Protecting Air Ambulance Services for Americans Act of 2025
- Sponsor
- Rep. Estes, Ron [R-KS-4]
- Committees
- Ways and Means Committee (primary)
- Last action
- Jul 29, 2025
Bottom line
The bill aims to improve the accuracy and fairness of Medicare payments for air ambulance services by mandating enhanced data collection and analysis, potentially leading to a revised fee schedule and better understanding of industry economics.
What it actually does
This bill authorizes the Secretary of Health and Human Services to revise the Medicare fee schedule for air ambulance services based on new, comprehensive data. It mandates regular data collection from air ambulance providers on their costs, utilization, and revenue, building upon existing data collection efforts. Additionally, it requires the Secretary to finalize an existing air ambulance data collection rule within six months and directs the Government Accountability Office (GAO) to conduct a study on emergency air ambulance costs and Medicare payment adequacy.
Proponents argue
Supporters argue that the current Medicare payment system for air ambulance services may not adequately cover the costs of providing these critical, often life-saving, services, particularly in rural and underserved areas. They contend that comprehensive, up-to-date data is essential to ensure sustainable access for Medicare beneficiaries, prevent unexpected costs for patients, and allow for a more equitable and data-driven fee schedule revision that reflects the true cost of operations.
Opponents contend
Critics might argue that increasing data collection requirements could impose additional administrative burdens on air ambulance providers, potentially leading to higher operational costs that could be passed on to patients or the Medicare program. Some may also express concern that granting the Secretary broad authority to revise the fee schedule based on new data could lead to increased Medicare spending without clear benefits, or that the revision process might not adequately balance provider needs with taxpayer interests.
The bill is very short and easy to understand, allowing ample time for comprehensive evaluation.
Section 2, amending Section 1834(l) of the Social Security Act
Authority to Revise Medicare Air Ambulance Fee Schedule Based on New Data
This provision grants the Secretary of Health and Human Services the authority to update the Medicare fee schedule for air ambulance services. This revision would be informed by new data collected from air ambulance providers, specifically regarding their fixed and operational costs per base, service utilization by Medicare beneficiaries, and revenue obtained from Medicare. If the Secretary chooses to revise the fee schedule, they must do so through a transparent process that considers stakeholder input and the collected data.
Supporters argue
Supporters argue that this provision is crucial for ensuring that Medicare payments accurately reflect the actual costs of providing air ambulance services. By basing payment revisions on comprehensive, up-to-date data, the system can better support providers, especially those serving rural and remote areas, and prevent situations where inadequate reimbursement leads to service reductions or surprise billing for patients.
Critics contend
Critics might contend that while data collection is valuable, granting the Secretary broad authority to revise the fee schedule based on this data without more specific legislative guidance could lead to unpredictable changes. They might also worry about the administrative burden of new data reporting requirements on smaller providers.
Tradeoffs
The tension lies between ensuring adequate reimbursement for critical services to maintain access, particularly in rural areas, and controlling Medicare spending. There's also a tradeoff between the administrative burden of data collection and the benefit of data-driven policy.
Section 3
Timely Finalization of Air Ambulance Data Collection Rule
This section mandates that the Secretary of Health and Human Services must finalize and publish a specific rule implementing existing air ambulance data collection requirements within six months of the bill's enactment. This accelerates the regulatory process for a data collection framework previously established by the Consolidated Appropriations Act, 2021.
Section 4
GAO Study on Emergency Air Ambulance Costs
This provision directs the Comptroller General of the United States (who leads the Government Accountability Office, or GAO) to conduct a study and submit a report to specific congressional committees. The report, due within one year of the new data collection beginning, must detail average annual operating costs per air ambulance base, average cost per transport, the payor mix for services, the adequacy of Medicare payments, geographic variations in costs, and recommendations for improving the Medicare fee schedule for air ambulance services.