• 02/04/2020 3:02 PM | Anonymous member (Administrator)

    The AAP has long been working with Pennsylvania Department of Human Services (DHS) Fee For Service, Division of Managed Care, and Office of Long Term Living to determine when; and for what services, Skilled Nursing Facilities (SNF) are responsible for payment of medical transportation.  Since October, 1983 the Department of Public Welfare, now DHS, has informed us via several iterations of a SNF Bulletin that “all non-emergency transportation of MA patients is the financial responsibility of the SNF where they reside”.  Over the years many changes to coverages have changed the delivery of medical transportation and the payment structures for the various delivery models.  As it turns out, SNF ARE responsible for Medicare Cost Sharing for dual eligible SNF residents under specific circumstances.

    The clarification in this bulletin resulted in many unanswered questions so we reached out to Page, Wolfberg & Wirth for their opinion.  

    In addition, the Eligibility Determination is performed at the County Assistance Office level and can take months to complete.  It often is approved with retroactivity to the application date.  As Providers, you must make constant attempts to verify/validate Medical Assistance or dual eligibility coverage.  The AAP urges you to keep in constant contact with your SNFs to maintain awareness of their “Presumptive MA” patient processes so that you are able to capture payment from the appropriate source as timely as possible. 

    This is the type of information that is included as a benefit of membership.  For more benefits of membership, please check out our Benefits of Membership.

  • 01/30/2019 3:00 PM | Anonymous member (Administrator)

    The Bill signing of HB 1013 in the Capitol happened on January 30. Governor Wolf along with State officials as well as members of the AAP Board of Directors were present.

    EMS Treat No Transport Bill Signed Into Law - Act 103 of 2018
    This law provides EMS agencies payment for EMS care/services rendered to a patient, even when a patient is not transported to a hospital.

    The act states the following -
    An EMS provider... "determines that emergency services are necessary, the emergency health care provider shall initiate necessary intervention to evaluate and, if necessary, stabilize the condition of the enrollee"..."The managed care plan shall pay all reasonably necessary costs associated with emergency services provided during the period of emergency, subject to all copayments, coinsurances or deductibles."

    Act 103 shall take effect in 60 days.

    Thank you to both our State Legislatures who sponsored and co sponsored this very important Bill as well as those on the AAP Board of Directors who made this a priority for our members!

  • 12/17/2018 2:59 PM | Anonymous member (Administrator)

    By Jan Murphy |, December 17, 2018

    The struggles facing fire and ambulance services across Pennsylvania has left them in critical condition.

    Between staffing, funding and training issues, these first responders are nearing or have approached the point where they can no longer can guarantee a timely or adequate response to a 9-1-1 call for a fire or ambulance.

    "I have never been one to cry wolf, never in my life, but I'm telling you we are in a crisis right now," said Sen. Randy Vulakovich, R-Allegheny County, at a Capitol news conference on Wednesday about the release of a report addressing the issue.

    A 95-page report not only sounds the alarm but offers 27 recommended actions developed following a nearly two-year study of issues affecting the delivery of emergency services by a commission comprising 39 representatives of fire and EMS organizations, many of whom were in attendance for the news conference. The bicameral, bipartisan commission was created by a Senate resolution Vulakovich sponsored last year.

    Among the report's recommendations was one calling for a cafeteria of enticements aimed at recruiting and retaining members such as offering tax credits on school and county taxes for volunteer service or college loan forgiveness or providing fire department attire.

    Others include bolstering funding for simplifying the process to regionalize fire and EMS services, provide state funding for basic first responder training, and develop a mental wellness and stress management protocol to deal with first responders' psychological wounds.

    It also recommended establishing a state fire commission chaired by the state fire commissioner to serve as the lead agency for fire services that would set standards for fire departments and inspect fire companies' compliance with them, collect fire data, and identify fire prevention tools and ways to improve service, among other duties.

    Two other recommendations include reinstating a sprinkler mandate for new one- and two-family homes and repealing or making changes to the fireworks law enacted last year that allowed Pennsylvanians to purchase consumer-grade fireworks but also increased the fire risk.

    Vulakovich, who co-chaired the commission with Rep. Steve Barrar, R-Chester County, said the recommendations that the commission unanimously approved won't solve all the problems fire and EMS organizations face but they can help to preserve these first responders "that are there when we are at our most vulnerable."

    Barrar called the report a playbook for when the new legislative session begins in January.

    "Our job now is to educate the other members in the House and the Senate to take it as serious as the work done by the" commission, he said.

    Rep. Frank Farry, R-Bucks County, a fire chief and longtime fire service volunteer who served on the commission, added it's important that the Legislature prioritize the recommendations and address them in quick fashion. "Because quite frankly, the volunteer fire service and our EMS providers are slowly going the way of the dinosaur and we cannot continue to let that happen," he said.

    The state association of township supervisors last spring passed a resolution calling on the General Assembly and Gov. Tom Wolf to take urgent action to address this crisis in keeping their residents safe and protected.

    A survey done by a subcommittee of the commission confirmed that the number of active firefighters is on the decline. Considering that more than 90 percent of the state's nearly 2,500 fire companies are volunteer organizations, failure to address this staffing crisis carries a steep price tag if they all were to become paid services. The report suggests it might be as high as $10 billion a year.

    "If the legislators in the commonwealth are serious and truly want to help preserve the fire and EMS service, then the Legislature must step up to the plate and act upon all the recommendations of this report, said Charles McGarvey, a Montgomery County municipal fire marshal.

    He said that doesn't mean just the easy recommendations that come with no cost "but those that have some political backlash and monetary support attached."

    McGarvey specifically cited the recommended sprinkler mandate which was repealed by former Gov. Tom Corbett in 2011 shortly after it took effect because of the opposition mounted by the builders community. A commission member noted sprinklers have proven to extinguish a fire before the first firetruck showed up.

    "Either restore the requirement or give local governments the ability to pass the [sprinkler] ordinance without any kind of appeal by the builders or anyone else," said Ed Mann, a former state fire commissioner who served on the commission.

    He and others said it's going to take a grassroots effort to get the attention of local officials and elected state leaders to focus on the solutions that the report recommends. The commission and members of the first responders are prepared to do just that. Mann said the staffing, funding and training problems that first responders are facing can no longer be ignored.

    Vulakovich said, "We are in a crisis right now and it's time we sit down and look at this thing and don't do what government has done in this area for a long time: Neglected it."


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