“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

Acadian’s Asbel Montes on Ambulance Payment Reform

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...

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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 (more…)

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 (more…)

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 (more…)

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’s High School Champions Program Leads the Way

Acadian Ambulance High School Champions Livonia

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. 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 (more…)

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. Read the PDF announcement (available now). Read the Federal Register post (available tomorrow, 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.

Spotlight: Matt Zavadsky

aaa conference

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 (more…)

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. Shawn Baird – Woodburn Ambulance Service co-owner and former AAA secretary Shawn Baird has been a paramedic for 35 years. In addition to his service to AAA as former secretary, he has contributed to the profession as president of the Oregon Ambulance Association and a member of the Oregon Public Health Advisory Board. Douglas Hooten – Doug Hooten is the executive director of MedStar Mobile Healthcare in Fort Worth, Texas, and has more than 33 years of EMS experience. He held senior leadership roles at American Medical Response, the Metropolitan Ambulance Service Trust, and Rural/Metro. He is president of the Coalition of Advanced Emergency Medical Systems (CAEMS), president of the Texas EMS Alliance, and a board member of the American Ambulance Association.