January 25, 2006

January 25, 2006
E-Update

Table of Contents

Sign Up for AAA Lobby Days and RTF Meeting

The AAA Needs Articles for the Winter Ambulance Service Journal

CMS Removes 2006 Ambulance Rates from Fee Schedule Website

Next Ambulance Open Door Forum

OIG Issues Report on Ambulance Services

CMS Rural Health Guide Now Available in Print and CD Rom Format

DHS Announces 2006 Workshops for Assistance to Firefighters Grant

NYPD Newsletter on Counter-Terrorism

Sign Up for AAA Lobby Days and RTF Meeting

On February 7 to 9, the AAA will be holding Lobby Days and a Reimbursement Task Force Meeting in Washington, DC. The Lobby Days will provide you with an opportunity to meet with your Members of Congress and their staff on important policy issues including Medicare reimbursement. We have advocacy guru Christopher Kush providing attendees with an interactive advocacy training session to help prepare you for your meetings. There will also be an AAA Federal Reimbursement Task Force meeting on February 7. So don't miss this opportunity to meet with your Members of Congress and have a direct voice in the formation of AAA reimbursement policy.

A brochure with registration form is attached to this E-Update. The brochure contains a full schedule of events and information on the program. So complete and return the registration form and start scheduling your meetings!

The AAA Needs Articles for the Winter Ambulance Service Journal

We've begun production on the next Ambulance Service Journal and are looking for member written articles. The deadline for all submissions will be
Close of Business- January 31, 2006
Please send articles to lpeacock@the-aaa.org

CMS Removes 2006 Ambulance Rates from Fee Schedule Website

The Centers for Medicare and Medicaid Services (CMS) has removed from their ambulance fee schedule webpage, the 2006 Public Use File (PUF) containing the incorrect 2006 Medicare ambulance rates. The AAA continues to work with CMS to correct the rates and other errors contained in the PUF and we will keep you posted of new developments.

Next Ambulance Open Door Forum

As reported in an AAA Member Advisory of January 20, the Centers for Medicare and Medicaid Services (CMS) has announced that the next Ambulance Open Door Forum will be held on Thursday, February 2, 2006 at 2:00 p.m. (eastern). To participate on the Forum, dial 1-800-837-1935 and provide the operator with the conference ID number of 3102165 and your name, organization name and the state from which you are calling. Below are more details on the Forum.

CMS Ambulance Open Door Forum

Date: Thursday, February 2, 2006
Time: 2:00 to 3:00 p.m. (eastern)
Conference Call Number: 1-800-837-1935
Conference ID: 3102165
Conference Leaders: Dr. Bill Rogers/Dr. Charlotte Yeh

TTY Communications Relay Services are available for the hearing impaired. For TTY services dial 7-1-1 or 1-800-855-2880 and for Internet Relay services click here http://www.consumer.att.com/relay/which/index.html. A relay communications assistant will help.

ENCORE: Call Number 1-800-642-1687; Conference ID Number 3102165
"Encore" is a recording of this call that can be accessed by dialing 1-800-642-1687 and entering the Conference ID number of 3102165. You can access the recording of the call from Monday, February 6 through Wednesday, February 8, 2006

OIG Issues Report on Ambulance Services

On Monday, January 23, the Office of the Inspector General (OIG) for the Department of Health and Human Services (HHS) issued a report (OEI-05-02-00590) on “Medicare Payments for Ambulance Transports”. A copy of the report can be accessed on the OIG website at http://www.oig.hhs.gov/oei/reports/oei-05-02-00590.pdf. Below is a summary provided by the OIG of the findings of their report and the recommendations that the OIG has made to CMS to reduce alleged improper payments for ambulance transports.

The AAA is currently having its legal team review the findings of the report to brief the AAA Board of Directors on if and how the AAA should respond to the report.

Summary of OIG Report on Medicare Payments for Ambulance Transports

Medicare covers and pays for emergency and nonemergency ambulance transports when a beneficiary's medical condition, at the time of transport, is such that other means of transportation, such as taxi, private car, wheelchair van, or other type of vehicle, would jeopardize the beneficiary's health. We found that 25 percent of ambulance transports in calendar year 2002 did not meet Medicare program requirements, resulting in an estimated $402 million in improper payments. Despite previous OIG inspections indicating that transports for dialysis treatment and other nonemergency transports were particularly vulnerable to abuse, the error rates for these kinds of transports continue to be high. We found that 27 percent of dialysis transports and 20 percent of other nonemergency transports did not meet Medicare's coverage requirements. In contrast, only seven percent of emergency transports were found not to meet requirements. We also determined that contractor safeguards are insufficient to identify and prevent improper payments for ambulance transports. Contractors use few ambulance-specific prepayment edits consistently and fewer than half of the contractors conducted postpayment reviews of ambulance claims. When reviews are conducted, there is no uniform requirement regarding the documentation that should be reviewed. While almost two-thirds of the coverage errors involved a transport from a dialysis facility, hospital, or other third-party provider, these providers received little education regarding Medicare's coverage requirements for ambulance transports.

OIG recommends that CMS implement program integrity activities designed to reduce improper payments for ambulance transports at greatest risk for error, such as dialysis and other nonemergency transports. Included in these activities should be:

(1) instructing all Medicare contractors to implement prepayment edits that target dialysis and nonemergency ambulance transport claims;

(2) instructing all Medicare contractors, when conducting postpayment medical reviews, to obtain documentation from ambulance suppliers and third-party providers to determine that ambulance transports meet program requirements; and

(3) directing all Medicare contractors to educate third-party providers responsible for initiating ambulance transports. Once this is accomplished, CMS may want to examine whether third-party providers continue to order noncovered ambulance transports. If third-party providers are still problematic, CMS may want to examine other administrative actions that can be taken and any potentially fraudulent or abusive providers should be referred to OIG.

CMS Rural Health Guide Now Available in Print and CD Rom Format

The Medicare Guide to Rural Health Services Information for Providers, Suppliers and Physicians is now available online and in both print and CD-Rom formats. This publication offers rural health information and resources in a single source and can be ordered free of charge from the Medicare Learning Network's Medlearn web page at http://www.cms.hhs.gov/MedlearnNetworkGenInfo/ the CMS website.

DHS Announces 2006 Workshops for Assistance to Firefighters Grant

The Assistance to Firefighters Grant (AFG) is a competitive grant opportunity for local fire departments and Emergency Medical Service (EMS) organizations that are not affiliated with a hospital. The AFG funds activities such as purchasing firefighting equipment, personal protection equipment, training, firefighting vehicles, and firefighter/first responder safety projects.

Each year the AFG regional staff conducts hundreds of workshops nationwide to provide up to date program information to applicants. On Wednesday, January 18, 2006 the Assistance to Firefighters Grant Program (AFG) will begin posting the FY 2006 AFG workshop schedule on its website: www.firegrantsupport.com. The workshops are scheduled and conducted by AFG regional representatives and offer current program information for any fire and/or EMS organization that wishes to submit a 2006 AFG application.

There is no admittance charge to any AFG workshop. The schedule will provide the locations, dates, times and points of contact for each workshop. If you are unable to attend a workshop offered in your area, the program office will also be providing on the AFG website an electronic copy of the PowerPoint presentation used at the workshops. In addition, by mid-February, the applicant tutorial, the FY 2006 AFG Program Guidance, and a list of FAQ's will be available on the website. During the application period, there will be an expanded help desk at 1-866-274-0960 and at FIREGRANTS@DHS.GOV.

Thank you for your continued interest in the AFG program and best of luck in the upcoming application period.

NYPD Newsletter on Counter-Terrorism

Forwarded from the New York Police Department

OPERATION NEXUS NEWSLETTER
“A Nation’s best defense is an educated citizenry.”
January 2006

The terrorist attacks of September 11, 2001, changed the world and life as we know it in the United States. As demonstrated that day, “ordinary” civilians have become the targets of terrorism. While the threat of terrorism must be addressed at all levels of law enforcement, it is imperative that the private sector be fully engaged in this process. For this reason, the New York City Police Department has implemented Operation Nexus. This counter-terrorism initiative is based on the following tenets:

· Terrorist events do not occur in a vacuum. They require planning, acquisition of materiel, storage of materiel, transportation of materiel, etc.

· Terrorists are tactically creative. They have demonstrated a propensity to use our resources against us in this free and open society.

· Terrorist operatives are trained to “hide in plain view.” They are also trained to avoid law enforcement officials. Therefore, it is more likely that the next Mohammed Atta will intersect with someone in a business in the private sector than someone in law enforcement.

· Approximately 85% of the “high value targets” are controlled and operated by private sector individuals.

This Operation Nexus Newsletter represents a continuing effort by law enforcement to keep the lines of communication open and encourage the reporting of suspicious customer transactions or encounters, as well as the loss or theft of inventory items.

Anatomy of a Terror Plot: How a Business Outside the “Target Area” Could be “Exploited” to Advance an Attack

Studies of the modus operandi of terrorist groups reveal that the distinct phases of a terror plot often take place in different locations. Individuals involved in the “planning phase” will work from one location, and those responsible for obtaining all of the necessary resources to carry out the attack will work from a second location. From these two separate and distinct locations a third location will have been identified for execution of the terror attack.

The Bottom Line

All businesses are encouraged to report any suspicious incidents or unusual fact patterns to local law enforcement. The NYPD Terrorism Hotline is another resource, available 24/7/365, @ 1-888-NYC-SAFE.

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