Dear Ground Ambulance Providers and Suppliers, We wanted you to be aware that we posted the following announcement on our Ambulances Services Center website: Calendar Year (CY) 2025 Physician Fee Schedule (PFS) Proposed Rule CMS issued the CY 2025 PFS proposed rule: https://www.federalregister.gov/public-inspection/2024-14828/medicare-and-medicaid-programs-calendar-year-2025-payment-policies-under-the-physician-fee-schedule that announces proposed policy changes for Medicare payments under the PFS and other Medicare Part B payment policy issues including ambulance services. CMS is proposing to modify the definition of advanced life support level two (ALS2) at 42 CFR §414.605 by adding the administration of low titer O+ whole blood transfusion (WBT) to the list of ALS2 procedures. For patients in hemorrhagic shock, the use of WBT has demonstrated a survival benefit when compared to traditional hemorrhagic resuscitative therapy. Under this proposal, a ground ambulance transport that provides WBT would itself constitute an ALS2-level transport. We are also seeking comments on whether we should add alternative blood product treatments such as the administration of packed red blood cells and plasma to the list of ALS2 procedures. We are aware that some established Emergency Medical Services (EMS) systems may already provide WBT to treat patients in hemorrhagic shock, while other jurisdictions, including those in rural areas, may rely on alternative blood product treatments.  We encourage you to submit comments on this proposal by September 9, 2024, to the website provided in the CY 2025 PFS proposed rule.

2024 Ambulance Ride-Along Toolkit

Educating your members of Congress about ambulance industry issues makes them much more likely to support your efforts. An easy and effective way to educate them is to invite them to participate in a local Ambulance Ride-Along! The House and Senate will be adjourning for summer recess at the end of July and members of Congress will return home to their districts and states. This is the perfect opportunity for you to educate your members of Congress about issues facing our industry, in particular the extension of our Medicare add-on payments, the VA Final Rule,  and the EMS workforce shortage, which are important to your operation. For additional information on these issues, visit the AAA Advocacy Page, which includes one pagers about all of our initiatives. The most effective way to deliver these key messages is to host your member of Congress or their staff on a tour of your operation and an ambulance ride-along. The AAA has made the process of arranging a ride-long or scheduling a meeting easy for you with our 2024 Congressional Ride-Along Toolkit.  Are you willing to host a Member of Congress at your service but unsure of how to set it up? Email  Meghan Winesett at mwinesett@ambulance.org! Everything you need to arrange the ride-along or schedule a meeting is included in the Toolkit.  Act now and invite your elected officials to join you on an Ambulance Ride-Along!

A group of Montana lawmakers met with ambulance service providers last week to see if there's a way to fix what many say is a financial crisis hitting the emergency services industry in the state.

Read the full article, which references Montana Ambulance Association leaders>>

Montana Department of Justice Motor Vehicle Division
302 N. Roberts
Helena, MT 59620

Agency:	Montana Ambulance Association
Subject:	CARS Implementation Changes Affecting Your Agency

MEMORANDUM

Date: September 22, 2023

The Montana Motor Vehicle Division is dedicated to driving customer service. To this end, the department is implementing new technology to improve customer service for all Montana residents. These changes, which will roll-out on November 13, 2023, will have a direct impact on your agency. This memo is to notify you of the specific changes affecting your department. Please share this information with anyone within your agency that would benefit from having this information.

Special Restrictions for drivers will now have defined restriction codes. If a driver has any special restrictions, you will see the code printed on the hard card credential (driver license or state ID card). These restrictions are meant to communicate any information important for first responders and medical professionals. A list of all restriction codes has been included as an attachment to this memo.

Q: What is the difference between how Special Restrictions are indicated now, versus how they will be indicated after November 13^th?

A: Prior to November 13^th, Special Restrictions were free format, allowing up to four lines of 50 characters each line. The first 130 characters printed on the back of the credential. If a customer wanted a special restriction added to their credential, the customer would complete the Special Restriction form 28-0202.

After November 13^th Special Restrictions will no longer be free format. Instead, they will be listed as a pre- defined code on the back of the credential.

Q: What are Special Restrictions and why are they important to me?

A: Special Restrictions can include medical issues that are important for first responders and medical professionals. For example, the code “ALLERA” indicates that the holder of the credential is allergic to Amoxicillin. The code “DIABET” indicates that the holder of the credential is diabetic. This information could be crucial when administering emergency medical care.

A full list of codes has been attached to this communication for your reference.

We look forward to collaborating as we work toward the institution of a private ambulance assessment in our state.