,i #aad? ,,congress #a/ ,session ,h4 ,r4 #hag ,,9 ,,! ,,h\se ,,( ,,repres5tatives ,febru>y #i1 #bjae ,mr4 ,nunes 7= himself1 ,mr4 ,b\/any1 ,mr4 ,?ompson ( ,cali=nia1 ,mr4 ,la,malfa1 ,mr4 ,kelly ( ,p5nsylvania1 ,mr4 ,valadao1 ,mr4 ,cook1 & ,mr4 ,de,fazio7 introduc$ ! foll[+ bill2 :i* 0 ref]r$ to ! ,committee on ,en]gy & ,comm]ce1 & 9 addition to ! ,committee on ,ways & ,means1 = a p]iod to be subsequ5tly det]m9$ by ! ,speak]1 9 ea* case = consid]ation ( su* provisions z fall )9 ! jurisdiction ( ! committee conc]n$ ,a ,,bill ,to susp5d ! implem5tation ( zip code reclassifications = ,m$ic>e paym5t = ambulance s]vices1 & = o!r purposes4 #a4 ,%ort title ,?is ,act may be cit$ z ! ,fairness 9 ,ambulance ,reimbursem5t ,act ( #bjae4 #b4 ,f9d+s ,congress f9ds ! foll[+3 7#a7 ,! ,c5t]s = ,m$ic>e ,m$icaid ,s]vices 9 bo? its propos$ & f9al cal5d> ye> #bjae physician fee s*$ule rules made adju/m5ts to ! geographic area designations us$ to calculate paym5ts = ambulance provid]s & suppli]s & misid5tifi$ ! numb] ( zip code designations t w\ld be impact$ by ! *ange4 7#b7 ,on ,july #aa1 #bjad1 ! ,c5t]s = ,m$ic>e ,m$icaid ,s]vices publi%$ a proposal 7#gi ,,fr #djcge7 in=m+ ! public t no zip codes 9 ! ,/ate ( ,cali=nia1 only two zip codes 9 ! ,/ate ( ,l\isiana1 & only "o zip code 9 ! ,/ate ( ,texas w\ld be *ang$ bas$ on ! ,(fice ( ,managem5t & ,budget's revis$ del9eations & updat$ ,rural-,urban ,commut+ ,area codes4 7#c7 ,aft] publication ( ! zip code proposal1 ! public _h #fj days to submit comm5ts1 p] ! requirem5ts ( ! ,adm9i/ration ,proc$ures ,act4 7#d7 ,on ,novemb] #ac1 #bjad1 ! ,c5t]s = ,m$ic>e ,m$icaid ,s]vices publi%$ a f9al regulation 7#gi ,,fr #fggdh7 in=m+ ! public1 = ! fir/ "t1 t #c4de p]c5t ( zip codes 7or #id zip codes7 9 ! ,/ate ( ,cali=nia1 #ac4fg p]c5t ( zip codes 7or #aja zip codes7 9 ! ,/ate ( ,l\isiana1 #e4if p]c5t ( zip codes 7or #aee zip codes7 9 ! ,/ate ( ,texas1 & #g4a p]c5t ( zip codes 7or #ce zip codes7 9 ! ,/ate ( ,oregon w\ld *ange bas$ on ! ,(fice ( ,managem5t & ,budget's revis$ del9eations ( ! ,rural-,urban ,commut+ ,area codes4 7#e7 ,?is *ange f ! data t 0 publi%$ 9 ! propos$ rule to ! data t 0 publi%$ 9 ! f9al rule did n af=d ! public prop] notice & comm5t & !re=e is an app>5t violation ( ! ,adm9i/ration ,proc$ures ,act4 7#f7 ,fur!r1 ! correct$ f9al li/ ( zip code *anges 0 n po/$ until ,decemb] #d1 #bjad1 less ?an a mon? be=e ! new policy 0 implem5t$ on ,janu>y #a1 #bjae1 giv+ ambulance provid]s & suppli]s insuffici5t "t to prep>e = ! *ange 9 reimbursem5t4 7#g7 ,! ,c5t]s = ,m$ic>e ,m$icaid ,s]vices also did n provide an impact analysis or c]tification det]m9+ :e!r !re is a significant economic impact on small entities1 z requir$ by law4 7#h7 ,^! *anges w result 9 ne>ly #i p]c5t cut 9 reimbursem5t "u ! ,m$ic>e program = transports orig9at+ 9 areas los+ rural /atus4 #c4 ,susp5sion ( implem5tation ( rural to urban zip code reclassifications = ,m$ic>e paym5t = ambulance s]vices 7a7 ,susp5sion ( rural to urban zip code reclassifications ,n lat] ?an ,july #a1 #bjae1 ! ,secret>y ( ,heal? & ,human ,s]vices %all issue a notice susp5d+ ?r\gh ,decemb] #ca1 #bjae1 ! implem5tation ( ! reclassification ( rural to urban zip codes = paym5t = ambulance s]vices "u ! fee s*$ule "u section #ahcd7l7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciem7l771 z conta9$ 9 ! f9al rule publi%$ by ! ,c5t]s = ,m$ic>e ,m$icaid ,s]vices 9 ! ,f$]al ,regi/] on ,novemb] #ac1 #bjad 7#gf ,f$4 ,reg4 #fggdd ?r\gh #fggej74 ,! ,secret>y %all ensure1 subject to subsection 7d77#a71 t claims = paym5t "u ! fee s*$ule "u section #ahcd7l7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciem7l77 = ambulance s]vices furni%$ dur+ #bjae 7beg9n+ on ,july #a1 #bjae7 are paid z if ! reclassification ( rural to urban zip codes appli$ "u su* f9al rule 7 ! classification ( zip codes appli$ ! day be=e ! effective date ( su* f9al rule4 7b7 ,reclassifications pursuant to notice & comm5t rulemak+ ,n lat] ?an ,novemb] #a1 #bjae1 ! ,secret>y ( ,heal? & ,human ,s]vices %all1 ?r\gh notice & comm5t rulemak+1 reclassify rural to urban zip codes = paym5t "u ! fee s*$ule "u section #ahcd7l7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciem7l77 = ambulance s]vices furni%$ on or aft] ,janu>y #a1 #bjaf1 tak+ into acc\nt ! revis$ geographic del9eations ( ! ,(fice ( ,managem5t & ,budget1 z describ$ 9 ! ,febru>y #bh1 #bjac ,(fice ( ,managem5t & ,budget ,bullet9 ,no4 #ac-ja4 7c7 ,treatm5t ( #bjae claims2 budget neutrality 7#a7 ,treatm5t ( #bjae claims ,no?+ 9 ?is section1 or ! am5dm5t made by ?is section1 %all be con/ru$ z in/ruct+ ! ,secret>y ( ,heal? & ,human ,s]vices to re-process any claims = paym5t "u ! fee s*$ule "u section #ahcd7l7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciem7l77 = ambulance s]vices furni%$ dur+ #bjae4 7#b7 ,budget neutrality 7,a7 ,det]m9+ affect ( #bjae susp5sion ,! ,secret>y ( ,heal? & ,human ,s]vices %all e/imate ! am\nt1 if any1 by :i*-- 7i7 ! aggregate am\nt ( paym5ts "u ! fee s*$ule "u section #ahcd7l7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciem7l77 = ambulance s]vices furni%$ dur+ #bjae aft] application ( subsection 7a71 exce$s 7ii7 ! aggregate am\nt ( paym5ts t w\ld h be5 made "u su* fee s*$ule = su* s]vices furni%$ dur+ su* ye> if subsection 7a7 _h n be5 enact$4 7,b7 ,adju/m5ts 9 #bjaf ,if ! ,secret>y e/imates ! am\nt "u clause 7i7 ( subp>agraph 7,a7 exce$s ! am\nt describ$ 9 clause 7ii7 ( su* subp>agraph1 ! ,secret>y %all1 ?r\gh notice & comm5t rulemak+1 adju/ paym5ts "u ! fee s*$ule "u section #ahcd7l7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciem7l77 = ambulance s]vices 7o!r ?an air ambulance s]vices7 furni%$ dur+ #bjaf su* t ! total am\nt ( su* adju/m5ts is equal to ! am\nt by :i* ! am\nt describ$ 9 su* clause 7i7 exce$s ! am\nt describ$ 9 su* clause 7ii74