AAA Government Affairs E-Update

February 3, 2010

1. Health Care Reform and Medicare Ambulance Relief Update

2. REMINDER: Details of Today's Next Ambulance Open Door Forum

3. Use of modifiers for Transport of Suspected H1N1 Virus Patients

1. Health Care Reform and Medicare Ambulance Relief Update

The fate of health care reform legislation is still extremely uncertain.   As a result, the AAA and other health care provider organizations are asking Congress to include Medicare provider relief extensions in another legislative vehicle.   We recognize that ambulance service providers across the country realized large reductions in Medicare reimbursement at the beginning of this year and we continue to push for retroactive extensions of relief beginning January 1, 2010.

2. REMINDER: Details of Today's Ambulance Open Door Forum

The next Ambulance Open Door Forum will be held today, Wednesday, February 3, 2010, at 2:00 p.m. (eastern).   To participate in the Forum, dial 1-800-837-1935 and provide the operator with the conference ID number of 49625807 and your name, organization name and the state from which you are calling.   Below are more details on the Forum.

CMS Ambulance Open Door Forum

Date: Wednesday, February 3, 2010

Time: 2:00 to 3:00 p.m. (eastern)

Conference Call Number: 1-800-837-1935

Conference ID: 49625807

Conference Leaders: Dr. Bill Rogers/John Warren/Natalie Highsmith

TTY Communications Relay Services are available for the hearing impaired.   For TTY services dial 7-1-1 or 1-800-855-2880.   A relay communications assistant will help.

ENCORE: Call Number 1-800-642-1687; Conference ID Number of 49625807.

"Encore" is a recording of this call that can be accessed by dialing 1-800-642-1687 and entering the Conference ID number of 49625807.  You can access the recording of the call from Wednesday, December 9, after 5:00 p.m. (EST) through Monday, February 8.

3. Use of modifiers for Transport of Suspected H1N1 Virus Patients

On January 29, 2009, CMS issued a notice to all Medicare providers concerning the use of the "DR" (Part A providers) or "CR" (Part B suppliers) modifiers.   These modifiers are used to indicate to a Medicare contractor that payment for a specific claim is authorized under a valid 1135 waiver.   In this notice, CMS clarified that "DR" and "CR" modifiers should only be used by providers that have been granted a formal waiver under Section 1135 of the Social Security Act.  

As a result of this clarification, ambulance providers should not use the "DR" or "CR" modifiers when transporting a patient suspected of being infected with the H1N1 influenza virus to an alternative treatment site established by a hospital under an 1135 waiver.  

On a November 10, 2009 conference call, CMS indicated that, where a hospital receives an 1135 waiver to operate an alternative treatment site, that alternative treatment site becomes part of the hospital for Medicare payment purposes.   Ambulance transports to an approved alternative treatment site should use the "H" modifier for the destination.