March 12, 2025

The Honorable Brett Guthrie Chair Committee on Energy and Commerce United States House of Representatives 2161 Rayburn House Office Building Washington, DC 20515	The Honorable Buddy Carter Chair Energy and Commerce Subcommittee on Health United States House of Representatives 2432 Rayburn House Office Building Washington, DC 20515
The Honorable Frank Pallone, Jr. Ranking Member Committee on Energy and Commerce United States House of Representatives 2107 Rayburn House Office Building Washington, DC 20515	The Honorable Dianna DeGette Ranking Member Energy and Commerce Subcommittee on Health United States House of Representatives 2111 Rayburn House Office Building Washington, DC 20515

Re: Medicaid Reimbursement for Ground Ambulance Services

Dear Chair Guthrie, Ranking Member Pallone, Chair Carter, and Ranking Member DeGette,

On behalf of our members, and the more than 16 million citizens served by our members, the Academy of International Mobile Healthcare Integration asks for your continued support for Medicaid supplemental payment programs that provide critical support to Emergency Medical Service (EMS) systems and providers.

Ambulance service providers face financial pressures and risk closure at an alarming rate in every state. A new tracking system we help support has documented over 2,700 local and national news reports about EMS, with 79% of the reports highlighting the economic and staffing crisis in EMS. In rural communities in particular, EMS providers are often the only healthcare providers delivering care for hundreds of miles. Medicaid supplemental payment programs offer transparent and sustainable ways to support first responders, allowing them to continue providing life-saving services, train paramedics, and ensure our rural communities are not left without care.

The most at-risk ambulance service providers—those serving rural communities—face unique challenges including large coverage areas, increased travel distances, and higher costs per transport. Adequate support for staffing, training, and equipment is already a major challenge. Medicaid and Medicaid supplemental payment programs help improve rural access to care by helping to fund the dedicated resources serving those communities.

We are deeply concerned by recent reports of proposals that may severely reduce critical Medicaid reimbursement by reducing federal matching funds, altering provider assessments and mandating the use of artificial caps on supplemental payments, any of which would likely have a significant impact on EMS delivery, especially in rural communities or communities with large proportions of Medicaid beneficiaries. 

EMS and ambulance service providers, rural hospitals, and safety-net health clinics would be at risk of closure without continued funding that Medicaid supplemental payment funds provide. The previously mentioned news tracking system has already identified 219 news reports of ambulance service closures since January 2021.

We, and other ambulance associations, are eager to collaborate with Congress and the Administration on solutions that sustain Medicaid financing to help ensure ambulance service providers can continue to meet the needs of their communities.

We appreciate the opportunity to engage in further discussion and provide data on how these programs directly affect each of our states.

Sincerely,

Robert Lawrence, President

Academy of International Mobile Healthcare Integration

Member Agencies:

• ·         Alberta Health EMS; Alberta, Ontario, CA
• ·         Emergency Medical Services Authority; Tulsa and Oklahoma City, OK
• ·         Mecklenburg EMS Agency; Charlotte, NC
• ·         Medic Ambulance; Vallejo, CA
• ·         Medic Ambulance of Scott County; Davenport, IA
• ·         Metropolitan Area EMS Authority; Fort Worth, TX
• ·         Metropolitan EMS, Little Rock; AR
• ·         Northwell Health Center for EMS; Syosset, NY
• ·         Novant Health; Wilmington, NC
• ·         Pinellas County Ambulance Authority; Largo, FL
• ·         Pro EMS; Cambridge, MA
• ·         REMSA Health; Reno, NV
• ·         Richmond Ambulance Authority; Richmond, VA
• ·         Three Rivers Ambulance Authority; Fort Wayne, IN