Loading...
HomeMy WebLinkAbout(1) AMBULANCE INFORMATIONFINANCE DEPARTMENT Date: To: From: RE: 3/1/2002 Mayor and City Councilm~.mb~e~ ¥ ~j~ Rebecca Underhill, Direct~m~-nc~ ^mbulance Information Provided by Goldstar The attached information and powerpoint presentation was provided by Goldstar for the March 5, 2002 Council Meeting. ru TRAil BLAZER HEALTH'ENTERPRISES I. LC 8530 LYNDON B, JOHNSON FREEWAY DALLAS TX 75243-1215 'AYER'~ Federa! ID Numbmr 7!;2784278 Ih,,Ih,,I,Ih,,h,h,hh,,llh,,h,,ll,,Ih,,Ihhh,lh,,I GOLDSTAR EHS LLC q,i~q GULFWAY DR P~}RT ARTHUR TX 7764Z-I715 .00 [] CORRECTED ~if checked] .00 2001 Income 1099-MISC OTHER THE HED B ~ 6,050,090.~7 TOTAL ~ 6,050,090.57 return return ,~s tax withheld. TRAILBLAZER IIEALlll EflI'ERPRISES LLC THE F I N/~tlCE 8,~30 LYr~l)aN B, JOHNSON FREEWAY DALLAS TX 75Eq3-)Z13 1-800- 991- 270 I EDS-IO0-1 CARRIERO0900 PROVIDER AMB020 GOLDSTAR EMS LLC PART B-DISCLOSURE REPORT FSY99 01/01/02 AREA 20 JEFFERSON COUNTY SPEC 59 AMBULANCE SERVICE SUPPLIER CPT CODE PROCEDURE MODIFIER PREVAILING A0426 BASE RATE NON EMER 450.00 A0427 BASE RATE EMER 475.00 A0390 MILEAGE 8.00 A0422 ALS OXYGEN 60,00 A0398 ALS DISP SUPP 45.00 IIC 267.46 267.46 4.52 30,57 25.00 RalPh Crall Fror~t: "Jason ~Goldstarems.co m" <Jeson@go[dstare ms.com> To: "Ralph Crall" <Ralph~goldstarems.com>; "Larry Cautben" <Larry~goldstarems.com> Cc: "Jason Boever" <Jeson~goldstarems.com> Se~U Friday, February 22, 2002 1:13 AM Sub,~ect: Press release from Medicare about fee schedule MEDICARE NEWS FOF[ IMMEDIATE RELEASE Contact: HCFA Press Office Monday September 11, 2000 (202) 690-6145 Medicare to Establish New Ambulance Fee Schedule The Health Care Financing Administration today pmpesed a new Medicare payment system to ensure that both senior citizens and Medicare pay appropflately for ambulance services. Under the proposal, Medicare will pay for covered ambulance services using a fee schedule beginning Jan. 1, 200~. The fee schedule will replace the current system of reimbursing suppliem based on their charges or costs with a system that pays them a set amount based on the service provided. As raquired by the Balanced Budget Act of 1997, HCFA participated in negotiations with affected industry groups to develop the new ambulance tee schedule. The proposed rule reflects the consensus of the negotiated rulemaklng committee, which included representatives of affected industry groups and other affected organizations. "We want to make sure that beneficiaries continue to get needed ambulance services and that Medicare pays ambulance suppliem more fairly and accurately" HCFA Administrator Nancy-Ann DeParle said. "These changes will protect beneficiaries and taxpayers from paying too much while preserving access to needed services." Under the proposed rule: o Seven categories of ground ambulance services, ranging from basic life supbort to specialty care transport, and two categories of air ambulance services will be established; o Payment for each category is based on the relative cost of the service, adjusted to reflect wage differences in different parts of the count~. Mileage will also affect payment levels; O o Ambulance providers will not be allowed to charge beneficiaries more than 20 percent of Medicare's approved amount for the service. Currently, providers can charge beneficiaries higher rates; The fee schedule allows for increased payments when ambulance services are provided in rural areas. Payment will bo 80% of the lesser of the actual charge from the ambulance provider or the Fee Schedule Amount - whichever is LESS. The patient will be responsible for the remaining 20%. Providers wi no longer be able to bill the patient any amount beyond the 20% coinsurance and any unmet deductible. Ground D/nbulances: Basic Life Support $157.52 Basic Life Support Emergency $252.03 Advanced Life Support $189.02 Advanced Life Support Emergency $299.29 Advanced Life Support 2 $433.18 Specialty Care Transport $511.94 2/22/02 Paramedic Intercept $275.65 ~tileage $5.00 Mileage (lst 17 miles from rural pickup) $7.50 Mileage (Mile 18-50 from rural pickup) $6.25 (added by Congress in December) To better serve beneficiaries in rural areas, HCFA will consider alternative approaches to ensure adequate pay~ent for isolated, essential, Iow-volume, rural ambulance suppliers as data becomes available. The new fee schedule will be phased-in over four years starting Jan. 1,2001, blending the current payment with the proposed fee schedule. In 2001, the blend will be 20 percent of the fee schedule rate and 80 percent of current rates. In 2002, the blend will be a 50-50 split. In 2003, the blend will be 80 percent fee schedule and 20 perc:ent current rates, and in 2004, the rates will be based entirely on the fee schedule. By law, Medicare pays for medically necessary ambulance sewlces in emergencies and other situations when other methods of transportation would pose a risk to the beneficiary's health. Medicare covers almost 9 million ambulance transports each year on behalf of 39 million elderly and disabled Americans. The negotiated rulematdng committee included the Amedcan Ambulance Association, the American Hospital Association, the Association of Air Medical Services, the International Associa§on of Fireflghters, the International Asscciafion of Fire Chiefs, the National Volunteer Fire Council, the National Association of Counties, the National Association of State Emergency Medical Services (EMS) Directors, and the National Association of EMS Physicians. The oroposed fee schedule will be pubished in the Sept. 12 Pederal Register. After accepting and reviewing public comment, HCFA will publish a final rule that establishes the fee schedule. 2/22/02 Page 1 of 6 Rall;,h Crall Frora: "Steve Haracznak" <steveh~the-aaa.org> To: <aaa-weekly-e-u pdata~llsts.the-aaa.org> Sent: Friday, February 22, 2002 2:47 PM Subiioct: CMS Fact Sheet and Press Release on Fee Schedule Final Rule Folk,wing FYI are the CMS Fact Sheet and CMS Press Rdease, both issued today by the CMS Public Affatrs Office, on the Fee Schedule Fi hal Rule, which will be printed in the Federal Register on 2/27/02. We Imow that there probably are many points in the Final Rule that are not covered in these two public doe]ments issued by CMS Public Affairs Office. Please refrain from contacting the AAA office with any questions on these documents until after we have distributed the detailed AAA analysis of the Final Rul,: to you next week. Of caurse, AAA Medicare consultant David Werfel and others will provide a detailed analysis of the Finat Rule at the AAA's Winter Reimbursement Conference in Dallas. March 64, 2002, and try to an~;zer many of your questions on it there. There is still time to register for the AAA Medicare Rei~]bursement Conference in Dailas, March 6-8. Thank you. Steue M~;DICARE FACT SI4 ~:ET FO2k IMMgDIATE RELEASE CM'5 Public Affairs Office Feb~xmry 22, 2002 M~DICARE FEE SCHEDULE FOR AMBULANCE SERVICES BACKGROUND: The Balanced Budget Act of 1997 (BBA) required the Centers for Medicare & Medicaid Services (CMS) to replace its eurrem ambulance payment methodologies with a national fee schedule to be developed through negotiated rulemaking. A proposed regulation based on the consensus of lite negotiated rulamaking committee was issued in September 2000, and CMS received over 340 pubic comments on the proposed rule. A final regulation will be published February 27, 2002 in the Ferl,~val Register. It went on display in the Offce of the Federal Register today. Phased-in implementation will begin April l, 2002. Until the new resulafion is implemented, paymem for ambulance services w/Il continue to be based on "reasonable charges" for independent suppliers and "reasonable costs" for provider-based services. This is tlc last major Medicare Part B benefit to be paid according to these methods; other benefits were moved to fee schedules over the past decade. Reasonable charge payments are based on historic local chi~'ging patterns that have resulted in large geographic discrepancies. Th~.~ negotiated rulemaking committee was convened by an outside convener and included CMS and 9 other members representing a wide range of iodustry interests, including urban, rural, volunteer, indcpendent, hospitai-based, ground, and air ambulance providers, as well as emergency physicians. BE,A requirements: In establishing the fee schedule, the BBA stated that aggregate payment during its fin,~: year may not exceed the aggregate amount that would have been paid that year without the fee sch,~lule. The BBA also directed the Secretary to: 2/22/O2 Page 2 of 6 *establish mechanisms to control increases in expenditures for ambulance services; *establish definitions for ambulance services that link payments to the type of services furnished; *consider appropriate regional and operational differences; *consider adjustments to payment rates for inflation and other relevant factors; *phase-in the fee schedule in an efficient and fair manner, and *require ambulance suppliers and providers to accept assiLmment. MA]OR PROVISIONS OF THE FEE SCHEDULE KEY PARAMETERS SET BY NEGOTIATED RULEMAKING: The negotiated rulemaking committee, which was convened by an independent convener, included CMS and 9 other members representing a wide range of industry interests, including urban, rural, volunteer, independent, hospital- based, ground, and air ambulance service providers, as well as emergency physicians. When the negotiations ended in February 2000, all members signed a consensus agreement, which CMS used as the basis for drafting the proposed regulation. In its consensus agreement, the committee recommended: * Seven categories of ground ambulance services (ranging from basic life support to specialty care tra~ sport), and two categories of air ambulance services; * A base rate payment plus separate mileage payment based on specified relative value units (RVUs) for ca% level of ambulance service; * Higher payment for services qualifying as an "emergency response;" * Adjustments to recognize differences in relative practice costs among geographic areas, and the higher trar,;portation costs that may be incurred by ambulance suppliers in rural areas with Iow population dem~ity; * Four-year phase in for the fee schedule; and * .4 ~mual updates as mandated by the BBA to account for inflation. FUllJRE ADJUSTMENTS: The fee schedule rates will be adjusted if actual experience under the fee schedule is significantly different than the assumptions used to calculate the rates (for example, the relalive volumes of different levels of service, or the extent of charges below fee schedule amounts, are diffident than expected). CHANGES IN THE FINAL RULE FROM THE PROPOSED RULE CH,MNGES tN CALCULATION OF THE FEE SCHEDULE 'CONVERSION FACTOR": To establish pa3'ment base rotes, the RVUs for each level of ambulance service are multiplied by a conversion factor (CF). Under the proposed rule, the CF for ground ambulances was $157.52. Under the final role, the grcund CF is increased to $170.54 because of the following changes: * ll.,:vision of the estimated amount of"low billing" (when suppliers bill less than the Medicare allowed amt~nt) that will occur under the fee schedule. * l;.,~storation of the money that would have been taken as immediate savings under the proposed rule res~.lfing from paying at the basic life support (BLS) rate for services furnished at the BLS level even when an advanced life support (ALS) vehicle is used. This policy change will instead be phased in along with other aspects of the fee schedule. * Caange in inflation adjustments for 2001 and 2002 as required by the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 (BIPA). * Correction in erosswaiking emergency services to the new levels of services established by the fee sc~ edule. * Correction in the calculation of mileage in the 1998 base data. 2/22/02 Page 3 of 6 (ClVlS did not calculate RVUs and a CF for air ambulance services because there are only two kinds of air ambulances: fixed wing and rotary wing. The fee schedule rates for these services were calculated dire,:fly, using similar procedures and assumptions as were used for ground services.) IMELEMENTATION AND PHASE-IN: The final rule provides for the fee schedule to begin on April 1, 2002 (rather than January 1, 2001, as stated in the proposed role), and the proposed 4-year phase-in has been extended to 5 years. DEFIlqITIONS OF LEVELS OF SERVICE: The final rule revises several aspects of how BLS and ALS service levels are defined. It also clafifias when an "emergency response" or the administration of certain drugs during transport may qualify for extra payment, and changes the payment for transports in which more than one patient is onboard the ambulance. MEDICAL CONDITION CODES: The final rule states that suppliers and providers may include in the "reft arks" field of an ambulance claim a condition from the list of medical conditions developed by a wofl: group of the negotiated rulemaking participants, and that Medicare contractors may not deny or reject claims solely for this reason. However, including a condition from the list does not automatically establish medical necessity. The contractors may still require documentation sufficient to show that the ser~: ce was medically necessary. PI-rYsICIAN CERTIFICATION OF MP_2D[CAL NECESSITY FOR NON-EMERGENCY AIC-~ULANCE TRIPS: * Unscheduled: Certification for unscheduled non-emergency transports may now be made by a health care professional who is employed by the attending physician. (Previously, this person had to be employed by the facility in which the beneficiary was being ~reated.) * S:heduled: Advance certification is now required only for repetitive scheduled non-emergency tran:;ports. (Previously, it was also required for non-repetitive scheduled non-emergency transports.) BE[}-CONFINFaMENT: The final role clarifies that bed-confinement alone does not necessarily est~lish the medical necessity of a non-eraevgency ambulance transport (other documentation may also be required). Beneficiaries who are not bed-confined may also be eligible for non-emergency ambulance ~'m~:~port if medicai necessity is documented for other reasons. OTHER CHANGES MADE BY BI'PA THAT ARE IMPI.FMENTED IN THE FINAL RULE CRITICAL ACCESS HOSPITAL EXEMPTION: BIPA exempted ambulance services provided by eritieai access hospitals (CAHs) (or entities owned and operated by a CAll) from the fee schedule, if ther, is no other ambulance provider or supplier within 35 miles. These entities will continue to be paid accvrding to "reasonable costs". RCRAL Mil .F.AGE INCREASE: BIPA increased payment for mml ambulance mileage greater than 17 mil~ and up to 50 miles by at least one-half of the additional payment per mile established under the fee sch¢~lule for the first 17 miles of a rural ~msport, for services provided before Janua~ 1, 2004. MILEAGE PHASE-IN EXEMPTION: BIPA exempted mileage payment from the fee schedule phase-in for :mppliers in States in which, prior to the fee schedule, the carder did not pay separately for in-county mileage (applicable only to North Carolina and Tennessee). These suppliers will be paid the full fee sch txtule mileage mount from the date the fee schedule begins rather than blended mileage payment dining the phase-in period. 2/22/02 Page 4 of 6 INCI[EASED INFLATION: The inflation factor used to set rates in 2001 was increased by one percent. The ~ates in the final role build on this one percent inerense. STARTING DATE AND PHASE IN SCHEDULE Implementation of thc fee schedule will begin on April 1, 2002, and will be phased-in over a 5-year per c<l according to the following schedule: Former Payment Percentage Fee Schedule Percentage Yea~ One (April-Dee. 2002) 80 20 Yem Two (CY 2003) 60 40 Yea~ Three (CY 2004) 40 60 Year Four (CY 2005) 20 80 Yeer Five (CY 2006) 0 100 MI3DICARE NEWS FO]t. IMMEDIATE RELEASE CMS Public Affairs Office Fel~uary 22, 2002 M~ DICARE ESTABLISHES NEW AMBULANCE FEE SCI4~.DULE The Centers for Medicare & Medicaid Services (CMS) announced a final regulation today creating a fee schedule to ensure that both beneficiaries and Medicare pay appropriately for ambulance services. Congress mandated this new payment mechanism in the Balanced Budget Act of 1997. Under the new system ambulance service providers will be paid a pre-established fee for each different sewice provided. This is similar to the method of payment Medicare has progressively adopted for hospitals, nursing homes, home health agencies and other health care providers, which has proven to be berc, x for patients, providers and the program. Previously, payment for ambulance services was based on prodders' costs or charges. A fiaal regulation implementing the new ambulance payment system was put on display today at the Office of the Federal Register. It will be published in the Federal Register on Februav~ 27, 2002. An important new protection for beneficiaries requires ambulance service providers to accept the Medicare approved fee as their full payment This means beneficiaries will not pay more than 20 percent of the approved amount, once they have met their annual $100 Medicare Part B deductible. "This new system will ensure that beneficiaries continue to get needed ambulance services and that Medicare pays ambulance service suppliers more fairly and accurately," said CMS Administrator Tom Scuily. Under the new fee schedule: * S,ven categories of ground ambulance services, ranging from basic life support to specialty care trm~sport, and two categories of air ambulance services are established. 2/22/02 Page 5 of 6 * P~,ment for each category is based on the relative value assigned to the service, adjusted to reflect wagi~ differences in different parts of the counm/. Mileage also will affect payment levels. * ~nbulanee providers will not be allowed to charge beneficiaries more than their deductible and 20 perc~aat of Medieare's fee for the service. Under the old payment system, providers ceuld charge beneficiaries higher rates. * The fee schedule allows for increased payments when an ambulance service is provided in rural areas. The final regulation contains a number of significant changes made in response to the large number of public comments CMS received following publieatiou of a proposed role in September 2000. Major ch~ges include: * Implementation of the fee schedule will begin on April 1, 2002 (rather than January 1, 2001, as stated in the proposed role), and will be phased in over a 5-year period (instead of the proposed 4-year phase- in). * T~e final rule reflects changes in several assumptions, which allowed an increase in payments. For exa~aple, CMS revised its previous estimate of the amount of"low billing" (when providers bill less than the Medicare approved amount) that will continue to occur after the fee schedule begins. * The new policy under which Medicare will pay a basic life support (BLS) rate for services furnished at the IlLS level even when an advanced life support (ALS) vehicle is used is modified under the final rule. Ureter the proposed rule the estimated savings from this change would have been deducted from the spew ding target for the fee schedule's first year. The final rule phases in this policy along with other aspects of the new system. The new ambulance payment system was produced under a negotiated mlemaking process that included affe,Xed industry, professional and governmental groups. This fee schedule for ambulance services was man dated by the Balanced Budget Act of 1997. Thc negotiating committee that developed the fee schedule expressed particular concern about amL, ulance access for beneficiaries in rural areas. While the new plan includes several bonuses for rural prm~ders, CMS will continue to consider alternative approaches to ensure adequate payment for iso] atect, essential, low-volume, rural ambulance suppliers as experience under the fee schedule becomes aveilable. The new fee schedule will be phased-in over five years, starting April 1, 2002, blending current payment witt~ the new fee sohedule rates. In 2002 the blend will be 20 percent of the fee schedule and 80 percent of current rates. Ia 2003 the blend will be 40 percent of the fee schedule rates and 60 percent of corrent rate;. In 2004 the blend will be 60 percent fee schedule and 40 percent current rates. Ia 2005 the blend will be 80 percent fee schedule and 20 percent em-rent rates. Beginning in 2006 payment will be based entirely on the fee schedule. By ]aw Medicare pays for medically necessary ambulance services in emergencies and other situations when other methods of transportation are contraindicated by the benefieiary's condition. Medicare cov,~s almost 9 million ambulance transports each year on behalf of 39 million elderly and disabled Americans enrolled in the program. In addition to CMS the negotiated rulemaking committee included the American Ambulance As:;aeiafion, the American Hospital Association, the Association of Air Medical Services, the Int~:rnational Association of Firefighters, the International Association of Fire Chiefs, the National Volunteer Fire Council, the National Association of Counties, the National Association of State Em,~rgency Medical Services (EMS) Directors, and the National Association of EMS Physicians. 2/22/02 Medicare Ambulance Fee Schedule Final Rule On Wednesday, February 27, 2002, the Final Rule for the new Medicare Ambulance Fee Schedule was published in the Federal Register. Highlights of the new rule are as follows: Ground Transport Fees BLS BLS-Emergency ALS1 ALS1-Emergency ALS2 SCT Paramedic Intercept* Loaded Mileage: Rural Mileage: miles 1-17: Rural Mileage: miles 18-50: $170.54 $272.86 $204.65 $324.03 $468.99 $554.26 *$298,45 $5.47 $8.21 $6.84 * Only applicable in certain ams of rural New York Fixed Wing Fixed Wing - Rural Rotor Wing Rotor Wing - Rural Loaded Mileage: Fixed Wing Fixed Wing - Rural Rotor Wing Rotor Wing - Rural Air Transport Fees $2,314.51 $3,471.77 $2,690.96 $4,036.44 $6.57 $9.86 $17.51 $26.27 Geographic Adjustment for Fees: The fees for base rates will be adjusted for vadaUon in the costs of living using the Practice Expense component of the Geographic Physician Practice Cost Tndex (GPC[). The formula for computing this adjustment is as follows: Port Arthur Texas GPCZ scale is ~0.88" Rural Transport Definition: A transpoCc will qualify for the rural amounts based on the zip code of the pick-up location of the patient. Rural zip codes will be all places outside of an MSA or rural census tracts within an I~ISA designated by the Goldsmith Modification. Effective Date: The Fee Schedule will begin on April 1, 2002. Mandatory Assignment: Effective April 1, 2002 all billets must accept assignment for all Medicare ambulance transports provided on or after that date. Phase-in Methodology: The Fee Schedule will be phased in over a five-year period. The original proposal was for a four-year phase-in. The phase-in will be as follows: Time period % of allowed charges % of new fee schedule 04/01/02 to 12/31/02 80 20 01/01/03 to 12/31/03 60 40 01/01/04 to 12/31/04 40 60 01/01/05 to 12/31/05 20 80 01/01/06 forward 0 100 During the phase-in process, those who have billed supplies, EKG, etc. up to this point (Method 3 or 4) may continue to bill that method IF they formally elect to do so In writing with their carrier. This does not apply to the hospital-based services that are paid through fiscal intermediaries. Payment Based on Condition of Patient: The level of service to be paid will be based on the condition of the patient, not the level of personnel providing the service. A patient who only needs a BLS assessment and treatment will by paid at the BLS rate even if a local ordinance mandates ALS on every ambulance. All ALS Providers: All ALS providers will be able to phase-in the payments for BLS transports based on their current ALS rates. The proposed rule would have required that all ALS providers use the existing BLS rate to transiUon to the new BLS rate, even though they had been paid at an ALS level up to now. Two new HCPCS codes will be used for these services. BLS & ALS Provider Definitions: The definitions of BLS and ALS providers will be based on each state's definitions of EMT-Basic, EMT-Tntermediate and EMT- Paramedic, not the National EMS Blueprint as originally proposed. ALS1 Definition: The definition of ALS1 has been made consistent with the recommendation of the negotiated rulemaking committee: Atdp qualifies for an ALS1 payment if the patient qualifies for an ALS assessment or one or more ALS interventions. ALS2 Definition: The definition of ALS2 has been made consistent with the recommendation of the negotiated rulemaking committee: A trip qualifies for an ALS2 payment if the patient condition warrants the administration of three different medications or the administration of at least one of six ALS procedures (see rule for list). Emergency Definition: The definition of what qualifies for the "Emergency" level of payment is clarified to include any trip that is dispatched as the result of a call to 9- 1-1 or its equivalent. The patient does not have to meet the old definition of an emergency patient to qualify for the emergency reimbursement. However, the transport itself must be medically necessary, e. g., the patient could not have safely been transported by another means. Conditions Codes: CMS is permitting condition codes to be placed on the claim. However, the carriem/intermedlaries are not required to use them to determine medical necessity. The reason for the delay in implemer~tatlon is the requirement by H][PAA that all new codes must go through a standardization process. The Final Rule also discusses some other changes In regulations and policies that will be Implemented on April 1, 2002: Medical Neceulty.' for non-emergency transports is clarified to Include either "bed- confined" or requiring medical care regardless of bed-confinementS. Physician Certification Statements (PCS): A PCS will now be required in advance for patients who have scheduled repetitive trips. The PCS will still be required for all other scheduled and unscheduled BLS and ALS3. trips, although they can be obtained after the transport. Multiple PatientS Zn Same Ambulance: When two patients are transported in the same ambulance Medicare will allow 75 percent of the fee and 50 percent of the mileage for each Medicare beneficiary. For three or more patients transported in the same ambulance, Medicare will allow 60 percent of the fee for each beneficiary and mileage to be prorated equally among the number ol= patient, Pronouncement of Death: ~ledicare will pay for ambulance services when the patient is pronounced dead prior to arrival at the hospital as follows: · Patient is pronounced dead between dispatch of ambulance and arrival -- the BLS rate and no mileage will be paid. · Patient is pronounced dead after being loaded into the ambulance -- the normal payment procedures will be followed. Multiple Agency Responses: First responder services will not be reimbursed; however, if a BLS unit transports a patient whose condition warranted an ALS assessment and/or is escorted by an ALS provider, the BLS service may be reimbumed at the appropriate ALS level. (]t would be up to the BLS agency and the ALS provider to negotiate any payment to the ALS provider for the services). AMERICAN AMBULANCE ASSOCIATION NEWS RELEASE For Immediate Release: February 27, 2002 Contact: Steve Huraczank or Tristan North - Tel. 202-452-gggg American Ambulance Association I.~sues Comment on Medicare Ambulance Fee Schedule Final Rule February 27, 2002 -- The American Ambulance Association (AAA) played a key role in the development of the Medicare Ambulance Fee Schedule through its participation on the Fee Schedule Negotiated Rulemaking Conm~ittea. "We are very appreciative to the Deptattaent of Health and Haman Services and the Centers for Medicare and Medicaid Services (CMS) for their willingness to listen and respond to the induatry's concerns, and take action within the scope oftbe law," said AAA President Ben Hioson. "For tbe first t/me, the ambulance industry was given the opportunity and participated effectively in major health care policy decision making. We arc gratified to have contributed to the process and look forward to working with Congress to address our funding concerns,~ said the AAA President. "Specifically, the AAA is pleased that CMS revised the Final Rule baaed on coonnents from the ambulance industry,~ said Hinson. "For example, m~y ambulance providers will be greatly assisted by CMS' plan to phase-out ALS payments due to local n~detes. We also ure pleased that the conversion factor was increased 4.3 percent over the Proposed Rule,~ he added. "However, as a result of the funding Ihnitafions mandated by Congress in the Balanced Budget Act of 1997, ambulance providers still face Medicare payments that are over 40 percent below the national average cost of providing the ambulance services. "For the average ambulance provider, approximately 30 percent to 50 poweat of all transports arc for Medicare beneficiaries. Therefore, ~be AAA urges all ambulance services and their national o~aniT~/ions to seek the support of their Membe~ of Congress ~gurding the importance of increasing the Medicare fcc schedule to cover the cost of service," said Hinaom The AAA urges Members of Congress to co-sponsor the "Medicare Ambulance Payment Reform Act," S. 3150 and H.R. 1309, which bases ambulance fee schedule rates on national average cost of service. Members of Congress also are urged to co-si)on-nor the "Medicare Rurni Ambulance Service Improvement Act,~ H.R. 2346 and H.R. 3545, wldch provides a 20 percent modifier for transports originating in a rural "It is essantial that the safety net provided by America's ambulance provide~,s is strong and has the capacity to respond to not only national public health and safety threats, such as the tragic events of September 11, but also to h~dividuul medical emergencies and tho routine ambulance transportation needs of the communities we serve,~ said the American Ambulance Association President. The American Ambulance Association (AAA) is based in Washington DC. Its ambulance operation members across the United States provide coverage for more than 95 percent of the urban U.S. population with emergency and non-emergency medical transpoltofion services. Founded In 1979, the AAA's Mission is: "To promote health care policies that ensure excellence in the ambulance services indusUy and provide research, education end commnaicafions programs to enable its membe~ to effectively address the needs of the communities they serve." American Ambulance Association 1255 Twenty-Third Street, NNV Washington, DC 20037-1174 Phone: 202.452.8888 o Fax: 202.452.0005