We are now accepting nominations for the 2023 TASA Awards. The deadline for nominations is December 15, 2022.
Each year, TASA gives an opportunity to EMS individuals and services to be recognized by their peers in a statewide search for the best in our field. Anyone can nominate individuals or emergency medical services that they believe are the best of the best. EMS professionals can only be nominated online. The following categories are recognized each year by TASA:
Nominations accepted in any of the above categories, except the L. Gale Allen President’s Leadership Award. This category is reserved as an exclusive decision of the TASA President.
The winner in each award’s category will receive an award package that will consist of: 4 tickets to the awards banquet (one for the recipient and 3 for their guests); the winner will receive 2 nights stay in the Park Vista Hotel in Gatlinburg; the winner may attend the TASA Mid-Winter conference free of charge and will receive a $100.00 prize (except Service Award), along with a crystal trophy. This year’s conference dates are February 22, 23 & 24, 2023. Nominations may be entered immediately and run until a cut-off date of December 15, 2022. You must submit your nomination(s) no later than December 15, 2022. Nominations cannot be accepted after this date. Awards will be presented during the Award’s Banquet on the evening of Wednesday, February 22, 2023.
TASA Board Members are not eligible to receive an award nomination personally nor may their service be nominated. Individuals employed in a TASA Board Members Service may be nominated.
The Centers for Medicare & Medicaid Services (CMS) has released the ground ambulance suppliers and providers selected for Years 3 and 4 of the Medicare ground ambulance data collection system. The list of the selected providers and suppliers is available on the CMS website. These providers and suppliers will be asked to collect data during their budget year starting in 2023 and to report the data within five months of the close of that year.
Providers and suppliers who are selected should respond to the notification letter sent by Medicare Administrative Contractors (MAC). Organizations may select a calendar year or fiscal year start date for the data collection period. Data will be submitted for a continuous 12-month period using the Medicare Ground Ambulance Data Collection Instrument: English (PDF).
The AAA continues to provide educational support for ground ambulance services to help them collect and report these data. In addition to in-person sessions, the AAA offers webinars on demand.
It is important that all ground ambulance providers and suppliers collect and report data through this program. The Congress intends to use the information to help reform Medicare ambulance fee schedule.
TennCare announces the restart of the Ground Assessment Program for Emergency Transports Only
On Thursday October 6, 2022 we received word from TennCare that they had completed the necessary data collection to re-launch the assessment program. TennCare will be sending a memo to providers today announcing the re-launch of the program.
According to TennCare, the first assessments (invoices) and payments (aka kicker payments) will cover SFY Q3 & Q4 (Jan-Mar & Apr-Jun 2022) and providers should begin receiving payments and invoices before the end of October.
The first invoices are based on 2020 emergency responses that resulted in a transport. Moving forward, the invoices will be based on 2021 emergency responses that resulted in a transport.
Assessments (invoices) SFY22 Q3 & Q4 (Jan-Mar & Apr-Jun 2022): $26.32 per emergency response that resulted in a transport in 2020. Example: ABC Ambulance Service made 5,648 total emergency responses that resulted in transport in 2020. This number is divided by 4 to get the per quarter responses then multiplied by the assessment rate. (5,648 / 4) x $26.32 = $37,163.84 each quarter.
Assessments (invoices) SFY23 Q1, Q2, Q3 & Q4 (July-Sep, Oct-Dec, Jan-Mar, Apr-Jun 2023): $20.43 per emergency response that resulted in a transport in 2021. Example: ABC Ambulance Service made 6,823 total emergency responses that resulted in transport in 2020. This number is divided by 4 to get the per quarter responses then multiplied by the assessment rate. (6,823 / 4) x $20.43 = $34,848.72 each quarter.
Payments (aka kicker payments) SFY22 Q3, Q4 and SFY 23 all quarters: $229.50 per emergency TennCare claim paid in the respective quarter. Qualifying paid TennCare claims = HCPCS codes: A0427, A0429, A0433, A0434. Example: ABC Ambulance Service was paid for 365 qualifying TennCare claims during SFY Q3. The kicker payment for this quarter would be: 365 x $229.50 = $83,767.50
Payment breakdowns will be sent out by TASA to the service address on file with the State EMS office
To address ongoing staffing challenges, the Tennessee General Assembly passed legislation this year creating an additional return to work opportunity allowing retired TCRS members to be employed as a K-12 teacher, bus driver, or emergency medical services personnel without the loss of their TCRS retirement benefits.
Beginning July 1, 2022, the law allows these personnel to return to work without suspension of benefits under the Return to Work 70% Retirement Benefit provision. Generally, if a retired member returns to service with a TCRS-covered employer under any circumstance, other than 120-day Temporary Employment or Limited Reemployment of Retired Teachers, his or her retirement payment is suspended during reemployment. The new legislation has expanded these exceptions. To return to work under the new guidelines, the following conditions must be met:
• The retiree must be retired at least 60 days.
• For teachers and bus drivers, the retiree must have the requisite experience and training for the position, there must not be any other qualified persons available to fill the position, and the position must be with a K-12 school system.
• For emergency medical services personnel, the retiree must possess a current valid license issued by the emergency medical services board through the Department of Health.
• The retiree’s retirement benefit will be limited to 70% of what would otherwise be payable for the period of reemployment.
• The retiree must not be drawing a TCRS Disability Benefit.
• The retiree’s appointment cannot exceed one year; however, they may be reappointed to additional one-year periods as long as the retiree still meets all of the above requirements.
Members must apply for this type of return-to-work provision using the Return to Service with 70% Retirement Benefit form found on the Forms and Guides page at RetireReady.gov. Before accepting a position with a TCRS-covered employer, retirees should contact RetireReadyTN at (800) 922-7772 to determine how their TCRS retirement benefits may be impacted.
EMS World Expo is headed to beautiful Orlando, Florida, this October. Everything you need to know about this year’s conference is now available in one simple download. Click the button below to view the 2022 brochure, and learn about new workshops, conference sessions, hotel options, and more.
TASA Members Save $100!
As a member of the Tennessee Ambulance Service Association, you have the opportunity to save $100* on a 3-day conference pass! Enter code TASA when registering to save. Claim a FREE Exhibit Hall Only pass with code TASAXPO
*Offer applies to new 3-day conference passes only, and cannot be combined with any other offers or discounts including NAEMT, group, and military discounts.
Topic: The Monkeypox Virus: Through the Lens of EMS
Emory University’s Serious Communicable Disease ECHO program is hosting a special to update the community on current special pathogens.
Anyone interfacing with patients, including physicians, nurses, pharmacists, hospital administrators, etc., are welcome to attend.
•Alexander Isakov, MD, MPH – Emory University, Department of Prehospital and Disaster Medicine and Office of Critical Event Preparedness and Response
•Wade Miles, NR-P – Emory University, Department of Prehospital and Disaster Medicine
•Lindsey B. Gottlieb, MD – Emory Healthcare, Infectious Disease
The Planners and Presenters of this activity disclose that they have no financial relationships with any commercial interest.
Aug 18, 2022 11:00 AM in Eastern Time (US and Canada)
President Valentine has scheduled a called special meeting (virtual) of the TASA Board for August 3, 2022 at 9am CST. The purpose of this called meeting is to review the current recommendations for the State EMS Board – as requested by Senator Bell’s office. His office has requested that each organization provide a list to his office no later than August 9th. The next scheduled meeting with Senator Bell and Senator Reeves is August 16th.
CMS Proposes Regulation Changes & Updates to Data Collection Tool
CMS just released the Proposed CY 2023 Physician Fee Schedule Rule, and it includes significant clarifications affecting the medical necessity regulation for nonemergency, scheduled, repetitive ambulance services and minor proposed revisions to the ground ambulance cost collection instrument. Please note, this is a proposed rule subject to change in a final rule that will likely be announced this Fall. Once the rule is published on July 27, 2022, you can submit comments on the rule at:
Proposed Changes to Nonemergency, Scheduled, Repetitive Ambulance Services Regulation
Currently, the regulation concerning medical necessity for nonemergency, repetitive scheduled transports states plainly that: “The presence of the signed physician certification statement does not alone demonstrate that the ambulance transport was medically necessary.” CMS also says that the existing regulation has been “interpreted too narrowly,” and often transports where beneficiaries simply need monitoring by EMS personnel are excluded from coverage. The proposed regulation will expound significantly on the existing regulation by stating:
While a signed physician certification statement (PCS), does not alone demonstrate that transportation by ground ambulance was medically necessary, the PCS and additional documentation from the beneficiary’s medical record may be used to support a claim that transportation by ground ambulance is medically necessary. The PCS and additional documentation must provide detailed explanations, that are consistent with the beneficiary’s current medical condition, that explains the beneficiary’s need for transport by an ambulance, as described at § 410.41(a), that includes observation or other services rendered by qualified ambulance personnel, as described in § 410.41(b).
4 Important Implications of the Proposed Changes:
Change to Regulation NOT RSNAT Program. These are proposed changes to the regulations, not the RSNAT guidelines for the Prior Authorization program. These changes would carry global weight for all scheduled, repetitive transports.
Observation of Patient. These changes would expressly add “observation” – i.e., monitoring by an EMS provider even if the patient doesn’t need “tangible services” – as a condition for which medical necessity can be established. CMS says that the existing regulation has been “interpreted too narrowly” by some. That means that CMS believes the current regulation includes coverage of repetitive, nonemergency transports where the patient simply needs monitoring. If this new regulation is passed, it can serve as great evidence in an appeal or reconsideration even of past claims that fall under the current regulation, since CMS is saying this “clarifies the intent of existing regulatory language.”
Additional Documentation. We believe it is a good thing that CMS is proposing that “additional documentation from the beneficiary’s medical record” can be used to support medical necessity. This essentially means that Medicare reviewers must consider facility and physician records when reviewing medical necessity (provided they meet the “detailed” and “consistent” criteria in the proposed regulation).
PCS Language Pitfall. CMS’s proposed language states that: “the PCS and additional documentation must provide detailed explanations…” This language seems to imply a new requirement for a PCS to include a “detailed explanation” – which sounds a lot like a “thorough narrative.” It’s possible that under the proposed changes PCS forms that only use check boxes and signatures would not satisfy Medicare to establish medical necessity for repetitive, scheduled non-emergency trips because they do not include a space for detailed explanations. CMS has always maintained that it does not dictate requirements for the design of a PCS form, other than the form must certify that the medical necessity provisions of the regulations are met. This proposed change seems to change that stance, at least for repetitive/scheduled non-emergencies.
Proposed Changes to Ground Ambulance Data Collection Instrument
CMS also proposed some changes to the ground ambulance data collection tool and instructions. Most of them are for clarity and consistency and to correct typos and technical issues. A draft of the updated instrument that includes all of the CY 2023 proposed changes to review and provide comments on is posted on the CMS Ambulance Services Website. CMS is also proposing an automated process for requesting a hardship exemption and informal review request and this is supposed to happen in late 2022.
Stay tuned as PWW monitors these proposals and considers its own comments to the proposed rule, which we will share with the industry. We will have information as soon as a final rule is announced. We’ll dive into what this means for the industry this Fall at our abc360 Hershey conference!