Veteran’s Administration Says It Will Delay Payment Cutting Rule for One Year
Good news for AAP members and all ambulance services across the country. In a court filing late yesterday (November 21), the Veterans Administration (VA) has represented to the United States Court of Appeals for the Federal Circuit, that it is now “developing a rule that would delay the Change in Rates effective date by approximately one year, until February 2025. The VA stated in the official court documents that it expects this “new” rule – solely to delay the effective date of its current payment cutting rule - to be published prior to February 16, 2024. The VA told the court that the VA “does not expect the change in Rates Rule to go into effect by the current effective date” – which is February 16, 2024. The new VA payment reduction rule, if implemented, will cut ambulance reimbursement for services provided to veterans by non-contracted ambulance services from the actual charge for the service to the “lesser of” the actual charges or the Medicare Fee Schedule amount. This will result in a drastic reduction in payments to ambulance services provided to our veterans.
Several ambulance companies, including MedStar Mobile Healthcare in Texas, and Quaker Valley Ambulance Authority, Valley Ambulance Authority, and AMED Ambulance Authority in Pennsylvania, filed a motion on November 1, 2023, in the federal appeals court to “stay” (delay) implementation of the rule. The AAP supported that effort with the filing of a “friend of the court” brief explaining the adverse impact that the rate reduction would have on ambulance services and veterans across Pennsylvania. The VA was required to file a response to the motion to stay by midnight on November 21st. The VA filed its response to the motion with its announcement to the court that it now intends to voluntarily delay the rule for another year. (The VA web page also just added a note that that the VA plans to delay the effective date “by approximately one year.”) https://www.va.gov/healthbenefits/vtp/
“It is good news that the VA has succumbed to the pressure to delay this rule. We believe that the litigation initiated in federal court, led by MedStar and Pennsylvania based ambulance services, was a big tipping point in our favor,” said Heather Sharar, Executive Director of the Ambulance Association of Pennsylvania. “This is one battle won in the war to preserve essential ambulance reimbursement for lifesaving 911 ambulance services provided to our veterans,” she said.
The VA response still needs to be acted on by the court. “It’s important to note that the federal court still needs to rule on the motion the ambulance services filed to delay the rule, even with the VA’s representation that it says it will delay implementation another year,” said Steve Wirth, attorney with Page, Wolfberg & Wirth, LLC which is general counsel for the AAP, and which also filed a “friend of the court” brief on behalf of the AAP supporting the delay. “The parties feel strongly that the VA lacked the legal authority to make the rate reduction change in the first place, and the merits of the case have yet to be decided,” he said. “A delay in the rule would allow the court more time to consider the merits of the case and receive more thorough legal briefing from the parties,” Wirth said. “We are optimistic that the court will grant the request to delay, in light of this new development.”
This is a positive development for ambulance services in Pennsylvania and across the country in the fight to preserve VA reimbursement. “There were many groups and forces that came together to bring about this positive result,” said Sharar. Ambulance services and EMS associations nationwide reached out to their federal legislators and told them that the VA’s drastic rate reduction could cripple ambulance services and reduce access to essential medical care for our veterans. “This favorable development is the result of a broad-based approach to advocating for our ambulance services and veterans. It shows the good that we can all do when we work together, with the interest of the patient – in this case our military veterans and those who serve them – at the forefront,” Sharar said.
