Congress Passes Year-End Omnibus Package; Includes Report Language on VA Rates, Helicopter Safety

AAMS Member Alert - December 30, 2023
 
Yesterday, President Biden signed a $1.7 trillion spending bill into law, averting a shutdown and keeping the government funded through September. The 4100-page FY 2023 Consolidated Appropriations Act saw the adoption of a handful of additional amendments long sought by state legislators, allowing state and local governments to utilize unused federal COVID-19 funds for infrastructure and/or disaster assistance.
 
Of particular note in the bill is report language on two issues: Veterans Health Administration rate changes and enhanced helicopter safety training regarding weather. AAMS and its members were successful in working with several House and Senate offices to include language on the VA Medicare parity issue, noting the lack of data on the costs of providing air ambulance services and the need to delay the implementation of the rule until its impact can be properly analyzed. We should also note that conversations around the applicability of the proposed rule have raised some questions about what type of ambulance transports are covered under the proposed rules changes. AAMS will continue to follow this very important issue and hopes to work more closely with VA and concerned legislators given the opportunity. The specific language is below: 
 
Air Ambulance Services.-The Committees urge the Department to ensure that any changes to the reimbursement policy for air ambulances do not reduce the availability of emergency services to veterans or increase mortality and morbidity among veterans needing air ambulance care, which is particularly important in rural areas. The Committees further note that Public Law 116-260 required the Department of Health and Human Services (HHS) to review updated cost data on air ambulance services, and encourage VA to coordinate with HHS to ensure that its data is accurate and up to date before finalizing any payment policy changes. 
 
In addition to this report language, the FAA was also directed to develop a “cue-based training program for commercial air tour pilots in Hawaii that specifically addresses hazardous aspects of local weather phenomena and inflight decision-making” and to “provide $5,000,000 for efforts to improve helicopter safety”. The language specifically references NTSB recommendations from the December 26, 2019 air tour helicopter crash in Kekaha, Hawaii. 
 
As the new year and the new Congress approaches, AAMS will focus its government relations efforts on improving the data collection process proposed by the Centers for Medicare and Medicaid Services (CMS) and working to implement requirements for long-term Medicare reform as it applies to air ambulances. As part of this strategy, AAMS will continue to work with its healthcare partners within the larger community as well as long-time Congressional champions on these issues. We will of course continue to engage with the VA and others to ensure no further changes to other government rates damage the sustainability of the emergency air medical system.  We have also received significant interest regarding the implementation of the No Surprises Act and the effect the law has had on payor behavior, specifically as it applies to a lack of enforcement on the commercial payor community. Several Congressional offices have expressed a keen interest in the need to see the law as it was written properly enforced, and recognize a lack of enforcement on the payor community across the healthcare spectrum. 
 
AAMS looks forward to representing its members on these important issues in 2023, the 118th Congress, and beyond.