Table of Contents

White House Tour for 2006 AAA Stars of Life

Select and Register your AAA 2006 Stars of Life

CMS Issues Updated Guide on Remittance Advice
Forwarded from CMS

House Budget Committee Approves FY2007 Budget Resolution

OIG Report on Ambulance Services during Inpatient Stays

Dawson Named Director of NHTSA EMS Office
Forwarded from NHTSA

Only Nine Days Remain in the FY2006 Fire Grant Application Period
Forwarded from the Department of Homeland Security

Secrets of Successful EMS Leaders now available on the LINK

NHTSA EMS Update

Commission on Accreditation of Ambulance Services (CAAS) Press Release

Pictures From Hurricanes Katrina and Rita Needed

ASM 2006 Summer Session

White House Tour for
2006 AAA Stars of Life

Patton Boggs, the advocacy firm for the AAA, was able to secure a White House Tour for this year’s Stars of Life.  The tour is scheduled for Tuesday, May 9, at 11:00 a.m.  Buses will transport the Stars of Life to the White House from the Reflecting Pool in front of the U.S. Capitol where the group and individual photos will be taken and then back to the U.S. Capitol or to the Omni Shoreham Hotel.  The tour of the White House should last approximately 45 minutes.  Please therefore do not schedule any congressional appointments for your Star(s) of Life until after 12:30 p.m. on Tuesday, May 9.  Please send the details of the congressional appointments for your Star(s) of Life to Stacy Bromley, AAA Manager of Member Services and Public Affairs.  Stacy can be reached at sbromley@the-aaa.org or 1-800-523-4447.

CMS Issues Updated Guide on
Remittance Advice
Forwarded from CMS

Understanding the Remittance Advice: A Guide for Medicare Providers, Physicians, Suppliers, and Billers has been updated and is now available online through the Medicare Learning Network’s publication page on the Centers for Medicare and Medicaid Services site at: www.cms.hhs.gov/MLNProducts/downloads/RA_Guide_Full_03-22-06.pdf

This comprehensive publication provides practical information on the types, uses, components of and standardized codes sets used on the RA as well as how to read the Standard Paper Remittance Advice and the Electronic Remittance Advice using PC-Print software (for institutional providers who receive RAs from Fiscal Intermediaries or Regional Home Health Intermediaries) and Medicare Remit Easy Print software (for professional providers who receive RAs from Carriers or DMERCs).  It also includes a number of helpful resources including field indexes (for institutional RAs and professional RAs), an acronym list, and a glossary.  In addition to the online version of “The RA Guide”, it will also be available in print and on CD ROM later this spring.  CMS will announce the availability of these products as they become available.

House Budget Committee Approves
FY2007 Budget Resolution

On March 31, the House Budget Committee approved the FY2007 House Budget Resolution.  The Resolution will now be referred to the House floor for consideration.  The Resolution as approved by the Budget Committee fortunately does not include the reductions in inflation updates for Medicare providers as proposed in the budget submitted by the Administration.  Three weeks ago, the full Senate approved their FY2007 Budget Resolution will also did not contain the inflation update reductions.

During the House Budget Committee consideration of the Resolution, Representative Ron Kind (D-WI) offered an amendment to provide relief to Medicare providers who serve rural areas.  The amendment would have increased the budget allocation to include the cost of extending the temporary 2% increase for rural ambulance service providers through 2007.  The amendment was defeated due to budgetary concerns.

The report accompanying the Budget Resolution did include language promoted by BKSH & Associates, the advocacy firm of American Medical Response, recognizing that ambulance service providers should be reimbursed based on cost.  While the language is not binding, it expresses the concern of the Committee regarding ambulance reimbursement.  The exact language is as follows: “Maintaining Access to Ambulance Services.  Medicare reimbursement for ambulance services continues to be well below the national average for the cost of providing those services.  Medicare patients on average account for 50 percent of the revenue of ambulance service providers.  In order to maintain adequate access and high quality service that Medicare beneficiaries deserve, it is essential that ambulance service providers be reimbursed for the cost of providing the service.”

OIG Report on Ambulance Services
during Inpatient Stays

On March 17, 2006, the Office of Inspector General (OIG) released a report concerning Part B payments for ambulance services to hospital in-patients in 2001-2003.  When a Medicare patient is an in-patient in a hospital, the hospital is responsible to pay for the ambulance round trip.  The OIG studied 150 situations where Part B was billed instead of the hospitals.  In the study, the OIG excluded transports that were on the date of admission or on the date of discharge.

The findings included the OIG stating that 203,377 ambulance claims were incorrectly paid, resulting in $21.7 million in overpayments by Medicare and $6.2 million in overpayments for co-insurance and deductibles.  Of the 150, the IG found the following:

• 28 did not know the patient was an in-patient at time of service;
• 20 were billed incorrectly with no specific reason given;
• 4 were not aware of the Medicare coverage requirements;
• 50 listed the wrong date of service (42 were error by ambulance; 8 were error by hospital);
• 3 were correctly paid because what appeared to be an in-patient turned out not to be.
• 45 did not respond or did not dispute the results.

The OIG recommended:

• CMS recover the $21.7 million;
• CMS establish payment controls to prevent Part B from paying for ambulance services provided during the in-patient stays;
• CMS alert Medicare Carriers to these errors and help them educate ambulance suppliers.

CMS agreed with the recommendations, although they pointed out this may be a past problem as they have since issued a Transmittal that went into effect January 3, 2006 for Carriers to implement the types of edits the OIG recommended.  The report gives no specific claims or examples from which we can determine if they are correct.

Please note: there has been no change in coverage.  Thus, transports to the hospital to be admitted and transports from the hospital following a discharge remain covered (assuming all other coverage criteria are met).  This OIG report is only commenting on transports the OIG believes are not covered by Part B as they are the responsibility of the hospital.

Dawson Named Director of NHTSA
EMS Office
Forwarded from NHTSA

Drew Dawson was selected as the first Director of the Office of Emergency Medical Services (EMS) at the National Highway Traffic Administration (NHTSA).  The EMS Office was established on February 6, 2006.  Since April, 2003, Drew has served as Chief of the NHTSA EMS Division.

Prior to coming to NHTSA, Drew served as the Chief of Montana’s Health Systems Bureau and as Montana’s State EMS Director for twenty years. He also served as a volunteer EMT for many years and has been active in national EMS activities.

The creation of the new Office of EMS is designed to continue and expand the agency’s leadership role in the delivery of post-crash and emergency medical care and to highlight the critical role played by the EMS community in national efforts to reduce fatalities and injuries due to motor vehicle crashes.  Drew will assume his new duties on April 2, 2006.

Only Nine Days Remain in the FY2006 Fire Grant Application Period
Forwarded from the Department of Homeland Security

The Assistance to Firefighters Grant (AFG) program office is reminding fire departments and non-affiliated emergency medical organizations that nine days now remain in the FY2006 fire grant application period.  The application period for AFG began March 6, 2005, at 8:00 a.m. Eastern Standard Time and ends 5:00 p.m. Eastern Daylight Time on April 7, 2006.  If you have started an application, please be sure to COMPLETE IT AND SUBMIT IT before the deadline.  All applications must be submitted (hit the submit button in the online application) to be considered for a grant award.  Once an application is submitted electronically, an automatic notification via e-mail is sent that we have received it.

Through the morning of March 27 a total of 1,313 applications have been submitted.  This compares to 2,045 submitted to this point in last year’s (2005) application period.  AFG makes available competitive grants for equipment, training, firefighter and first responder safety and response vehicles.  AFG applications are automated and accessible via the AFG web site: www.firegrantsupport.com. The web site contains important information on the AFG, including the FY2006 funding priorities and program guidance, a web based tutorial on the application process, a listing of frequently asked questions, and other materials.  Fire departments that have questions regarding this grant opportunity should contact the Help Desk at 1-866-274-0960 or at firegrants@dhs.gov.

The AFG is administered by the Department of Homeland Security’s Office of Grants and Training (G&T) in cooperation with the U.S. Fire Administration.  The AFG program assists rural, urban and suburban fire departments throughout the United States.  In addition the AFG accepts applications from nonaffiliated EMS organizations for the activities (equipment, training, vehicles, etc.) for which fire departments are also eligible to apply.

The AFG program office offers three grant opportunities in each year.  AFG “fire grant” funds are used by the nation’s firefighters and first responders to increase the effectiveness of firefighting and emergency response operations.  The application period for SAFER grants is scheduled for June of 2006.  SAFER grants provide funding for the hiring of firefighting personnel and incentives for volunteer recruitment and retention.  The third grant opportunity will be in September 2006 when the AFG program office opens an application period for Fire Prevention and Safety grants.  These grants support not only fire departments, but also other organizations experienced in fire prevention and in firefighter safety research.  Through the Department of Homeland Security Appropriations Act of 2006, Congress provided $648 million for the Assistance to Firefighters Grants, with $108 million of the funding specified for SAFER grants and a minimum of $27 million for the Fire Prevention and Safety grants.

NHTSA EMS Update

The Office of EMS at NHTSA is making a concerted effort to keep their constituency better informed of our activities, programs and products.  One of the strategies they are using to accomplish that is a newsletter entitled "EMS Update."  Attached is the inaugural issue.  This newsletter will be published quarterly, and target audiences for this publication are EMS decision-makers and EMS providers. 

 FOR IMMEDIATE RELEASE

April 1, 2006

For more information contact:
Meredith Hellestrae
Phone: (847) 657-6828

 Dale Berry, President and CEO of Huron Valley Ambulance (HVA), Ann Arbor, Michigan, has been selected to replace Jimm Murray of La Vista, Nebraska, as business representative to the CAAS Panel of Commissioners. HVA is a nonprofit, regional provider of EMS and health transportation serving eight counties in southeast and south central Michigan. Its more than 100 paramedic ambulances cover 900,000 9-1-1 lives, transporting about 75,000 patients in 2005. In addition to providing ambulance service, HVA provides mobility transportation, nurse-based telemedicine services, 2-1-1 information and referral, medical examiner investigative services and fire department dispatching services. All of its five corporate member organizations are nationally accredited by CAAS.

Mr. Berry majored in police administration at Wayne State University in Detroit, Michigan. During his career in law enforcement, he attended EMT and paramedic school, becoming Ambulance Director/Public Safety Supervisor for the City of South Lyon, Michigan in 1975. He was recruited to serve as General Manager at HVA in 1981 and became President and CEO in 1991. Dale is currently Secretary of the American Ambulance Association and has also held the office of Treasurer, regional board member, and member of the Ethics Committee. He has twice served as President of the Michigan Association of Ambulance Services and made significant contributions to CAAS as board member and Chairman of its Board of Directors. Mr. Berry is the first Commissioner appointed by CAAS who also serves as a Chief Executive Officer of an ambulance service.

Jimm Murray, recently retired Administrator of the Wyoming Department of Health, Community, and Family Health Division in Cheyenne, sat on the CAAS Panel of Commissioners for the past six years, serving as its Chair for all of that time. Jimm was also among the first on-site reviewers for CAAS and sat on its board of directors, as well.

In 1971, Jimm was one of two individuals selected to start the Wyoming EMS program. While there, he co-founded and helped to establish numerous inter-agency programs and public policy groups including The Wyoming State Poison Center and the National Association of State EMS Directors. He co-authored legislation to improve emergency medical care and legal accountability, including the Wyoming Emergency Medical Services Act of 1977, the Trauma

Systems Act of 1993, and the CPR/Do Not Resuscitate Directive Act of 1993. Jimm has authored one text as well as over 40 articles for regional and national publications; has been an invited speaker at more than fifty state, regional and national symposia and seminars; and has received nearly twenty service awards during his distinguished career. As a charter member of NREMT, he is #3 on the list of active Registered EMTS in the United States. He currently serves as Vice Chairman of the Board of Directors for the NREMT, having previously served as Treasurer. He is a contributing editor to EMS INSIDER, and was recently awarded the 2005 Rocco V. Morando Lifetime Achievement Award by the National Association of EMTs. Jimm is also an active reviewer for CECBEMS and is now working with Air Methods Corporation in their Life Net Division of air medical services.

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The Commission on Accreditation of Ambulance Services (CAAS) was formed in 1990 as a not-for-profit agency to be a standard bearer for medical transportation systems. It is sponsored by the American Ambulance Association, the American College of Emergency Physicians, the National Association of EMS Physicians, the National Association of State EMS Officials, the National Association of EMTs, and the International Association of Fire Chiefs, with liaison representation from The National Highway Transportation Safety Administration. Accreditation signifies that ambulance services have met the “gold standard” determined by the ambulance industry to be essential in a modern emergency medical services provider.

Pictures From Hurricanes Katrina and Rita Needed

As we are looking forward to the Stars of Life Event in Washington, DC, we remember the work that members did to assist in affected areas in the aftermath of Hurricanes Katrina and Rita. The AAA would like you to send pictures or videos of your crews in action that we may with use at the Stars of Life Banquet.

We need all photos by COB Monday, April 24, 2006. Please send any images you may have to: edavis@the-aaa.org

ASM 2006 SOLD OUT!

Now accepting enrollment for a special 2006 summer session of the Ambulance Service Manager (ASM) Program.  Reserve your place today!

2006 Ambulance Service Manager (ASM)
The ASM Program is sponsored by the American Ambulance Association (AAA) and is for aspiring, new, and experienced managers who wish to develop their leadership competencies and sharpen essential management skills.  The program provides a broad foundational curriculum matching cutting edge management theory with real-life practical applications.

The ASM Program is a certification course designed to immerse participants in an engaging learning cohort.  A small group of 40 participants moves together through two weeks of face-to-face instruction and experiential learning led by industry leading faculty bridged by several weeks of online discussion and group project work.

ASM Graduates will:

• Develop 41 competencies essential to contemporary leaders managing sustainable EMS Organizations.
• Build problem solving skills through real life case studies, group work, and an industry specific team research project.
• Appreciate principles of system design, operational efficiency, and performance management.
• Demystify the complexities of finance, budgeting, and the ever evolving reimbursement landscape.
• Learn cutting edge practices and theories including appreciative inquiry, emotional intelligence, and other human relations innovations.
• Engage industry leaders as they present current trends in EMS including system design, technology, best practices, and what the future holds.

Dates for the 2006 program are:

• Online begins June 21, 2006
• Onsite week 1: July 20-25, 2006
• Onsite week 2: September 7-12, 2006

Questions?  Call Sharon Conroy at (816) 431-2600.

Go to http://www.fitchassoc.com/Services/conferences.htm to download the brochure and registration materials. http://www.fitchassoc.com/

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