AAA Government Affairs E-Update

August 18, 2010

1. AAA Hosting Lobbying Days in DC in September

2. Just 6 Days Left to Submit Fractional Mileage Comment Letter

3. Host Your Members of Congress on an Ambulance Ride-Along

4. Cosponsors of Permanent Medicare Ambulance Relief Bills

5. Cosponsors of Nongovernmental EMS Federal Death Benefits Bills

1. AAA Hosting Lobbying Days in DC in September

The outcome of several Medicare issues over the next couple of months will be critical to the bottom line of your operation.  So please plan to make a trip to Washington, DC on September 15 to meet with your Members of Congress.  The AAA will be hosting a congressional fly-in that day and will provide you with all the necessary material.

While we were successful in getting extensions of Medicare ambulance relief, those extensions of the 2% urban, 3% rural and super rural bonus increases expire at the end of this year.  So you need to meet with your Members of Congress and advocate for the extensions of relief.  Without your help, these extensions could expire at the same time your operation could be getting less revenue from the proposed change to fractional mileage and a negative 0.25% inflation update which will definitely go into effect on January 1, 2011.

Medicare already reimburses ambulance service providers below the costs of providing critical health care services to Medicare patients.  Help ensure that our industry doesn't receive even less reimbursement.  To do that, you need to come to DC on September 15 or anytime in mid to late September.  Regardless of the timing of your trip, the AAA will help you have productive and effective meeting with your Members of Congress.

If you plan to travel to DC in September, please let AAA SVP of Government Affairs Tristan North know of your travel plans.  He can be reached at tnorth@the-aaa.org. Please also go ahead and schedule your own congressional meetings and let Tristan know the dates and times so that he can coordinate with other potential participants from your state and make sure an AAA representatives attendees your meetings should you so chose.  If you need assistance with finding a hotel, please contact Katie McNealy of the AAA at kmcnealy@the-aaa.org.

2. Just 6 Days Left to Submit Fractional Mileage Comment Letter

There are just 6 days left for you to submit a comment letter to the proposed change on fractional mileage.  Please submit a comment letter today!

The Centers for Medicare and Medicaid Services (CMS) issued a proposed rule which would change how ambulance service agencies are reimbursed for mileage.  If implemented, starting January 1, 2011, CMS would reimburse mileage at the tenth of a mile instead of the current policy of rounding up to the next whole mile.  According to CMS, this change would result in the reduction of between $45 and $80 million a year in payments to our industry which is already under reimbursed by Medicare.

The policy change is currently a proposal which means you have an opportunity to comment on the proposed change and influence how and whether it is implemented.  The AAA has developed a sample letter for you to use.  Simply download the letter and customize it to your organization.  Please feel free distribute this e-mail to other ambulance service agencies and members of your state ambulance association.  Letters are due to CMS by August 24.

Submit on Comment to CMS on the Proposed Fractional Mileage Change!

Click here for sample letter for individual ambulance service providers

Click here for sample letter for state ambulance associations

How to Submit a Comment Letter to CMS on Proposed Rule

Comments to the proposed rule must be received by August 24, 2010.

1. Submitting a Letter Electronically

·         Option 1: Cut and paste the full link into the address line of your Internet browser and you should be taken directly to the proper page. 

http://www.regulations.gov/search/Regs/home.html#submitComment?R=0900006480b182c9

OR

·         Option 2: Click on http://www.regulations.gov/search/Regs/home.html#home.  Under "Select Document Type", select "proposed rule".  Then in the box labeled "Enter keyword of ID", enter "CMS-2010-0205-0002" and hit "search".  When taken to the next page, click on "Submit a Comment" to the far right of the page under "Actions".  You should be directed to the proper page.

THEN

• Complete the section entitled "Enter Information" including your first name, last name and oganization.
• For "Category", select "health care provider/association".
•   Under the section entitled "Type Comment & Upload File", either cut and paste your letter into the box provided or use the "browse" button to find your letter on your computer and then hit "attach" to upload the letter.
•   Hit "submit" once you have entered your information and included your letter in the box or uploaded it.
• Please send a copy of your letter to me at tnorth@the-aaa.org.

2. Submitting a Letter by Regular Mail

·         Print out your letter and mail it to:

Centers for Medicare & Medicaid Services

Department of Health and Human Services

Attention: CMS-1503-P

P.O. Box 8013

Baltimore, MD 21244-8013

·         Please send a copy of your letter to me at:

American Ambulance Association

Attn: Tristan North

8400 Westpark Drive, 2^nd Floor

McLean, VA  22102

There is still an opportunity to influence this proposed change but only if you send a letter to CMS!  Thank you in advance for sending a letter.

3. Host Your Members of Congress on an Ambulance Ride-Along

We encourage AAA members to use the opportunity provided by the August recess to educate members of Congress about issues important to your operation.  The most effective way to deliver these key messages is to host your member of Congress on a tour or your operation and an ambulance ride-along.  The AAA has made this process easy for you with our 2010 Congressional Ride-Along Toolkit.

The AAA 2010 Congressional Ride-Along Toolkit is available on the AAA website at: http://www.the-aaa.org/capitol_hill/congressional_ridealongs.html

In addition, September is "National Preparedness Month" which presents you with an opportunity to generate more awareness within your community and with local and state officials about the important role of your operation as a first responder.  We have updated our Emergency Preparedness Toolkit which includes information about National Preparedness Month and how your operation can generate awareness.  That toolkit can also be accessed at: http://www.the-aaa.org/capitol_hill/congressional_ridealongs.html

4. Cosponsors of Permanent Medicare Ambulance Relief Bills

Congress is currently in recess so new cosponsors won't be officially added until after Labor Day.

The Medicare Ambulance Access Preservation Act (MAAPA) was introduced in the Senate by Senators Charles Schumer (D-NY), Pat Roberts (R-KS), Kent Conrad (D-ND) and Jeff Sessions (R-AL) and in the House by Congressmen Richard Neal (D-MA) and Fred Upton (R-MI).  MAAPA (S. 1066, H.R. 2443) would provide a permanent 6% Medicare increase for ambulance transports originating in urban or rural areas and permanently extend the bonus base payment of 22.6% for ambulance transports originating in super rural areas.

The AAA was successful in efforts to extend the temporary 2% urban, 3% rural and super rural bonus increases until the end of 2010.  The relief from MAAPA would take the place of any temporary Medicare ambulance relief beyond 2010 and not in addition to it.  The AAA will continue to pursue efforts for the extension of the temporary Medicare ambulance relief provisions as well as advocate for passage of MAAPA as the permanent solution to below-cost Medicare ambulance reimbursement.  Medicare ambulance relief is the top legislative priority of the AAA.

Current Cosponsors of MAAPA

Below is a list, current as of today, of members of Congress who have officially been added as cosponsors to MAAPA (S. 1066, H.R. 2443).  The names of sponsors and champions of the bills are underlined.

AL: Sen. Jeff Sessions

AR: Sen. Blanche Lincoln, Sen. Mark Pryor, Rep. Marion Berry

CA: Rep. Devin Nunes

CT: Rep. Rosa DeLauro: Rep. Chris Murphy

DC: Del. Eleanor Holmes Norton

GA: Sen. Saxby Chambliss, Sen. Johnny Isakson

IL: Rep. Aaron Schock

IA: Sen. Tom Harkin

KS: Sen. Pat Roberts

KY: Brett Guthrie

LA: Sen. Mary Landrieu, Rep. Charlie Melancon

ME: Sen. Susan Collins, Rep. Michael Michaud

MP: Del. Gregorio Sablan

MA: Sen. John Kerry, Rep. Richard Neal, Rep. James McGovern, Rep. Mike Capuano

MI: Sen. Debbie Stabenow, Rep. Fred Upton, Rep. Dale Kildee, Rep. Bart Stupak, Rep. Mark Schauer

MN: Sen. Amy Klobuchar; Rep. Jim Oberstar

MS: Sen. Thad Cochran

MO: Sen. Kit Bond

MT: Sen. Jon Tester

NE: Rep. Adrian Smith

NV: Rep. Shelley Berkley

NJ: Sen. Frank Lautenberg, Rep. Steven Rothman, Rep. Albio Sires

NY: Sen. Charles Schumer, Sen. Kirsten Gillibrand, Rep. Paul Tonko

NH: Sen. Jeanne Shaheen

ND: Sen. Kent Conrad, Sen. Byron Dorgan

OH: Rep. Patrick Tiberi

OR: Rep. Peter DeFazio, Rep. David Wu

PA: Rep. Jim Gerlach, Rep. Tim Murphy, Rep. Tim Holden, Rep. Patrick Murphy

RI: Sen. Sheldon Whitehouse, Rep. James Langevin

SD: Rep. Stephanie Sandlin Herseth

SC: Sen. Lindsey Graham

VA: Rep. Gerry Connolly

VT: Sen. Patrick Leahy, Sen. Bernie Sanders, Rep. Peter Welch

WA: Rep. Doc Hastings

WV: Rep. Nick Rahall

WI: Rep. Steve Kagen, Rep. Tammy Baldwin

5. Cosponsors of Federal Death Benefit Nongovernmental EMS Bills

Congress is currently in recess so new cosponsors won't be officially added until after Labor Day.

The second highest legislative priority of the AAA is to ensure that paramedics and EMTs who are employed by nongovernmental ambulance agencies are covered by federal death benefits in the unfortunate event that he or she dies in the line of duty.   To address this issue, the AAA has been working closely with the offices of Senator Patrick Leahy who introduced the Dale Long Emergency Medical Service Providers Protection Act (S. 1353) and Congressman Keith Ellison who introduced the Nongovernmental Emergency Responder Family Protection Act (H.R. 2485).  S. 1353 is pending on the Senate Calendar and H.R. 2485 has been referred to the House Judiciary Committee.

The Nongovernmental Emergency Responder Family Protection Act (NERFPA) would clarify that the PSOB program covers private non-profit and for-profit public safety officers who provide emergency medical and ground or air ambulance service, fire protection and suppression.  The Dale Long Emergency Medical Service Providers Protection Act would cover non-profit public safety officers.

Below is a list, current as of today, of members of Congress who have officially been added as cosponsors to the Dale Long Act (S. 1353) and H.R. 2485.  The names of sponsors and champions of the bills are underlined.

Dale Long Act (S. 1353) Cosponsors

MI: Sen. Debbie Stabenow

MN: Sen. Al Franken

NJ: Sen. Bob Menendez

NY: Sen. Chuck Schumer

ND: Sen. Kent Conrad

OR: Sen. Jeff Merkley

VT: Sen. Patrick Leahy, Sen. Bernie Sanders

NERFPA (H.R. 2485) Cosponsors

CA: Rep. Zoe Lofgren

DC: Del. Eleanor Holmes Norton

GA: Rep. Sanford Bishop

IN: Rep. Andre Carson

KS: Rep. Dennis Moore

ME: Rep. Michael Michaud

MD: Rep. Elijah Cummings

MA: Rep. Barney Frank

MI: Rep. Mark Schauer

MN: Rep. Keith Ellison, Rep. Collin Peterson, Rep. Tim Walz

NJ: Rep. Steven Rothman

NY: Rep. Yvette Clarke, Rep. Paul Tonko

OR: Rep. David Wu

VT: Rep. Peter Welch