According to a press release from the office of Congresswoman Terri Sewell, she and several colleagues in the House introduced the Medicare Ambulance Access, Fraud Prevention, and Reform Act earlier today. Her bill has gained the support of industry leaders who say that it will
The purpose of the bill, according to her release, is to “strengthen ambulance service providers and help ensure they are able to continue delivering critical first responders and health care services in communities across the country.”
“Ambulance services are a vital component of our local and national health care and emergency response systems, especially in rural and underserved areas where they are often the sole provider of emergency medical services in their communities,” Sewell said. “The Medicare Ambulance Access, Fraud Prevention, and Reform Act of 2019 will implement critical reforms to help ensure Alabamians have access to lifesaving emergency care, no matter where they live.”
Sewell’s office points out that, “Although ambulance providers provide critical emergency services to communities across the country, the Government Accountability Office has found that they are reimbursed below cost by Medicare, which has hampered the ability of ambulance service providers to hire new staff, update equipment, and provide life-saving around the-clock services in their communities, especially those in economically distressed areas. Without frequent add-on payments authorized by Congress, these providers must often operate at a loss.”
Included in the legislation are provisions to permanently increase the rate at which ambulance providers are reimbursed by Medicaid, allow ambulance services that serve low population areas to continue to receive additional rural Medicare funding and eliminate burdensome duplicative paperwork requirements.
Included in Sewell’s release was a quote from the American Ambulance Association (AAA) President Aarron Reinert who said, “The Medicare Ambulance Access, Fraud Prevention and Reform Act of 2019 would give organizations that provide vital emergency 9-1-1 and non-emergency ambulance services greater certainty as to the future of desperately-needed Medicare funding relief as identified by the Government Accountability Office. Most importantly, it would help ensure continued access by Medicare beneficiaries and all Americans in urban and, in particular, rural and extremely rural, areas to medical first response and mobile health care.”
“The American Ambulance Association greatly appreciates the leadership and hopeful outlook of Congresswoman Sewell and Congressman Nunes as well as Congressmen Welch, Blumenauer, and Mullin in addressing this critical issue.”
Their website highlights the benefits of this bill saying, “H.R. 4938 would help stabilize current and future Medicare reimbursement of ambulance services and set the stage for future reform of the Medicare ambulance fee schedule.” According to the AAA, if passed, this bill would:
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Make Medicare Add-ons Permanent – Current temporary 2 percent urban, 3 percent rural, and super rural bonus payments would be made permanent.
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Expand Prior Authorization Pilot Program Nationwide – To address fraud and abuse with the transportation of dialysis patients by ambulance, the bill expands the Centers for Medicare & Medicaid Services (CMS) national prior authorization program for repetitive non-emergency basic life support (BLS) dialysis transports. CMS has not yet exercised its authority to expand this successful pilot program nationwide. While CMS is considering exercising its authority to extend the program nationwide in a recent proposed rule, it has not made a final determination yet.
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Provide Regulatory Relief – Amend requirements under the 855 form to make change notifications less burdensome.
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Protect Access to Ambulance Services in Rural and Low Population Density Areas – Protect access to ambulance services in rural and super-rural areas, by establishing a policy to protect low volume areas and a process for CMS to review changes in the rural or super-rural status of an area after the next census occurs.
