When the bill was first introduced, it covered both ambulance and the emergency department care. However, in order to get support from Kaiser, ACEP agreed to remove the provision covering ambulance services. Unfortunately, this was not made clear to many members of Congress who were under the impression that Emergency Medical Services (EMS) included the ambulance service as well as emergency department care.

I learned this week that there is an opportunity to rectify this matter. HR 1777, was introduced by Rep. Upton to require managed care plans to pay for emergency ambulance services using the prudent layperson standard. Senator Grams has introduced S 911 that includes a similar provision. Furthermore, the sponsors of the major Patient Bill of Rights bills are prepared to include ambulance.

In the past ACEP has not supported including ambulance in "their" legislation because of the deal with Kaiser. Now, however, ACEP's provision is no longer controversial in the least and the addition of ambulance, assuming the CBO finds that it will not dramatically increase premiums, has been accepted by the major sponsors. The only thing holding up full support by all parties is the lack of ACEP's support. The key legislative staff have all said that we must get ACEP to agree to the provision.

I encourage ACEP members to contact your Board representatives and encourage them to include emergency ambulance in the Access to Emergency Medical Services provisions pending before the Congress.