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Item C29 BOARD OF COUNTY COMMISSIONERS AGENDA ITEM SUMMARY Meeting Date: June 18.2008 Division: Emergency Services Bulk Item: Yes ~ No Department: Fire Rescue Staff Contact Person: Camille Dubroff AGENDA ITEM WORDING: Approval of Resolution of the Board of County Commissioners of Monroe County, Florida superseding Resolution 245A-2006 and adopting an amended fee schedule for use for providing Emergency Medical Air, Transport Service. ITEM BACKGROUND: The current fee schedule is outdated as it has been two years since the initial adoption of this fee schedule. In preparation of this rate increase, Advanced Data Processing Inc. (ADPI) provided us with data that our current transport fees are lower than the Medicare reimbursement standard and there is an anticipated reimbursement increase, which is set by Medicare Ambulance Payment Extension Act. (See Attachment) Medicare reimbursements define the industries standard for compensation for the different levels of service. After analyzing all of the data we have based our recommendations for the proposed amended fee schedule upon knowledge of service type, volume, current Medicare reimbursement fee revisions in progress, as well as Monroe County's geographical isolation. PREVIOUS RELEVANT BOCC ACTION: On November 17, 1987, the Board of County Commissioners adopted Ordinance No. 050-1987 allowing the right to establish rates of user fees by Resolution. On July 19, 2006 the Board approved a Resolution 245A-2006 ofthe Board of County Commissioners of Monroe County, Florida to adopt a fee schedule for use for providing Emergency Medical Air Transport Service. CONTRACT/AGREEMENT CHANGES: STAFF RECOMMENDATIONS: Approval as written. TOTAL COST: N/A BUDGETED: Yes No COST TO COUNTY: N/A SOURCE OF FUNDS: N/A REVENUE PRODUCING: Yes lL No AMOUNT PER MONTH Year X ~ ! Air Tr~ort ~eceivables (past ]2 months) - $45].335.98 APPROVED BY: County Arty ~ OMB/Purchasing~ Risk Managemen~nv DOCUMENTATION: Included X Not Required_ DISPOSITION: AGENDA ITEM # Revised 11/06 Emergency Services RESOLUTION NO. -2008 A RESOLUTION OF THE BOARD COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA SUPERSEDING RESOLUTION NO. 245A-2006, AND ADOPTING AN AMENDED FEE SCHEDULE FOR USE BY THE SPECIAL TAXING DISTRICT FOR PROVIDING EMERGENCY MEDICAL AIR TRANSPORT AMBULANCE SERVICES. WHEREAS, Ordinance No. 050-1987 was passed and adopted by the Board of County Commissioners of Monroe County, Florida on November 17, 1987; WHEREAS, in accordance with Section 3 of said Ordinance No. 050-1987, the governing bodies shall have the right to establish rates of user fees by Resolution; and WHEREAS, the Board of County Commissioners of Monroe County, Florida previously adopted Resolution 245A-2006, adopting a fee schedule for use for providing Emergency Medical Air Transport Services in Monroe County; WHEREAS, the Board desires to revise the fee schedule; NOW THEREFORE, BE IT RESOLVED BY THE BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA, that, 1. Effective June 18, 2008, Resolution 245A-2006, adopted by the Board of County Commissioners on July 19,2006, is hereby superseded by this Resolution; and 2. Effective June 18, 2008, the Board adopts the following Fee Schedule for use for providing Emergency Medical Air Transport Ambulance Services. Air Ambulance Transport Fee Mileage $5500.00 $ 80.00 per mile PASSED AND ADOPTED by the Board of County Commissioners of Monroe County, Florida, at a regular meeting of said Board held on the day of , 2008. Mayor Mario Di Gennaro Commissioner Dixie Spehar Commissioner George Neugent Commissioner Charles "Sonny" McCoy Commissioner Sylvia Murphy (SEAL) BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA Attest: DANNY L.KOLHAGE, Clerk By: Deputy Clerk By Emergency Services RESOLUTION NO.245A -2006 A RESOLUTION OF THE BOARD COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA ADOPTING A FEE SCHEDULE FOR USE BY THE SPECIAL TAXING DISTRICT FOR PROVIDING EMERGENCY MEDICAL AIR TRANSPORT AM;BULANCE SERVICES. WHEREAS, Ordinance No. 050-1987 was passed and adopted by the Board of County Commissioners of Monroe County, Florida on November 17, 1987; WHEREAS, in accordance with Section 3 of said Ordinance No. 050-1987, the governing bodies shall have the right to establish rates of user fees by Resolution; and WHEREAS, the Board of County Commissioners of Monroe County, Florida desires to adopt the following fee schedule for providing air ambulance service; NOW lHEREFORE, BE IT RESOLVED BY THE BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA, that the Board hereby adopts the following Fee Schedule for use for providing Emergency Medical Air Transport Ambulance Services: Air Ambulance Transport Fee Mileage $4500.00 $8Q..()O, p~r !llil~:, /i.".,;:I""'-,~./-5 -~ \_,) ,", ,~.,~I,._.,":' :~~() ~J .,;'; (~;~( ~:,=:,I" 11i"~~.., ,'~'~"~1t~~; PASSED AND ADOPTED by the . Board... of County,.Commissioners of Monroe County, Florida, at a regular meeting of said BI?~d;,~~t4~p~lln~ 'j,~'{i:;.&y:of' JULY ,2006. "t-!'~i:~~~ ,;:"~'brnD h~i"-:: j- ,'":, . Attest: I>ANNY L.KOLHAGE, Clerk .:r I:;) 0 ::z: l> ::Oe'";:lz or-:;C M;Jl;:-< n. r- oo. c::: - -:I:; :t: ;0 a -lor- :t:loo ;u ::< ~=:I: :a:: '"TJ BOARD OF C~TY c;eMElISSSNEIiS OF MONROE C TY, ~ORIbA ~ ~ By: ~ ~ ~ l- N .{:'* '"T1 r= r'f1 o ~ o :::0 .. .'. ();; c..~>< . 'i~.1 (S~., f" '<,,: -:.. ~ /" { \, \. ' :';'. ',. .,~~.-> ..<.:: . j B(~ Deputy Clerk Mayor/Chairperson MONROE COUNTY ATTORNEY A PRO D f\S TO FORM: en en (I.) ...-- en ctS >dl:::: m...-- C C <( (I.) (I.) E Q) (I.) LL ~ >.,::J +-' ..c C E ::J ._ o (I.) 00:: Q) (I.) e ro C () o .- ~~ ~ t/) 0 0' W 0 0 b w d d u. 0 CO C C It) :::::J W iii' 0 0 C Z G.l W 2 :e r:: :e 0 ::E 0 0 W a::' ~ ~ It) co oo:t: N en 'l"" M "Cl 0 l! co M - G.l 'l"" N - - :::::J ..n ca .... a::' E - :o:l c CI) Q) ~ ~ w E ! G.l '<t I'-- ca l!.! (0 .... C,) :::::J (ij I'-- N .- .c 0 N "Cl E E It) Q) .- ..... M :e Q) 0 a::' z ~ ~ .... en t'o! N co CO N "Cl 0 e 0 M G.l - .... .... - - :::::J It) ca .... a::' E - :o:l c CI) Q) w E ~ ~ ! Q) l!.! CIO e") CIS '<t It) C,) :::::J .- .c (ij It) ..- "Cl E E 0 N Q) .- '<t :e G.l ..... 0 e") a::' Z ~ ~ co It) C) .... - iii oct d c - co M ! c ... CO Q) :::::J '<t~ ... E a::' :::::J 0 Q) ! l!.! ~ ~ :::::J CIS .c .!::! E .... 0 "Cl .- (ij e") It) CD CD E M ci :ea::' ... '<t N 0 N Z M fA- ~ a- 0 0 c CI) 0 0 CD ci ci ::J CD 0 LL. 0 co 0 It) - -<f CD' c 0 ~ .... C :::::J 0 0 :e ~ ~ (jj > G.l ~ ..J G.l Q) III C,) If! .!'! .~ III ~ co CD ..... ..... CI) <( <( If! .m ro a::' +"" C Q)e") E_ n 0 lll.... :i +"" C Q) E Q) ~ ::I ..c E '(j) c::: ~ ro .~ u Q) ::::E ...I ~ :J a::' lI) Q) > '(j) o ~ .?;> C ::J o U Q) e c o ::::E 2 o Z ~ About the Medicare Ambulance Payment Extension Act The Medicare Ambulance Payment Extension Act was introduced on May 3 by Senators Charles Schumer (D~NY) and Kent Conrad (D-ND) ill the Senate and Representatives Mike McNulty (D-NY), Tom Reynolds (R-NY), Chip Pickering (R- MS) and Tom Allen (D-ME) in the House. Representative Phil English (R-PA) also signed on as an original cosponsor of the House bill. The legislation would provide critical timely Medicare relief to all ambulance service providers. The legislation would implementa Medicare increase of 5% to all ambulance service providers regardless of th'e state or area in which the transport originated. The two-year relief would apply to just the base rate and not mileage. The bill language states the reUefwould commence on January 1, 2008 and expire on December 31, 2009. Since we are past the commencement date, we will advocate that it commence on .July 1,2008 and expire on .June 30, 2010. The legislation is a different approach, supported by the findings of the May 2007 GAO ambulance cost report, to extending the expiring ambulance provisions of the Medicare Modernization Act (MMA). The bills would not impact the relief currently in place including the SO plus mileage bump, the regional fee schedule adjustment or the super rural bonus payment. If enacted, S. 1310 and U.R. 2164 would result in an estimated $341 million in additional Medicare relicfto ambulance service providers. Attachment 200 r;-,~=~~~'~II~~~l;;~2!ttr:lJ;gW)I;X:.I-r. - "' I .... .. _ _ "'~I" I.' _ ,._ 1"'1 '-"j ~- - I I ,~, ~'~IIIlJ:l ~~ ,Ii I f~IMSULA'N~e' 'l,.: ,III 14_~ ._-..-..J~","=-_ o;,.,llr'=-~ 2008 Ambulance Fee Schedule Section 1834(1) (3) (B) of the Social Security Act (the Act) provides the basis for updating payment limits that carriers, fiscal intermediaries, and PartAJB Medicare administrative contractors use to determine how much to pay you for the claims that you submit for ambulance services. Specifically, this section of the Act provides for a 2008 payment update that is equal to the percentage increase in the urban consumer price index (CPI-D), for the l2.month period ending with June of the previous year. The resulting percentage is referred to as the ambulance inflation factor (AIF). CR 5801 furnished the calendar year 2008 AIF, which is 2.7 percent. The revised fees are effective for dates of service JanuafY 1, 2008 and after. Connecticut Fees Florida Fees Code Fee Code Loc 99 Loc 03 Loc 04 A0425 6.42 A0425 6.42 6.42 6.42 A0426 285.36 A0426 229.04 240.27 249.50 A0427 451.82 A0427 362.64 380.44 395.04 A0428 237.80 A0428 190.86 200.23 207.92 A0429 380.48 A0429 305.38 320.37 332.67 A0430 2952.17 A0430 2,624.31 2,715.08 2,789.59 A0430 4428.26* A0430 3,936.46 4,072.62 4,184.39* A0431 3432.33 A0431 3,051.13 3,156.67 3,243.31 A0431 5148.49* i\{)J;.j j 4,576.70 4,735.01 I ~l.7;t...'.'::;(, .ic A0432 416.15 A0432 334.01 350.40 363.85 A0433 653.95 A0433 524.88 550.63 571.77 A0434 772.84 A0434 620.31 650.74 675.73 *""Rural Rate '" "" Rural Rate Source: Publication 1 00-20, Change Request 5944 Revision to Certification for Hospital Services Covered by the Supplementary Medical Insurance Program as it Pertains to Ambulance Services CMS has issued the following MLN Matters article. Informationfor Medicare Fee-for.Service Health Care Professionals. Provider Types Affected Physicians, providers, and suppliers submitting claims to Medicare contractors (carriers, fiscal intermediaries [FIs], and/or PartAIB Medicare administrative contractors [AJB MACs]) for ambulance services provided to Medicare beneficiaries. Provider Action Needed Change request (CR) 5833 rescinds and fully replaces CR 5684. This article is based on CR 5833, which updates the section 20 of chapter 4 of the Medicare General Information, Eligibility, and Entitlement Manual as it pertains to physician certification statement (PCS) requirements for all ambulance providers. CR 5833 deletes from that manual section the paragraph that requires a physician certification of ambulance services provided by a hospital to transport a patient during an emergency situation, such as transport from the scene of an accident. Background The Centers for Medicare & Medicaid Services (CMS) discovered there was a problem with a paragraph in the Medicare General Information, Eligibility, and Entitlement Manual, chapter 4, section 20 regarding language not allowing the current exception under PCS, i.e., that the PCS is not required during an emergency situation (such as the scene of an accident). Therefore, CR 5833 deleted the following paragraph in chapter 4 (section 20) of the Medicare General Information, Eligibility. and Entitlement Manual (Pub 100-01) that pertained to Physician Certification and Recertification of Services and Ambulance Services because it conflicted with title 42 of the Code of Federal Regulations (CFR), sections 41OAO(d) (2) and (3); Certification by a physician in connection with ambulance services furnished by a participating hospital is required. In cases in which the hospital provides ambulance service to transport the patient from the scene of an accident and no physician is involved until the patient reaches the hospital, any physician in the hospital who examines the patient or has knowledge of the case may certify as to the medical needfor the ambulance service. Deletion of this paragraph brings the manual into alignment with current regulations, which eliminate the pes requirement in these emergency situations. February 2008 The FCSO Medicare B Updatel Attachment 30n 9