March 5, 2009

AAA MEMBER ADVISORY

TO:          AAA Membership

FROM:    Tristan North

                AAA Senior Vice President for Government Affairs

RE:          Permanent Medicare Ambulance Relief Legislation to be Introduced Shortly

In the next few weeks, Senators Charles Schumer (D-NY), Pat Roberts (R-KS) and Kent Conrad (D-ND) in the Senate and Congressman Richard Neal (D-MA) in the House will introduce legislation for permanent Medicare ambulance relief.  The provisions of the legislation would begin on January 1, 2010 when the 2% urban, 3% rural and 22.6% super rural increases expire and the regional fee schedule is completed phased out.  The legislation is based on the AAA package adopted by the AAA Board of Directors on October 1, 2008.

The provisions of the legislation will be as follows:

• 6% increase for ground transports originating in an urban or rural area.  The overall average increase of 6% reflects the findings of the Government Accountability Office (GAO) and AAA cost reports.  The increases 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. 
• 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% increase for super rural areas would remain in place but the mileage rate would increase by only 6%.  The 22.6% base rate and 6% mileage rate increases equal an overall average increase of 17% which reflects the findings of the GAO and AAA cost reports.
• Implementation of a new definition of rural based on Rural Urban Commuting Areas (RUCA).  This new 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%.

This legislation will replace our efforts last year for short-term relief with the Medicare Ambulance Payment Extension Act (S. 1310, H.R. 2164) which resulted in the 2% urban and 3% rural increases currently in place.  Attendees of the AAA Lobbying Days have already started to attract original cosponsors for the new legislation.  We will launch a grassroots campaign once the legislation is introduced to ask AAA members to contact their members of Congress in support of permanent Medicare ambulance relief.