Congressional Override Boosts Medicare Rates

     Both houses of the U.S. Congress voted overwhelmingly in July to override President George W. Bush's veto of the so-called Medicare physician fix package, thus preserving a boost in reimbursement rates for ground ambulance services.

     Under H.R. 6331, the Medicare Improvements for Patients and Providers Act (MIPPA), payments will be raised by 2% for urban services and 3% for rural ones for 18 months. These increases take effect immediately and will apply retroactively to July 1. In total, they will mean roughly $170 million in additional payments for ambulance services.

     Physicians were facing a reduction in payments of more than 10% unless Congress acted. Now, payments to insurers will be cut instead.

     Earlier in the month, the Centers for Medicare and Medicaid Services proposed expanding beneficiary signature exceptions for emergency transports contained in last year's final rule to also apply to nonemergency transports. The American Ambulance Association was a key group promoting this change.

     Other relevant bills for fiscal 2009 were also working their way through Congress over the summer. A $300 billion farm bill conference report, also passed over a Bush veto, authorized a $30-million-a-year grant program for rural fire and EMS. But a key appropriations bill for Labor, Health and Human Services and Education, funding several key programs of note to EMS (e.g., the Rural and Community Access to AEDs, Traumatic Brain Injury and EMS for Children programs), stalled in the House amid partisan procedural squabbling.

     For the latest, see www.advocatesforems.org.

LINE-OF-DUTY DEATHS

•      The collision of two medical helicopters in Flagstaff, AZ, reported last month claimed seven victims. The involved craft were from Classic Lifeguard Aeromedical Services of Page, AZ, and Air Methods of Englewood, CO. Both were carrying patients to Flagstaff Medical Center.

       Victims aboard the Classic craft were medic Tom Clausing, of Leavenworth, WA; pilot Tom Caldwell, of Page; nurse James Taylor, of Salt Lake City; and patient Michael MacDonald, of Browning, MT. MacDonald, a firefighter with the Blackfeet Tribe's Chief Mountain Hotshots, was in anaphylactic shock following treatment for a bug bite incurred while fighting a wildfire at the Grand Canyon. Clausing was an instructor for Wilderness Medical Associates and a member of its faculty committee. Taylor, the crash's sole initial survivor, died of his injuries several days afterward.

       Victims aboard the Air Methods craft were flight nurse Shawn "Clyde" Shreeve, Jr., and pilot Patrick Graham, both of Flagstaff, and patient Raymond Zest, whom they were transporting from Winslow.

• Middle Island (NY) Fire Department EMT Rico Torres collapsed and died on July 4 after responding to a call.