This morning, President Donald Trump signed into law a Continuing Resolution (CR) that included a five-year renewal of the ambulance Medicare add-ons. 

The specific provisions included are:

• 5 year extension of the ambulance Medicare add-ons through December 31, 2022, retroactive to January 1, 2018.
• The American Ambulance Association's preferred method of Cost data collection that provides flexibility to the Secretary of HHS in developing the system. Consultation with the industry is required so that it strikes the appropriate balance between obtaining meaningful data while not overly burdening or onerously penalizing the ambulance services.
• The penalty for failing to report required data would be a reduction in payment up to 10% for the year following the year in which the data should have been submitted. American Ambulance Association objected to the house proposed penalty of up to a year of Medicare payments clawback or withholding of payments. A clause is included to wave the penalty in cases of hardship.
• A “pay-for” for the 5-year extension of the add-ons with a 13% cut to non-emergent dialysis transports – the American Ambulance Association had objected to the offset and pushed for a cut targeted to just those entities which abuse the dialysis transport benefit. We were successful in reducing the initial cut from 22% to 13%. The American Ambulance Association is actively working on other pay-for options that would replace the 13% cut with something targeting dialysis fraud and abuse.