[Congressional Record Volume 153, Number 72 (Thursday, May 3, 2007)]
[Senate]
[Page S5602]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. SCHUMER (for himself, Mr. Lott, and Mr. Conrad):
  S. 1310. A bill to amend title XVIII of the Social Security Act to 
provide for an extension of increased payments for ground ambulance 
services under the Medicare program; to the Committee on Finance.
  Mr. SCHUMER. Mr. President, today I, along with Senators Lott and 
Conrad, introduce the Medicare Ambulance Payment Extension Act. Without 
this legislation, ambulance service providers stand to lose $306 
million in Medicare reimbursement in 2008 and 2009 in addition to the 
nearly $150 million they will lose this year. Our legislation will 
restore $341 million in Medicare reimbursement with a 5 percent 
increase in payments for 2008 and 2009.
  Ambulance services are a vital component of the health care and 
emergency response systems of our Nation. Unfortunately, ambulance 
services providers are being significantly under-funded in providing 
their critical services to Medicare patients. We need to ensure that 
our ambulance service providers have the financial resources necessary 
to provide all Americans with high quality, life-saving services.
  Fortunately, in the Medicare Modernization Act of 2003, MMA, Congress 
implemented several provisions to provide temporary relief to help 
struggling ambulance service providers. The MMA ambulance provisions 
provided short-term relief through 1 percent urban and 2 percent rural 
increases, a mileage rate increase for long trips, a payment boost for 
ambulance transports in extremely rural areas, and a regional 
adjustment that helped a majority of providers depending on their 
state. While the rural payment boost and long trip increase are 
temporarily still intact, the 1 percent urban and 2 percent rural 
increases expired at the end of last year and the regional adjustment 
has dropped from 80 percent to only 20 percent of payments. If Congress 
does not act, ambulance service providers will lose over $450 million 
in relief from 2007 through 2009.
  Ambulance service providers cannot afford to face decreased 
reimbursement in the coming years. Ambulances services respond to not 
only 911 calls and nonemergency requests but also as first responders 
to natural disasters and acts of terrorism. Medicare patients account 
for approximately 45 percent of the call volume of an ambulance 
operation. Ambulance service providers cannot afford to have half of 
their transports reimbursed at below the cost of providing services.
  While all health care providers face reimbursement challenges, 
ambulance service providers are required by law to respond to a plea 
for emergency medical care, regardless of whether the provider will 
recoup the full, if any, cost of the service. This additional 
responsibility along with the requirement that ambulance service 
providers accept the Medicare ambulance fee schedule rate as payment in 
full has further deteriorated the financial stability of ambulance 
operations. With increased focus on ensuring that our first responders 
are prepared in the event of a terrorist attack or national disaster, 
we should be bolstering, not deteriorating, this health care safety 
net.
  The Medicare Ambulance Payment Extension Act will ensure that 
patients across America will continue to have access to critical 
ambulance services. We urge our colleagues to support this legislation, 
and I look forward to its passage this year.
  I ask unanimous consent that the text of the bill be printed in the 
Record.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

                                S. 1310

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Medicare Ambulance Payment 
     Extension Act''.

     SEC. 2. EXTENSION OF INCREASED MEDICARE PAYMENTS FOR GROUND 
                   AMBULANCE SERVICES.

       Section 1834(l)(13) of the Social Security Act (42 U.S.C. 
     1395m(l)(13)) is amended--
       (1) in subparagraph (A), in the heading, by striking ``In 
     general'' and inserting ``For the second half of 2004 and for 
     2005 and 2006'';
       (2) by redesignating subparagraph (B) as subparagraph (C);
       (3) by inserting the following after subparagraph (A):
       ``(B) For 2008 and 2009.--After computing the rates with 
     respect to ground ambulance services under the other 
     applicable provisions of this subsection, in the case of such 
     services furnished on or after January 1, 2008, and before 
     January 1, 2010, the fee schedule established under this 
     section shall provide that the rate for the service otherwise 
     established, after application of any increase under 
     paragraphs (11) and (12), shall be increased by 5 percent.''; 
     and
       (4) in subparagraph (C), as redesignated by paragraph (2)--
       (A) in the heading, by striking ``Application of increased 
     payments after 2006'' and inserting ``No effect on subsequent 
     periods''; and
       (B) by adding at the end the following new sentence: ``The 
     increased payments under subparagraph (B) shall not be taken 
     into account in calculating payments for services furnished 
     after the period specified in such subparagraph.''.

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