AAA Government Affairs E-Update

July 2, 2008

1. Senate Expected to Vote Again on Physician Fix Package-NEW

2. CALL TO ACTION: Contact Your Senators about Medicare Ambulance Relief

3. Cosponsors to the Medicare Ambulance Payment Extension Act

1. Senate Expected to Vote Again on Physician Fix Package-NEW

Early next week, the U.S. Senate is expected to vote again to invoke cloture and end debate on the physician fix package.  This will be the third such attempt in the past several weeks by the Senate.  The last vote failed to pass by one vote.  On June 24, the U.S. House of Representatives passed the physician fix package by a vote of 355 to 49.  The package contains an 18-month Medicare increase of 2% urban and 3% rural for ambulance service providers.  The Administration has stated that the President will veto the legislation in its current form.

2. CALL TO ACTION: Contact Your Senators about Medicare Ambulance Relief

Next week, the U.S. Senate is expected to once again consider a physician fix package.  That package includes Medicare relief for ambulance services.  Please continue to contact your Senators in support of passing a package right away which contains Medicare ambulance relief.

The package contains an 18-month Medicare increase of 2% urban and 3% rural for ambulance service providers.  This relief would begin retroactively on July 1 of this year and result in approximately $170 million in desperately-needed Medicare relief for ambulance services.  However, the fate of the ambulance relief provision and the physician fix package is still uncertain.

If you have not contacted your Senators on this issue since June 2, please write and call them in support of passing a physician fix package which includes both urban and rural ambulance relief.  Please write and call your Senators today!

To access draft letters, talking points and the phone numbers of your Senators, please go to:  http://capwiz.com/the-aaa/home/

3. Cosponsors to Medicare Ambulance Payment Extension Act

If you have received a commitment from one or more of your members of Congress to cosponsor the Medicare Ambulance Payment Extension Act but don't see their name on the list, please contact Tristan North, AAA Senior Vice President of Government Affairs, with the name of the Member and his or her staff member.  Tristan will follow up with his or her office to ensure the Member is added.  Tristan can be reached at tnorth@the-aaa.org .

Below is a complete list as of July 2 of current cosponsors:

Senate Cosponsors (24) of S. 131

Barbara Boxer (D-CA)

Hillary Rodham Clinton (D-NY)

Thad Cochran (R-MS)

Norm Coleman (R-MN)

Susan Collins (R-ME)

Kent Conrad (D-ND)

Byron Dorgan (D-ND)

John Ensign (R-NV)

Tom Harkin (D-IA)

Tim Johnson (D-SD)

John Kerry (D-MA)

Amy Klobuchar (D-MN)

Herb Kohl (D-WI)

Patrick Leahy (D-VT)

Joe Lieberman (I-CT)

Blanche Lincoln (D-AR)

Claire McCaskill (D-MO)

Ben Nelson (D-NE)

Mark Pryor (D-AR)

Ken Salazar (D-CO)

Bernie Sanders (I-VT)

Chuck Schumer (D-NY) – Sponsor

Olympia Snowe (R-ME)

Debbie Stabenow (D-MI)

Jon Tester (D-MT)

House Cosponsors (66) of H.R. 2164

Neil Abercrombie (D-HI)

Robert Aderholt (R-AL)

Rodney Alexander (R-LA)

Tom Allen (D-ME)

Michael Arcuri (D-NY)

Shelley Berkley (D-NV)

Marion Berry (D-AR)

Marsha Blackburn (R-TN)

John Boozman (R-AR)

Dan Boren (D-OK)

Ken Calvert (R-CA)

Steve Cohen (D-TN)

David Davis (R-TN)

Diana DeGette (D-CO)

William Delahunt (D-MA)

Rosa DeLauro (D-CT)

Vernon Ehlers (R-MI)

Jo Ann Emerson (R-MO)

Phil English (R-PA)

Bob Filner (D-CA)

Jim Gerlach (R-PA)

Raul Grijalva (D-AZ)

John Hall (D-NY)

Ralph Hall (R-TX)

Stephanie Herseth Sandlin (D-SD)

Brian Higgins (D-NY)

Maurice Hinchey (D-NY)

Peter Hoekstra (R-MI)

Eddie Bernice Johnson (D-TX)

Mary Kaptur (D-OH)

Dale Kildee (D-MI)

Randy Kuhl (R-NY)

Steve LaTourette (R-OH)

John Lewis (D-GA)

Kevin McCarthy (R-CA)

Betty McCollum (D-MN)

Mike McNulty (D-NY) – Sponsor

Gary Miller (R-CA)

Harry Mitchell (D-AZ)

Patrick Murphy (D-PA)

Devin Nunes (R-CA)

Ed Pastor (D-AZ)

Ed Perlmutter (D-CO)

Jon Porter (R-NV)

James Oberstar (D-MN)

Collin Peterson (D-MN)

Chip Pickering (R-MS)

Todd Platts (R-PA)

Ted Poe (R-TX)

Nick Rahall (D-WV)

Jim Ramstad (R-MN)

Tom Reynolds (R-NY)

Ciro Rodriguez (D-TX)

Mike Ross (D-AR)

Tim Ryan (D-OH)

Louise Slaughter (D-NY)

Vic Snyder (D-AR)

Mark Souder (R-IN)

Betty Sutton (D-OH)

Bennie Thompson (D-MS)

Mac Thornberry (R-TX)

Fred Upton (R-MI)

Greg Walden (R-OR)

James Walsh (R-NY)

Tim Walz (D-MN)

Peter Welch (D-VT)

David Wu (D-OR)

About the Medicare Ambulance Payment Extension Act

  The Medicare Ambulance Payment Extension Act was introduced on May 3, 2007 by Senators Charles Schumer (D-NY) and Kent Conrad (D-ND) in the Senate and Representatives Mike McNulty (D-NY), Tom Reynolds (R-NY), Chip Pickering (R-MS) and Tom Allen (D-ME) in the House.  Representative Phil English (R-PA) also signed on as an original cosponsor of the House bill.  The legislation would provide critical timely Medicare relief to all ambulance service providers.

The legislation would implement a Medicare increase of 5% to all ambulance service providers regardless of the state or area in which the transport originated.  The two-year relief would apply to just the base rate and not mileage.  The bill language states the relief would commence on January 1, 2008 and expire on December 31, 2009.  Since we are past the commencement date, we will advocate that it commence retroactively on July 1, 2008 and expire on June 30, 2010.

  The legislation is a different approach, supported by the findings of the May 2007 GAO ambulance cost report, to extending the expiring ambulance relief provisions of the Medicare Modernization Act (MMA).  The bills would not impact the relief currently in place including the 50 plus mileage bump, the regional fee schedule adjustment or the super rural bonus payment.  If enacted, S. 1310 and H.R. 2164 would result in an estimated $370 million in additional Medicare relief to ambulance service providers.

On June 24, the U.S. House of Representatives passed the physician fix package by a vote of 355 to 49.  The package contains an 18-month Medicare increase of 2% urban and 3% rural for ambulance service providers.  In the Senate, the physician fix packages by Senate Finance Committee Chairman Max Baucus and Ranking Member Charles Grassley contain an 18 month increase of 2% urban and 3% rural for ambulance service providers.  The current physician fix expired at the end of June and the Senate is expected to vote on the House-passed package when Congress returns next week from the 4^th of July recess.