant messaging against ACA from conservatives, and there is the potential that the idea of “repeal and delay” may gain more traction.  Nonetheless, in the short term, the Speaker indicated he would move on to other items on his conference’s agenda – including tax reform.  Keep in mind, however, that since health-related tax provisions are a major component of the tax code, it would not be surprising to see some health issues resurface in tax reform.

The Speaker indicated that he expects the ACA marketplace to get worse – specifically citing rising premium costs.  In his own remarks on the failure to pass AHCA, the President suggested the Democrats will own any rising premiums, and provided a rare moment of optimism for the day when he indicated that a bipartisan health care reform bill may be achievable in the future when that happens.   As the Legislative Branch takes time to develop consensus, more focus will be placed on the Executive Branch.

We expect HHS Secretary Tom Price and White House Budget Director Mick Mulvaney to take an increasingly important role in driving the health agenda.  It is unclear at this point whether the Trump Administration will let ACA drift in the wind, take administrative actions to try to improve the marketplace, or even actively work to derail it further.  A likely bellwether as to the Administration’s intent is how it approaches the pending litigation over cost-sharing reduction (CSR) subsidies.  The House had sued the Obama Administration over the program, which funnels federal dollars to insurers to help keep out-of-pocket costs manageable for lower-income individuals, saying the funding had to be appropriated.  But after the inauguration, the House and Trump Administration sought a stay of the case until May 22 to allow time to resolve the issue.  If the Administration agrees to fold, the subsidies would be cut off, leading to further market instability.  If the House folds, the CSR payments would continue into the indefinite future.

From a health care legislative perspective, 2017 will still be far from a quiet year.  The President has proposed significant changes in the funding levels of important discretionary health programs.  Those budget battles will now move more front and center on the legislative agenda.  Furthermore, there continue to be “must pass” pieces of health care legislation, including CHIP reauthorization, FDA User Fee legislation, and certain Medicare extenders legislation.

House Holds Hearing on Veterans Choice Program

The House VA Committee hearing started at 7:30 p.m., but it was well-attended and lasted until 10 p.m. The witnesses included Senator John McCain (R-AZ), VA Secretary David Shulkin, and representatives of the VA Office of Inspector General and the Government Accountability Office. Senator McCain and Secretary Shulkin were both warmly welcomed by Members of the Committee on a bipartisan basis.

Chairman Roe (R-TN) emphasized the need to act quickly to extend the authorization for the Veterans Choice Program, which expires on August 7. To that end, the House VA Committee is voting today on a bill to eliminate the sunset of the program’s authorization. In addition, the Committee will consider broader legislation later this year to make comprehensive reforms to the Choice Program. He noted that the VA has additional funds available but will not be able to spend them once the authorization expires. A copy of Chairman Roe’s opening statement is available here.

Secretary Shulkin testified in support of extending the Choice Program, and he clarified that the VA was not seeking additional funding – just the authority to spend funds already obligated. He noted that the VA already is being forced to deny Choice Program coverage to veterans whose episodes of care would extend beyond the August 7 expiration date (e.g., pregnancy).

Secretary Shulkin also urged Congress to support the VA’s efforts to bring appointment scheduling in-house for care coordination purposes. However, the VA OIG witness noted challenges in records going out to community-based providers and coming back to the VA. The GAO witness also underscored the need for the VA to have better systems in place in order to effectively coordinate care, which will take time to procure and implement. Rep. Brownley (D-CA) echoed that point, calling the VA’s information technology systems a “Model T in a Tesla world.” Rep. Esty (D-CT) also urged improvements in the VA’s information systems and expressed concern that veterans are being improperly billed.

Other Members, including Rep. Wenstrup (R-OH) and Rep. Poliquin (R-ME), raised concerns about continuing delays in the processing of claims and payments to providers. Secretary Shulkin agreed that providers deserve to be paid for their services, noting his own experience as a physician in the private sector. He acknowledged that the VA is not processing enough claims electronically today, and he advised that he plans to pursue options outside the VA for systems procurement going forward.

Many Members also raised serious concerns about treatment of PTSD and mental health conditions for veterans, including Rep. Wenstrup (R-OH), Rep. O’Rourke (D-TX), Rep. Sablan (D-MP), Rep. Banks (R-IN), Rep. Rutherford (R-FL) and Rep. Takano (D-CA). Rep. O’Rourke emphasized that suicide among veterans is the most serious crisis, and Secretary Shulkin agreed that it is his number one priority. The Secretary announced that the VA will begin providing urgent mental health care that also will include individuals other than those service members who were honorably discharged. He added that the VA needs 1,000 more mental health providers, as well as telemental health services, and is looking to expand community partnerships to address suicide.

Rep. Banks noted interest among Indiana veterans in greater access to alternative treatments for PTSD and traumatic brain injury. Secretary Shulkin underscored that he is “most concerned about areas like PTSD, where we do not have effective treatments.” He also advised that the VA has established an “Office of Compassionate Innovation” (separate from the VA’s Center for Innovation), which will focus on finding new approaches to health and physical wellness and explore alternative treatment options for veterans when traditional methods fall short.

Rep. Wenstrup inquired about the VA’s GME and residency programs, as well as its associations with academic institutions. Secretary Shulkin responded that the VA is “doubling down” on partnerships with academic medical institutions.

Chairman Roe concluded his remarks by emphasizing the need to extend the Choice Program authorization soon and to consolidate the VA’s community-based care programs. He also expressed support for the VA’s decision to stop developing its own information technology internally.

CMS Extends Temporary Moratorium (NJ, PA, TX)

On January 9, 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 July 29, 2017.

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 moratoria have been extended every six months thereafter.

However, on August 3, 2016, CMS announced changes to its existing moratoria on the enrollment of new ground ambulance suppliers. Specifically, CMS announced that the moratoria would be lifted for the enrollment of new emergency ambulance providers and supplier, but that it would expand the enrollment moratorium on non-emergency ambulance services to cover the entire states of New Jersey, Pennsylvania, and Texas. At the same time, CMS announced the creation of a new “waiver” program that would permit the enrollment of new non-emergency ambulance providers in these states under certain circumstances.

On or before July 29, 2017, CMS will need to make a determination on whether to extend or lift the enrollment moratorium.

Have a Medicare question? AAA members, send your inquiry to Brian Werfel, Esq. using our simple form!

Payment Reform Chairs Pen Op-Ed in JEMS

Ambulance payment reform is critical to the future of emergency medical services across our country. Don’t miss the op-ed in JEMS by Asbel Montes and Jimmy Johnson, chair and vice chair of AAA’s Payment Reform Committee.

Before the industry as a whole can embrace mobile integrated health, community paramedicine, and value-based purchasing, the industry must contend with standardizing cost data and submitting it to the federal government. We must also fight to ensure that payment is linked to the health care services provided and less to the act of transporting patients.

Read the full op-ed►

Ready to add your voice to the conversation? Join fellow members at AAA’s Payment Reform Town Hall at EMS Today in Salt Lake City. Learn more►

Acadian’s Asbel Montes on Ambulance Payment Reform

“EMS is instrumental to the healthcare fabric of our country. As the healthcare industry continues to innovate, it is imperative to recognize the value that EMS brings to the pre- and post-hospital environment. EMS providers are the only gatekeepers to the healthcare system in many communities.

73% of all ambulance suppliers credentialed with Medicare bill the program less than 1,000 transports per year. It is imperative that any cost data collection system reporting requirements consider this to ensure the reliability of the data and the administrative burden to ambulance providers and suppliers.”

Asbel Montes
Vice President of Governmental Relations & Reimbursement, Acadian Ambulance
Co-Chair, American Ambulance Association Payment Reform Committee

CMS Moratoria Update

The Centers for Medicare & Medicaid Services Lifts Moratoria on Enrollment of Part B Emergency Ground Ambulance Suppliers in All Geographic Locations; Moratoria for Part B Non-Emergency Ground Ambulance Suppliers Extended

Effective July 29, the Centers for Medicare & Medicaid Services (CMS) has lifted the temporary moratoria in all geographic locations for Part B emergency ground ambulance suppliers.  Beginning in 2013, CMS placed moratoria on Medicare Part B ground ambulance suppliers in Harris County, Texas, and surrounding counties (Brazoria, Chambers, Fort Bend, Galveston, Liberty, Montgomery, and Waller).  In February 2014, CMS announced it would add six more months to these moratoria and add Philadelphia, Pennsylvania, and surrounding counties (Bucks, Delaware, and Montgomery), as well as the New Jersey counties of Burlington, Camden, and Gloucester.  Since that date, CMS extended the moratoria four additional times, most recently in February of this year.

CMS considers qualitative and quantitative factors when determining if there is a high risk of fraud, waste, and abuse in a particular area and whether or not it should establish a moratorium.  If CMS identifies an area as posing an increased risk to the Medicaid program, the State Medicaid agency must impose a similar temporary moratorium as well.  CMS also consults with the Office of the Inspector General (OIG) within the Department of Health and Human Services (HHS) and the Department of Justice (DOJ) when identifying potential areas and providers/suppliers that should be subject to a temporary moratorium.  Finally, CMS also considers whether imposing a moratorium would have a negative impact on beneficiary access to care.  In areas where there is a temporary moratorium, the policy does not apply to changes in practice location, changes to provider/supplier information (e.g., phone number, address), or change in ownership.  Temporary moratoria remain in place for six months, unless CMS extends the policy through notice in the Federal Register.

CMS may lift a moratorium at any time if the President declares an area a disaster under the Robert T. Stafford Disaster Relief and Emergency Assistance Act, if circumstances warranting the imposition of a moratorium have abated, if the Secretary of HHS has declared a public health emergency, or if, in the judgment of the Secretary of HHS, the moratorium is no longer needed.  After a moratorium is lifted, providers/suppliers previously subject to it will be designated to CMS’s “high screening level” for six months from the date on which the moratorium was lifted.

CMS has announced it will lift the moratoria on new Part B emergency ambulance suppliers in all geographic locations because the Agency’s evaluation has shown the primary risk of fraud, waste, and abuse comes from the non-emergency ambulance supplier category and that there are potential access to care issues for emergency ambulance services in the areas with moratoria.  New emergency ambulance suppliers seeking to enroll as Medicare suppliers will be subject to “high risk” screening.  If enrolled, these suppliers will be permitted to bill only for emergency transportation services.  They will not be permitted to bill for non-emergency services.

The moratoria remain in place for Medicare Part B non-emergency ground ambulance suppliers for all counties in which moratoria already are in place in New Jersey, Pennsylvania, and Texas.

 

MAC Novitas March 2016 Updates to Ambulance Services

On March 4, Novitas Solutions, Medicare Administrative Contract managers for several jurisdictions, asked AAA to share the following information with ambulance services.

March 4, 2016 – Letter to Ambulance Providers | March 4, 2016 – Letter to Beneficiaries

Jurisdictions Covered By Novitas

  • The Medicare Administrative Contract (MAC) Jurisdiction L (JL), which spans Pennsylvania, New Jersey, Maryland, Delaware and Washington D.C.;
  • The Medicare Administrative Contract (MAC) Jurisdiction H (JH), which spans Colorado, Oklahoma, New Mexico, Texas, Arkansas, Louisiana, Mississippi, Indian Health Service (IHS) and Veterans Affairs (VA); and
  • The payment processing for the Federal Reimbursement of Emergency Health Services Furnished to Undocumented Aliens contract, as authorized under Section 1011 of the 2003 Medicare Modernization Act.

Spotlight: Mark Postma

Mark Postma
Vice President, Paramedics Plus
President-Elect, AAA Board
Chair, Commission on Accreditation of Ambulance Services (CAAS)
Largo, Florida, USA

Can you please tell us a little about yourself? How did you come to work in EMS?

I grew up in a small town outside Sioux Falls, South Dakota, and obtained my EMT license at age 16. I became a paramedic in 1984 and began working in Davenport, Iowa at MEDIC EMS. After working there for 20 years and becoming Executive Director, I began at SUNSTAR Paramedics in 2004. I am the COO for SUNSTAR and Vice President of Paramedics Plus operations (Sioux Falls, Fort Wayne, and Oakland).

I have been married 31 years to my great wife, Lisa. I have two children: Delaney, a registered nurse at Florida Hospital in Orlando; and my son, Parker, a sophomore at the University of Florida. My hobbies are basketball, boating, and IndyCar Racing.

What do you enjoy most about your job?

It is very diverse. As the Vice President, I really oversee daily operations and have great people who work for me. They are local and report out how things are going, daily achievements and challenges.

Paramedics Plus/ETMC is a great organization and is focused on providing great care over financial constraints. I work for a great boss, Ron Schwartz, who fully understands the industry and its daily challenges. We are both from the Midwest and work together on issues.

What is your biggest professional challenge?

Sometimes it is just a challenge wearing my CAAS Chairman hat, AAA hat, SUNSTAR hat and Paramedics Plus hat. Everyday you have to decide which issues need to be the priority. Just glad I own an iPad and have a great staff!

What is your typical day like?

I wake up at 0500 eveyday and read emails and try to read at least 2 newspapers. After that, I run 2-5 miles depending on my schedule. The only days I take off are travel days.

After getting to work or on an airplane, it is interacting with staff until our daily PULSE meetings. Most afternoons are teleconferences from all of our operations or AAA meetings.

I go to lunch with my staff every day whether I am in Pinellas or one of the other operations. Evenings are usually laid back, but the weekends are boating and basketball. I am usually in bed at 9:00 pm!

How has participation in AAA membership and advocacy helped your organization?

I have been very involved with the Commission on Accreditation of Ambulance Services (CAAS) as the representative for the AAA for the past 20 years. I am currently the Chairman of the Board and have enjoyed the AAA/CAAS relationship.

Transitioning to the AAA President will have its challenges as it is a huge responsibility. The AAA represents EMS in America, and I would like to see members embrace our organization as the “”go to”” organizations for challenges in our industry.

The AAA membership and advocacy is immeasurable in how it helps our organization every day!

Spotlight: Asbel Montes

Asbel Montes
Vice President, Acadian Ambulance Service, Inc
Lafayette, Louisiana, USA
Follow Asbel on Twitter at @asbelmontes
Asbel’s LinkedIn

Can you please tell us a little about yourself?

I was born in San Bernardino, CA and lived there until I was five. My dad was in the Air Force. When I was five, he felt the call to become a pastor in North Carolina and was discharged from the Air Force.

I am married and have one daughter who is fifteen years old.

I have played the piano since I was eight years old and used to be the music minister for my dad and my brother-in-law, until my career became too demanding to do both.

I am an avid read of non-fiction and fiction. I enjoy a great political or legal thriller.

How did you come to work in the industry? How long have you been involved?

I started in the ambulance industry at the age of 21. I answered an ad in the newspaper for an account manager position for an ambulance billing company in North Carolina. I have been in the revenue cycle space for almost 19 years.

What do you enjoy most about your job?

I enjoy the people I work with at Acadian. Acadian Ambulance Service has a culture where the employees truly care about the success of the company. This culture is prevalent throughout the organization from senior leadership to front-line staff.

What is your biggest professional challenge?

My biggest challenge is the federal and state regulations that continue to negatively impact our industry from Medicare, Medicaid, and insurance companies. This has a downstream effect on increasing our cost per claim due to the excessive administrative burden, as well as reducing our revenue per transport.

What is your typical day like?

My day starts at 4:45 am. I like to meditate and read for about an hour before getting to the office by 7:00 am. My day is packed with meetings and typically culminates with me leaving the office around 6:00 pm.

I travel extensively between Austin, Baton Rouge, and Washington, DC.

How has participation in AAA membership and advocacy helped your organization?

The American Ambulance Association has been beneficial in helping to create a united front in the ambulance industry for important initiatives on Capitol hill.

Spotlight: Macara Trusty

Macara Trusty
Clinical Education & QA/QI Manager/Professional Development Manager
MedStar Mobile Healthcare
Fort Worth, Texas, USA

Can you please tell us a little about yourself?

I grew up on a cattle ranch in a small Texas town, called Farmersville, about 50 miles northeast of Dallas. I spent my free time herding cattle and hauling hay. I have been married for 17 years and have two teenage daughters. We spend our family time camping, fishing, hiking, rock climbing, and watching movies.

How did you come to work in EMS?

I came to work in EMS after a car accident in 1989 that almost killed my grandfather and resulted in my having a broken back and many other internal injuries. The small town in which I lived had only one ambulance, staffed by volunteers. There were a total of seven critical patients (including myself) on the scene, and we had to wait up to 30 minutes for the next ambulance to arrive. Having been raised in a family of public servants, I had previously considered becoming a nurse like my grandmother, but quickly changed my plan after the accident.

In 1994, I enrolled in the local EMT program. I had every intention of working in the town to give back for what the town and its people had done for us. However, I also quickly realized that working in such a small town, where everyone knew everyone else, may not be such a good idea. I began working in Dallas instead, then joined MedStar in 1997. I have been involved in EMS for 21 years now. Although I can’t honestly say I’ve loved every minute of it, I can say that this job has taught me so much and made me a better person. I wouldn’t trade that for anything!

What do you enjoy most about your job?

The best part of my job is helping people accomplish goals they have set for themselves! As a Paramedic, I would say “I love helping patients”. In my current role, I help EMTs and Paramedics become better EMTs and Paramedics. I help civilians accomplish the goal of becoming an EMT or First Responder. I help our leadership team become better leaders. I’m still helping people, but the reach seems greater in this position. It’s NOT “one patient at a time”. I work with an awesome team and it’s heartwarming to see everyone pull together to accomplish a goal, or to help others accomplish their goals.

What is your biggest professional challenge?

My biggest professional challenge is balancing the needs of the entire organization with training and education and encouraging others to explore alternative delivery methods for the education they want to provide, without having a traditional classroom session. Convincing some that it’s okay to embrace technology, provide education and convenience for your employees (and you too!), and show the “millennial employees” that you can understand their communication style can be quite a challenge some times.

What is your typical day like?

What is a typical day? Do those even exist? My typical day starts with the end of the day before. I look to see what classes we have scheduled for the following day, to see if we need to reconfigure classrooms, rearrange table & chairs, etc. When I arrive, I meet briefly with my team to find out what everyone has planned for the day, what challenges we may encounter, what meetings are on the agenda, and to get feedback from other meetings. Every day is different, so some days I will teach, other days are full of meetings with various departments, and some days I spend catching up on emails, building classes, etc.

How has participation in AAA helped your organization?

The education and thought sharing is extremely helpful. The ideas shared by the visionaries involved in AAA help make our profession stronger, both locally and nationally.

Health Affairs shows “frequent flier” needs taper over time

Last week, Health Affairs published a study on the so-called “super utilizers” of the healthcare system, those who are in and out of emergency rooms with such frequency that their need for readmission is nearly assured.

The researchers found that these folks have an intense need that tapers off over time. Of the 1,682 identified as such, just 28 percent fell into the category after 12 months. Baseline spending decreased from $113,522 per capita to $47,017 the following year when they were enrolled in a program to help them stay on top of their health. The study, performed by the medical center Denver Health, analyzed nearly 5,000 patients and found that 3 percent were accounting for 30 percent of adult charges between May 1, 2011 and April 30, 2013.

Read the full article in the Dallas/Fort Worth Healthcare Daily.

Acadian Ambulance High School Champions Livonia

Acadian’s High School Champions Program Leads the Way

Founded in 1971 in with just eight staff and two vehicles, Acadian Ambulance has grown over the years to more than 4000 employees with a fleet of 400 ground ambulances, helicopters, fixed-wing airplanes, and van and bus transports. Their territory has expanded from Lafayette Parish, Louisiana, to stations spanning large swaths of Louisiana, Texas, and Mississippi.

How does such a large and varied service feed their talent pipeline? In addition to many other strategies, Acadian is leading the industry in its efforts to engage young adults in EMS through its High School Champions program, a division of their National EMS Academy.

Porter Taylor, Acadian's Director of Operations
Porter Taylor, Acadian’s Director of Operations

To learn more about the ins-and-outs of the program, AAA caught up with Porter Taylor, Acadian’s Director of Operations. Taylor has been in EMS for 29 years, since he joined Acadian Ambulance as a college sophomore. “I love making a difference in people’s lives. When I was working on a unit it was the patient, and now, almost 30 years later, it is the employees that I love helping.”

Establishing High School Champions was not a linear path. Initially, Acadian would send medics to career fairs and school functions to introduce the field and promote its National EMS Academy (NEMSA) as an opportunity after graduation. “There are a lot of technical grants out there, and a critical staffing need for EMS in general. We wanted to create an avenue for educating students about the benefits of becoming EMTs to support our staffing needs long term,” said Taylor.

Although these medic visits were effective, Acadian wanted to expand the fledgling program’s scope and reach. He began visiting area high schools and meeting with school boards and directors more than a year ago to build relationships and explore opportunities. The partnerships he built added another facet to the High School Champion initiative wherein Acadian continues to promote NEMSA, coupled with an effort to get the schools to incorporate an EMT program as an elective prior to graduation. “[I wanted] to introduce them to our company and our support of this technical career path. My goal was to let the teachers and technical program directors know that Acadian has jobs for their students upon the successful completion of the program. Once students turn 18, Acadian will be able to offer them a rewarding  position with good pay and benefits and with continuing education opportunities.”

Acadian Operations Manager Justin Cox was instrumental in the implementation at Livonia High School, a recent addition to the program. In concert with his professional know-how, Cox had a personal connection to the school—his thirteen year old daughter attends Livonia.

Collaborating with the administration, Acadian now works with schools like Livonia to introduce EMS career paths at the end of high school, a time when students are making key choices about their futures. Students can start the EMT training program as an elective prior to graduation and take the national certification exam upon turning 18. Students spend 2-3 hours 3 days a week, during their junior and senior years preparing. “It is a joy to work on this program,” said Taylor, “It is a privilege to help young people make a career choice that is full of rewards.”

Does your service have a great program that is making a difference in your area? Let us know in the comments section below, or email ariordan@ambulance.org.

CMS Extends Ambulance Enrollment Moratoria

On July 25, 2015, CMS issued a notice extending the temporary moratorium for enrollment of new ambulance suppliers in the Texas counties of Brazoria, Chambers, Fort Bend, Galveston, Harris, Liberty, Montgomery and Waller, as well as in Philadelphia and the surrounding counties of Bucks, Delaware, Montgomery (Pennsylvania), Burlington, Camden and Gloucester (New Jersey). This notice will appear in the Federal Register on July 28, 2015.

MedStar Helps Reunite Baby, Mom After Tragic Crash

(Details and video courtesy of Fox 4 News and Medstar.)

On June 25, Sergeant Colby Bozo and his wife Kristen were driving home when their vehicle was struck by a stolen car being pursued in a police chase. Sadly, Colby Bozo was killed on impact, and Kristen, then 37 weeks pregnant, was very seriously injured and required an emergency caesarian section.

AAA member MedStar Mobile Healthcare, in coordination with John Peter Smith Hospital, and Cook Children’s Hospital surprised Kristen by arranging for her to see her newborn baby for the first time. Staff took a detour to Cook Children’s Hospital during mom’s ambulance transfer from JPS in Fort Worth to Baylor Rehabilitation Center in Dallas.

George Church, a MedStar Operations Supervisor who helped coordinate the reunion, said at the time, “I’ve been in EMS a long time, and there are very few moments that get to me any more—this one got to me.”

Great job, MedStar, JPS, and Cooks Children’s!

Video from Fox4News.com

Supporters of Kristen and the baby are invited to donate at a Fund.ly page.

aaa conference

Spotlight: Matt Zavadsky

Matt Zavadsky
Fort Worth, TX, USA
Public Affairs Director, MedStar Mobile Healthcare

Tell us a little about yourself, please.

Originally from Connecticut and have lived in Lincoln, NE; Augusta, GA; Orlando & Daytona Beach, FL; Lacrosse, WI and now Fort Worth in the Republic of Texas since 2008. Married to my best friend, Tessa, and we each have grown children, and one grandchild (so far!). Aside from doing what I love at work, Tessa and I are avid Harley Davidson Riders (“it’s not a motorcycle, it’s a lifestyle”). We also do a lot of volunteer work with the North Texas Patriot Guard Riders and the Fort Worth Police Code Blue Citizen’s on Patrol program. I’m also a licensed amateur radio operator and certified storm spotter working with the Tarrant County (TX) Radio Amateur’s in Emergency Service (RACES) program.

How did you come to work in the industry? How long have you been involved?

My dad died suddenly in 1979. The hometown Trumbull, Connecticut volunteer ambulance crew that came to help him so impressed me that I signed up to volunteer the week he died. I started as a “driver” at age 17 and was originally trained in a High-Top Cadillac ambulance (the best unit I ever worked in!).

aaa emt membershipWhat do you enjoy most about your job?

Two things. First, making a difference! Whether you are an EMT, Paramedic, EMD, billing specialist, maintenance tech, logistics tech, scheduler, whatever—what we do MATTERS in people’s lives. Second, is the innovation occurring in the healthcare system, and the role the ambulance industry is now playing in the healthcare system every day, literally! The ability for us to define and redefine our profession’s future is an incredible in the environment we are in today!

What is your biggest professional challenge?

Keeping up with the rapid pace of change in the healthcare environment AND helping others see the future. There are a handful of leaders in our profession who can truly see the opportunity that lies ahead of us and are daring enough to take the risk to do something totally different. At the same time, helping our own folks, the people who really matter at the patient contact level, understand how important they are to our future as an industry.

What is your typical day like?

Up at 3:10 a.m., workout with Tessa at the MedStar gym, in the office by 6:00 a.m. to get more done before 8:00 a.m. than I’ll get done the rest of the day. Run from meeting to meeting to community events, in between try to get projects done until I leave for home at 6ish to finish up emails in the evening…

How has participation in AAA membership and advocacy helped your organization?

The education and communication is invaluable. The daily happenings updates, the education at events like the Annual Conference and Tradeshow, combined with the collaborative work with committees for things like government affairs, professional standards and reimbursement reform is invaluable. The ideas shared by visionary entrepreneurs that do this work every day helps make our profession stronger, both locally and nationally.

Community Paramedicine’s Growth Hindered by Reimbursement Issues

From Politico’s “Reimbursement issues block paramedics from expanded role“—

Despite the track record of [community paramedicine] initiatives in places like Nevada and Texas, where paramedics are providing in-home care, coordinating patient services and saving millions in the process, Medicare, Medicaid and most private insurance plans still won’t reimburse for such work. The program successes to date are only beginning to change that…

Nationwide, the impact from reducing ambulance calls and demands on ERs while freeing up doctors could be huge. A 2013 study in Health Affairs estimated that more flexible reimbursement for paramedicine approaches could save Medicare $283 million to $560 million annually and similar sums for private insurers.

AAA Members Named to NEMSAC

On May 12, 2015, two AAA member leaders were appointed to the  National Emergency Medical Services Advisory Council (NEMSAC) by U.S. Transportation Secretary Anthony Foxx. NEMSAC advises the Department of Transportation and the Federal Interagency Committee on critical EMS issues.

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