Legislative Ltrs - Medicare etcMEMORANDUM
September 11, 2003
TO:
FROM:
SUBJECT:
The Honorable Mayor and City Council Members
Michael C. Van Milligen, City Manager
Letters to Senators Harkin and Grassley and Congressman Nussle
Fire Chief Dan Brown is recommending that the City support modifications in the
Medicare Prescription Drug and Modernization Act to provide fiscal relief to ambulance
services that have seen their Medicare reimbursement rate decline in light of a previous
restructuring of Medicare.
I concur with the recommendation and respectfully request Mayor and City Council
approval.
Mfchael C. Van Milfigen
MCVM/jh
Attachment
cc: Barry Lindahl, Corporation Counsel
Cindy Steinhauser, Assistant City Manager
E. Daniel Brown, Fire Chief
Bill Baum, Economic Development Director
Pauline Joyce, Administrative Services Manager
CITY OF DUBUQUE, IOWA
MEMORANDUM
September 10, 2003
TO: Michael C. Van Milligen, City Manager
FROM: E. Daniel Brown, Fire Chief
SUBJECT: Attached lettem to Senators Harkin and Grassley and Congressman
Nussle
Attached please find letters to the members of our Congressional delegation requesting
their support for modifications in the Medicare Prescription Drug and Modernization Act
(H.R.1), which is currently in conference. One provision of this piece of legislation is to
provide some fiscal relief to ambulance services that have seen their Medicare
reimbursement rote decline in light of a previous restructuring of Medicare.
The current language of this legislation treats Iowa and 12 other states unfairly. Our
letters ask that permanent and financially meaningful relief be applied to all ambulance
services, including our own and our neighbors in Iowa.
I respectfully request that you ask the support of the Mayor and City Council for this
position and that the Mayor be asked to sign and send these letters on behalf of the City
of Dubuque.
EDB~jt
September 15, 2003
The Honorable Jim Nussle
U.S. House of Representatives
Washington, DC 20515
Dear Representative Nussle:
As House and Senate conferees negotiate on the Medicare Prescription Drug and
Modernization Act (H.R. 1), I wanted to take this opportunity, on behaff of my organization
and the Iowans that we serve to urge you to ask the House conferees to support relief for
ambulance service providers that is both as permanent and f'manciaH¥ meaningful as
possible. It must be emphasized that as HR 1 stands today, Iowa would be excluded
from the maiority of fundin.q, as would 12 other states. This bill in its present form
takes more of a regional approach, which was seen prior to the Balanced Budget Act
going into effect. We encourage you to ask the House Conferees to include stabilized
funding but please make that for all states to include Iowa.
Ambulance service providers are pleased ambulance relief has been included in both the House and
Senate passed Medicare bills. Because all ambulance providers are coping with severe cuts in
Medicare reimbursement, ambulance service providers seek relief that is permanent and substantial
to the industry. Therefore, please ask House conferees to:
1. Include $600 million in Medicare ambulance relief in the f'mal conference agreement;
and
2. Help all ambulance service providers sustain in America's communities by providing the
relief in the most fair and effective manner possible.
Thank you for advocating with conferees on these important issues and for your ongoing support
of America's ambulance service providers. If you have any questions about these issues, please
feel free to contact our Fire Department Medical Supervisor, Ric Jones, at (563) 589-4160.
Sincerely,
Terrance M. Duggan
Mayor
September 15, 2003
The Honorable Chuck Grassley
United States Senate
Washington, DC 20510
Dear Senator Grassley:
As House and Senate conferees negotiate on the Prescription Drug and Medicare Improvement
Act (S. 1), I wanted to take this opportunity, on behalf of my organization and the Iowans
that we serve to urge you to ask the Senate conferees to support relief for ambulance service
providers that is both as permanent and financially meaningful as possible. It must b~
emphasized that as HR 1 stands today, Iowa would be excluded from the maiority
of fundin.q, as would 12 other states. This bill in its present form takes more of a
regional approach, which was seen prior to the Balanced Budget Act going into effect.
We encourage you to ask the House Conferees to include stabilized funding but please
make that for all states to include Iowa.
Ambulance service providers are pleased ambulance relief has been included in both the House and
Senate passed Medicare bills. Because all ambulance providers are coping with severe cuts in
Medicare reimbursement, ambulance service providers seek relief that is permanent and substantial
to the industry.. Therefore, please ask Senate conferees to:
1. Include $600 million in Medicare ambulance relief in the final conference agreement;
and
2. Help all ambulance service providers sustain in America's communities by providing the
relief in the most fair and effective manner possible.
Thank you for advocating with conferees on these important issues and for your ongoing support
of America's ambulance service providers. If you have any questions about these issues, please
feel free to contact me at (563) 589-4160.
Sincerely,
Terrance M. Duggan
Mayor
September 15, 2003
The Honorable Tom Harkin
United States Senate
Washington, DC 20510
Dear Senator Harkin:
As House and Senate conferees negotiate on the Prescription Drug and Medicare Improvement
Act (S. 1), I wanted to take this opportunity, on behalf of my organization and the Iowans
that we serve to urge you to ask the Senate conferees to support relief for ambulance service
providers that is both as permanent and financially meaningful as possible. It must be
emphasized that as HR 1 stands today, Iowa would be excluded from the maiority
of lundin.q, as would 12 other states. This bill in its present form takes more of a
regional approach, which was seen prior to the Balanced Budget Act going into effect.
We encourage you to ask the House Conferees to include stabilized funding but please
make that for all states to include Iowa.
Ambulance service providers are pleased ambulance relief has been included in both the House and
Senate passed Medicare bills. Because all ambulance providers are coping with severe cuts in
Medicare reimbursement, ambulance service providers seek relief that is that is permanent and
substantial to the industry. Therefore, please ask Senate conferees to:
Include $600 million in Medicare ambulance relief in the tYmal conference agreement;
and
Help all ambulance service providers sustain in America's communities by providing the
relief in the most fair and effective manner possible.
Thank you for advocating with conferees on these important issues and for your ongoing support
of America's ambulance service providers. If you have any questions about these issues, please
feel free to contact me at (563) 589-4160.
Sincerely,
TerranceM. Duggan
Mayor