On Saturday, November 7, the House of Representatives passed the Affordable Health Care for America Act (H.R. 3962) by a vote of 220 to 215.  Two hundred and nineteen Democrats and one Republican, Congressman Joseph Cao (R-2-LA), voted in favor of the bill and 176 Republicans and 39 Democrats voted against it.  To see how your Representative(s) voted, go to http://clerk.house.gov/evs/2009/roll887.xml.

H.R. 3962 includes a number of items that specifically address ambulance and emergency services issues, including an extension of the 2% urban and 3% rural Medicare ambulance relief.  Due to restrictions on floor amendments, supporters on Capitol Hill were not able to include an extension of the super rural ambulance bonus payment.  However, the extension will very likely be included in the Senate bill.  The following is a list of key sections of H.R. 3962 of particular interest to EMS:

Sec. 1131. Incorporating productivity adjustment into market basket updates that do not already incorporate such improvements.  Incorporates a productivity adjustment beginning in 2010 for ambulance services.  This provision is the same as the one included in the original house bill.

Sec. 1196. Extension of ambulance add-ons.  Extends bonus payments made by Medicare for ground and air ambulance services in rural and other areas through the end of 2011.  This provision would extend the 2% urban and 3% rural ambulance increases for another two years.

Sec. 1737. Continuing requirement of Medicaid coverage of non-emergency transportation to medically necessary services.  Requires State Medicaid programs to continue covering non-emergency transportation to medically necessary services as specified in regulations in effect on June 1, 2008.

Sec. 2552. Emergency care coordination. Creates an Emergency Care Coordination Center within the HHS Office of the Assistant Secretary for Preparedness and Response.  Authorizes such sums as may be necessary for each of FY 2011 through FY 2015 to carry out the various activities of the Center.

Sec. 2553. Pilot programs to improve emergency medical care.  Establishes a pilot program for the design, implementation, and evaluation of innovative models of regionalized, comprehensive, and accountable emergency care systems.  Authorizes $12 million for each of FY 2011 through FY 2015 to carry out this program.  This provision is similar language to the Improving Emergency Medical Care and Response Act by then-Senator Obama and Representative Henry Waxman (D-CA) from last Congress.

Sec. 2554. Assisting veterans with military emergency medical training to become State-licensed or certified emergency medical technicians (EMTs).  Establishes a new program for states to assist veterans with military emergency medical training in becoming state-licensed or certified medical technicians.  Authorizes sums as may be necessary for each of FY 2011 through FY 2015 to carry out this program.  Requires the GAO to conduct a study on the barriers experienced by veterans with military emergency training in becoming licensed or certified civilian health professionals. This provision is similar language to the Veterans to Paramedics Act by Senator Amy Klobuchar (D-MN) and Representative Stephanie Herseth Sandlin (D-SD) from last Congress.

Sec. 222. Notification of Provision of Emergency Contract Health Services.  Allows 30 days for notification to the Indian Health Service (IHS) of any emergency medical care or services received by an elderly or disabled Indian from a non-IHS provider or in a non-IHS facility.

The debate now moves to the Senate where Senate Majority Leader Reid has stated that he plans to bring a health care reform bill to the Senate Floor prior to Thanksgiving.