Five Months!
Five Months have passed since Senators Stabenow, Roberts,
Leahy, Collins and Schumer introduced S. 967 entitled the “Medicare Ambulance
Access, Fraud Prevention and Reform Act of 2017” and yet the legislation has
not passed. Companion bill H.R. 3236 also remains in limbo.
We’re just three months away from what potentially can be a
serious blow to the ambulance industry should the add-on bonus payments be
allowed to expire. Already underfunded,
our industry will lose even more precious dollars that we can’t afford to
forfeit.
Time for Action…
Now is the time for you to take action.
The American Ambulance Association is promoting an easy way
for you to contact your Federal legislator with an urgent request that he/she
take action on the measure today. A quick visit to https://ambulance.org/advocacy will
provide you with an easy method to send your Congressman or Senator a message. There’s
no time to waste.
And with that in mind, earlier this year we blogged a 4-part
series about the importance of these bills to the ambulance industry in
America. To re-educate you on the matter, we are including highlights from Part
I of the series from May to remind all of us of the urgent need to push this
legislation to passage.
We hope you take time to read, understand and act!
4 Parts
S. 967 (and H.R. 3236) addresses four areas to benefit all
of EMS in America.
- Reform to the Medicare ambulance fee schedule
- Prior Authorization for ambulance transports of ESRD beneficiaries
- Requiring providers of services and ambulance service providers to submit cost data and other information with respect to ambulance services
- Treatment of ambulance service providers
It’s important to remember, however, that as the American
Ambulance Association (AAA) has warned, there will most likely be changes that
take place as the bill gets passed around through the Finance Committee and
then, hopefully, to the floor for final consideration.
Reform to the Medicare ambulance fee schedule
It’s been 15 years since the inception of the Medicare
ambulance fee schedule.
However, it didn’t take long for all of us to realize that
the fee schedule underfunded most of us. Lobbying efforts produced a “band-aid”
measure called the add-on bonus payments. Each year for many years Congress has
passed these add-on payments on top of the fee schedule payments- 2% additional
for urban areas, 3% for rural and 22.6% for the most remote areas of the
Country labeled as super-rural. Plus the rural and super-rural areas receive a
50% increase in the mileage payment above and beyond the fee schedule amounts.
These add-ons always rode the coattails of what was
then-known as the “Doc Fix” for the physician fee schedule and always were
passed in the 11th hour just before (and one year even after- then
paid retroactively) they expired. Left to lapse and the American ambulance
industry would have reeled to fill the gap in reimbursement.
But, the “Doc Fix” has been permanently fixed, which means
at the end of this year unless this measure passes the add-ons will disappear
and with no real avenue to extend them, as in the past.
Increase the conversation factor for ground ambulance services
S. 967 and H.R. 3236, if passed, will permanently increase
the conversation factor in the Medicare ambulance fee schedule to include the
add-ons in the fee schedule calculations.
The super rural is proposed to increase by 25.6%, the rural
census tract areas would remain at 3% and urban approval rates would be boosted
by the same 2% factor. The revisions would become effective January 1, 2018.
Mileage boosts would be calculated at an additional 3% for
the super-rural and rural areas and the urban providers would actually see an
increase of 2% within the calculation methodology.
Important Why?
The Why of this is simple.
No ambulance service that we know of can stand to lose a
single penny. Losing 2%, 3% or 22.6% of our money potentially would drive the
final nail into many an EMS system’s coffin of demise. Costs have skyrocketed
while reimbursement have been stale- and that includes the bonus payments.
If left to languish, already squeezed EMS budgets would be
choked.
Now’s the time to push hard. Take action! Contact your
Leislator’s office TODAY to advocate for S.967 and H.R. 3236 to pass. Time’s
running short- there’s no time to waste.
Act now!
