Table of Contents

President Signs Port Security Bill and EMS Language into Law

Meet with Your Members of Congress on Temporary Medicare Ambulance Relief

Summary of Ambulance Open Door Forum of October 17
By David M. Werfel, Esq.

Submit Your Ambulance Cost Survey Today

Past CMS Fee Schedule FAQs Now on AAA Website

National Provider Identifier News
Forwarded from CMS

CMS Briefing on Medicaid Integrity Program
Forwarded from CMS

IOM Emergency Care Dissemination Workshops: Registration for Capstone Workshop in Washington, D.C. Now Open

President Signs Port Security Bill and EMS Language into Law

On October 13, President Bush signed into law (Public Law 109-347) the SAFE Port Act or "Port Security Bill" (H.R. 4954). As reported in the AAA Member Advisory of October 2, the AAA was able to include in the conference report to the Port Security Bill the language of "governmental and nongovernmental." This language amends the definition of "emergency response provider" in the Homeland Security Act to help clarify for state and local officials that public and private ambulance service providers are eligible for homeland security funding.

Summary of Ambulance Open Door Forum of October 17

By David M. Werfel, Esq.

On October 17, 2006, CMS held its latest Open Door Forum. As is their procedure, they started with an announcement, then answers to a few questions that were previously asked and then had a Question/Answer session.

The announcements and answers to prior questions were as follows:

1. NPI - CMS reminded everyone to get their NPI.

2. Bariatric Transports - CMS indicated that there will be no additional payments for bariatric transports, extra attendants, etc. Their reason was simply that we are now fully under the fee schedule and that amount is all-inclusive (except for mileage).

3. 911 to Helipad - In stating the answer, CMS admitted it did not have a good grasp of the question. CMS indicated that if the question was which modifiers should be used when a ground ambulance transports from a scene to meet the air ambulance and then which to use when the air ambulance takes the patient to the hospital, the answers were "SI" and "IH".

4. SNF to ER - Part B should be billed for transports of SNF patients, even in the Part A stay, for emergencies to the hospital as well as the return following emergency treatment.

5. Signature - ABN - Emergency - In a prior Open Door Forum, CMS was asked if an Advance Beneficiary Notice is needed when the patient is having an emergency. They answered "No".

6. Enrollment Form - CMS reminded listeners that the NPI is needed when completing a new enrollment application. Also, new applicants as well as existing providers/suppliers amending an application will have to submit a form to accept payments electronically.

Following the above, CMS took 13 calls. Several will be answered off-line by the local CMS Regional office; a few merely confirmed information; but there were a few worth noting, as follows:

• the Final Rule (that includes SCT) is scheduled to be published in early November.
• a patient with an emergency condition can not be asked to sign an ABN, but one of the callers noted that the ABN is needed when air ambulance is downgraded to ground ambulance. To be covered, air ambulance must be for emergency transports. This appears to be a Catch-22. CMS indicated that these must be resolved through the appeals process.
• in response to one call, CMS seemed to think - - they were not sure - - that the signature is not needed in box 12 and 13 on the 1500 form. THERE HAS BEEN NO CHANGE IN POLICY - - THE PATIENT SIGNATURE REQUIREMENTS HAVE, UNFORTUNATELY, NOT CHANGED.
• a few questions involved payment for long distance mileage. Again, there has been no change in policy. Mileage is still paid to/from the nearest appropriate facility. An average mileage to facilities in the area can not be used, as one caller asked.
• residence to a physician's office is not covered.
• residence to a free standing facility is not covered (it would be for dialysis). CMS recommended that if you are not sure whether a facility is a hospital, a free standing diagnostic facility, etc., you should ask your Carrier.

There were 232 callers.

The next ambulance Open Door Forum will be December 19, 2006

Submit Your Ambulance Cost Survey Today

You still have time to submit your completed ambulance cost survey. If you received a follow up phone call from Randy Strozyk, Brenda Staffan, Jerry Zapolnik or Larry Wiersch and you pledged to complete and submit a survey, please do so at your first opportunity. Quantria Strategies has received only 79 completed surveys which is well below our target. It is therefore crucial if you received a letter to complete and submit a survey today.

Quantria Strategies has sent letters to 1,000 ambulance service providers asking that they participate in an ambulance cost study. The providers were randomly selected and represent a cross section of all provider types, service area populations and regions of the country. The AAA hired Quantria Strategies to conduct the study so that the ambulance industry will have a basis by which to compare the results of the Government Accountability Office (GAO) study on the costs of ambulance services now expected to be released this fall.

If you receive a letter, please follow the instructions and participate in the survey. It is critical that we have a large response rate. If you receive a letter and have any questions, please contact John O'Hare of Quantria Strategies at jfo@quantria.com or Judy Xanthopoulos at jax@quantria.com .

Past CMS Fee Schedule FAQs Now on AAA Website

You can now access past CMS fee schedule FAQs on the AAA website at www.the-aaa.org . The AAA received permission from CMS to post the FAQs which were posted on the CMS website for 2002. The FAQs are on the AAA homepage and contained in four Adobe Acrobat files which can be searched electronically.

On Thursday, October 26, 2006, from 3:00 to 4:00 pm ET, the Centers for Medicare & Medicaid Services (CMS) will hold a briefing to discuss the Medicaid Integrity Program.

Under the provisions of the Deficit Reduction Act (DRA) of 2005, Congress provided resources to CMS to establish the Medicaid Integrity Program (MIP). MIP represents the first national strategy to detect and prevent Medicaid fraud and abuse in the program's history. Under the leadership of the Center for Medicaid & State Operations (CMSO), the agency will fulfill the mandates of this new program. The Comprehensive Medicaid Integrity Plan, released July 18, 2006, will guide CMSO's efforts to fulfill this new obligation.

Please join Robb Miller, the Acting Director of the Medicaid Integrity Group on a conference call as he describes the broad responsibilities, guiding principles, and operational functions and strategies of the MIP included in the Plan.

For more information about the Comprehensive Medicaid Integrity Plan, visit:

http://www.cms.hhs.gov/DeficitReductionAct/02_CMIP.asp

Call-in information for the call is found below:

DATE: Thursday, October 26, 2006

TIME: 3:00 PM ET

DURATION: 1 Hr.

TOLL FREE #: 1-888-552-9191

PASSCODE: 8866043

_____________________________________________
This message was intended to be viewed in HTML. If you are unable to view HTML with your e-mail application, please visit (http://www.the-aaa.org/Publications/E-Update/10_18_06-GA.htm)

You are receiving this E-Update because you signed up to receive communications from AAA, to be removed reply to this email using the "reply" address.
American Ambulance Association - 8201 Greensboro Drive, Suite 300 - McLean, VA 22102

Copyright 2006, American Ambulance Association. No material can be reproduced or forwarded to individuals outside of your company without the express written permission of the publisher.