May 19, 2009

AAA MEMBER ADVISORY

TO:          AAA Membership

FROM:    Tristan North

                AAA Senior Vice President for Government Affairs

RE:          Schumer, Roberts, Conrad and Sessions Introduce     

               Permanent Medicare Ambulance Relief Bill in Senate

Yesterday, Senators Chuck Schumer (D-NY), Pat Roberts (R-KS), Kent Conrad (D-ND) and Jeff Sessions (R-AL) introduced in the United States Senate the Medicare Ambulance Access Preservation Act (MAAPA).  The bill number is S. 1066.  The language of S. 1066 is identical to the House companion bill (H.R. 2443) which Congressmen Richard Neal (D-MA) and Fred Upton (R-MI) introduced on May 14.  Senators Mary Landrieu (D-LA), Patrick Leahy (D-VT) and Bernie Sanders (I-VT) were original cosponsors of S. 1066.

The Medicare Ambulance Access Preservation Act consists of two of the three components of the AAA permanent Medicare ambulance relief package developed by the AAA Reimbursement Task Force and adopted by the AAA Board of Directors.  The provisions would take effect on January 1, 2010 when all the current temporary Medicare ambulance relief provisions are set to expire.

The two provisions of the Medicare Ambulance Access Preservation Act are as follows:

1. 6% increase for ground transports originating in an urban or rural area.  The increase of 6% reflects the findings of the Government Accountability Office (GAO) of May 2007. The increase would be to base and mileage rates and would replace the temporary 2% urban and 3% rural increases which also apply to base and mileage rates.
2. 17% increase for ground transports originating in super rural areas.  Since there is only a rural mileage rate and not one specifically for super rural, the current 22.6% base rate increase for super rural areas would remain in place and the mileage rate would increase by 6%.  The 22.6% base rate and 6% mileage rate increases equal a combined average increase of 17% which reflects the findings of the GAO report.

The AAA is working with our supporters in the House Rural Health Coalition and the Senate Rural Health Caucus to include a new ambulance rural definition in a larger rural health care bill which is scheduled to be introduced in the coming weeks.  The new definition of rural is based on Rural Urban Commuting Areas (RUCA).  The definition would expand the number of rural areas and result in 7% of urban transports being classified as rural transports and thus eligible for the 1-17 rural mileage bump of 50%.  A rural ambulance definition based on RUCA is the third component of the AAA permanent Medicare ambulance relief package.

We will be issuing a Call To Action to ask ambulance service providers to contact their Members of Congress in support of cosponsoring MAAPA.