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Your Action is Needed for Medicare Ambulance Relief
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By Member Heather Sharar
October 9, 2017

House Committee Passes Medicare Ambulance Relief Bill

On Wednesday, the House Ways and Means Committee voted out favorably an amendment in the nature of a substitute to the Comprehensive Operations, Sustainability, ant Transport Act of 2017 (HR 3729) by Congressman Nunes (R-CA) and Sewell (D-AL). H.R. 3729 would extend for five years the Medicare ambulance add-on payments of 2% urban, 3% rural and the super rural bonus. The legislation would also implement cost reporting for ambulance service suppliers.

H.R. 3729 is a revised version of the Ambulance Medicare Budget and Operations Act (HR 3236)introduced by Congressmen Nunes (R-CA), Upton (R-MI) and Welch (D-VT). While the AAA supports H.R. 3236, there were several changes made in H.R. 3729 that are very concerning to the AAA. In particular, the addition of an offset which would implement an additional 22% cut to BLS nonemergency transports to and from dialysis centers and a change in the penalty for not filing a time, complete and accurate cost report.

The AAA has grave concerns about the language surrounding overpayments and the proposed offset. This week, AAA Board Members and Volunteer Leaders were in DC and met with both sponsors of the bill and other key offices to express our concerns over these new provisions. The AAA was able to secure the commitment of House Ways and Means Chairman Kevin Brady (R-TX) and Congressmen Nunes and Sewell to work with us on those two key provisions.

The Committee stated the inclusion of an offset in the bill was necessary for its consideration and the AAA is pushing for our language from S. 967 on prior authorization or similar approach just targeting dialysis transport fraud and abuse to replace the cut. The AAA is also pushing for the Senate to consider S. 967which would make the add-ons permanent and require a random sampling of ambulance services to collect data instead of mandatory annual cost reporting by all ambulance services suppliers.

The AAA encourages its members to write their Senators to cosponsor S. 967.

Details on H.R. 3729
H.R. 3729 would do the following:
• Provides Medicare Ambulance Relief, by extending for five years the current temporary 2 percent urban, 3 percent rural, and super rural bonus payments.
• Requires the Medicare Payment Advisory Commission (MedPAC) to submit a report to Congress detailing the burden of cost reports on the ambulance industry and accuracy of the data received through ambulance cost reports and making recommendations on whether the system should be modified no later than July 1, 2019.
• Requires CMS to work with stakeholders in the development of an ambulance cost report.

This is all the same as originally found in HR 3236.

HR 3729 would also:
• Let the Secretary suspend payments to a supplier of ground ambulance services if they have not submitted a timely cost report for the first two years of cost reporting.
• If the Secretary determines that a supplier of ground ambulance services has not submitted a complete, accurate, and timely cost report, payments made during the time in question can be deemed to be overpayments and CMS is able to recoup such overpayments.
• Starting October 1, 2018, dialysis ambulance transports are subject to a 32%, instead of the current 10%, cut in reimbursement.

Ask your Senators to Support S.967 – 2017 Medicare Ambulance Access, Fraud Prevention, and Reform Act
The current 33-month extension of the Medicare add-on payments is set to expire at the end of December 2017. Losing these add-on payments would be a devastating blow to ambulance services across the country. It is crucial that the payments be made permanent as we push for a long-term solution. More details about the Bill can be found below. Let your Senators know that you support S. 967 — Here are three quick and easy ways to get involved!

Writing to your members of Congress only takes 2 clicks, follow these simple steps:
1. Enter contact information below (required by Congressional offices) and click “Submit”
2. On the next page you’ll see the letter(s) to your Senators – click “Submit Messages”

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