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DelBene, Estes, Bennet, Blackburn Introduce Bill to Support Lifesaving Emergency Services for Americans in Rural Communities

Bipartisan legislation updates Medicare reimbursement rates for emergency air medical services, improving access to care

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WASHINGTON, DC , June 1, 2023 | comments

U.S. Representatives Suzan DelBene (WA-01) and Ron Estes (KS-04) and Senators Michael Bennet (CO) and Marsha Blackburn (TN) introduced bipartisan, bicameral legislation to improve access to emergency air medical services that are critical for saving lives, particularly for Americans living in rural communities. The Protecting Air Ambulance Services for Americans Act would use data collected under the No Surprises Act to update Medicare reimbursement rates for emergency air services.

“During medical emergencies, time is of the essence, and many Washingtonians rely on air ambulance services for critical care and speedy transport to the hospital. Sadly, Medicare’s reimbursement system for air medical services is outdated and no longer reflects the cost of care, jeopardizing people’s access to lifesaving transport—particularly those in underserved and rural communities,” said DelBene. “Receiving air ambulance services can be a matter of life or death. This legislation will give CMS the authority to update Medicare reimbursement rates for air medical services based on updated cost data, so Washingtonians can continue to access emergency care.” 

“Air ambulances provide lifesaving services, especially for the many Kansans living in rural parts of our state,” said Estes. “The bipartisan bill I’m introducing with Rep. DelBene, along with my colleagues Sens. Bennet and Blackburn in the Senate, is a common sense way to ensure all Americans have efficient access to hospitals and specialized providers regardless of their location. When seconds matter, air ambulances have proven to be the best way to care for patients in need, and under this new legislation, the work of the pilots and medical professionals on board will continue to save lives.”

“As air ambulance bases across rural America have been forced to close, people in rural communities have lost access to lifesaving care. Coloradans should be able to trust that if they are sick or injured, they can get the medical attention they need, no matter where they live,” said Bennet. “Our bipartisan bill builds on our efforts to bring transparency to our health care system and improves access to lifesaving care for all Americans.”

“It is critical that Tennesseans living in rural areas have access to emergency medical transportation, including air ambulance. Reimbursement for these emergency medical services should be updated to accurately reflect the costs of providing this life-saving care. The Protecting Air Ambulance Services for Americans Act will ensure continued access to air ambulance services for Tennesseans living in rural areas,” said Blackburn.

Air ambulances can be the difference between life and death. A 2019 study found that injured patients transported by air ambulance were less likely to die than those taken by ground ambulance.

Medicare beneficiaries account for nearly 40% of all air medical transports. While operational costs of air ambulance services have increased, the rate of Medicare reimbursements have not. A 2017 Government Accountability Office  report found that Medicare reimbursement rates for air ambulance services are significantly below the costs of providing care, especially in rural areas. 

The current Medicare reimbursement rate for air medical services is determined by the air ambulance fee schedule. The Centers for Medicare and Medicaid Services first established the air ambulance fee schedule in 2002 using data from a 1998 cost pool, and it has not been updated since. Since then, over 35 air ambulance bases have closed, and more closures are expected – particularly limiting emergency care access for Americans living in rural communities.

To ensure seniors, Americans living in rural areas, and patients in need of emergency care have access to air medical services, the Protecting Air Ambulance Services for Americans Act updates the Medicare fee schedule for these critical services. Specifically, the bill authorizes CMS to update the Medicare Fee Schedule using data collected through the No Surprises Act passed in 2020. The bill also requires air ambulance providers to submit additional data on the operational costs of air medical services and the Government Accountability Office to issue a report on the costs associated with providing air ambulance services for Medicare beneficiaries.

“This is a momentous occasion for those in our industry dedicated to ensuring that everyone—including those living in rural and remote communities—has access to critical emergency and specialized care in their moment of medical crisis,” said Jeff Richey, University of Washington Medicine’s Executive Director of Airlift Northwest. “The legislation will preserve emergency air medical services in rural communities for years to come. Thanks to Congresswoman DelBene, Congressman Estes, Senator Bennet, and Senator Blackburn for leading on this issue.”

A copy of the bill text is available here. A copy of the bill summary is available here.

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