AAA MEMBER ADVISORY

TO:           AAA Membership

FROM:     Tristan North

                AAA Senior Vice President for Government Affairs

RE:           Status of Extensions of Medicare Ambulance Relief

As it stands now, all of the Medicare ambulance relief currently in place will expire at the end of this year.   This includes the loss of the temporary 2% urban, 3% rural and super rural bonus payment increases as well as the final complete phase-out of the regional fee schedule.   Tomorrow, the AAA will be issuing its 2010 Medicare Rate Calculator and Forecasting Tool which will not include any of the relief.   We will release a revised version of the Tool upon enactment of extensions of Medicare ambulance relief.

The AAA has been advocating tirelessly for Congress to extend the temporary 2% urban, 3% rural and super rural bonus payment increases.   As a result of the efforts of the AAA and our members, the health care reform bill passed by the House on November 7 contains a two-year extension starting on January 1, 2010, of the 2% urban and 3% rural increases.   The health care reform bill (H.R. 3590) presently being considered by the Senate contains a one-year extension starting on January 1, 2010, of the 2% urban, 3% rural and super rural bonus payment increases.   The Senate is scheduled to vote on passage of H.R. 3590, the Patient Protection and Affordable Care Act, on Thursday, December 24.

Should the Senate pass health care reform legislation on December 24 as expected, the House and Senate will then hold a brief conference committee to resolve differences in the two bills.   Unless in the unlikely event that the House just passes the Senate bill.   Once a compromise is reached, the House and Senate will vote on the final combined bill which is then sent to the President for his signature.   This is planned to occur before the State of the Union Address by the President in February.

The extensions of Medicare ambulance relief would therefore be retroactive to January 1, 2010.   The process for implementing the new rates would likely be very similar to when the 2% urban and 3% rural increases were passed in the Medicare Improvements for Patients and Providers Act (MIPPA).   The Centers for Medicare and Medicaid Services (CMS) would issue a transmittal to Carriers and Fiscal Intermediaries on the change in reimbursement rates and post a revised Public Use File for 2010 with the new rates.

Please be prepared to contact your Members of Congress regarding extensions of Medicare ambulance relief.   We need to ensure that the final bill resulting from conference committee includes the extension of the super rural ambulance bonus payment as well as the retroactive effective date of January 1, 2010.   We will provide all the necessary information for you to make the contacts.