RESCUE Act Explained: How H.R. 9970 Would Update Medicare Ambulance Reimbursement
The RESCUE ACT, introduced to Congress by a bipartisan group of representatives, seeks to modernize Medicare reimbursement for ground and air EMS transport. H.R. 9970, if passed, would amend title XVIII of the Social Security Act to make sure Medicare payments for ambulance services reflect updated and current costs of emergency medical services, including supporting readiness.
Rep. August Pfluger (TX-11) introduced the Reimbursing Emergency Services for Critical Urgent Encounters (RESCUE) Act of 2026 to the U.S. House of Representatives on July 27, 2026. Pfluger was joined by seven cosponsors — Reps. Jill Tokuda (HI-02), Beth Van Duyne (TX-24), Brad Schneider (IL-10), John Joyce (PA-13), Kim Schrier (WA-08), Claudia Tenney (NY-24), and Terri Sewell (AL-07). As of this writing, the bill has been referred to the Committee on Energy and Commerce and the Committee on Ways and Means.
“I'm proud to help lead the bipartisan RESCUE Act to ensure EMS is reimbursed based on the real cost of the care they provide, just like other healthcare providers already are,” Rep. August Pfluger said. “This is especially critical in rural communities, where a funding shortfall can mean the difference between an EMS agency staying open or shutting its doors.”
What H.R. 9970 Would Change
The RESCUE Act, if passed into law, will:
- Modernize Medicare’s emergency medical response payment structure
- Reflect accurate, updated cost inputs
- Provide a long-term, forward-looking solution
- Protect access to EMS in underserved communities
- Sustain the nation’s emergency medical infrastructure for ground and air ambulances
RESCUE Act supporters say the bill will require Medicare to use a data-backed and cost-based approach to setting payment rates, paying for the actual cost of providing services. The bill also eliminates the need for temporary payments and creates a transparent public-rule making system with stakeholders for annual notice and comment.
There are also provisions in the bill to require Medicare's payment methodology to account for all costs related to uncompensated care, which is a normally reimbursable transport that the patient or their insurer fails to pay.
For David Torres, Managing Director, Falck Alameda County, the RESCUE Act's provision to make sure funding is appropriate every three years is an opportunity for better operational planning and employee stability.
"It's about the providers. This would provide a stage where they can establish a career in EMS rather than a steppingstone to another career," Torres said. "Having (career) longevity is only going to benefit the residents of Alameda County."
Who is Backing the RESCUE Act?
The RESCUE Act is supported by the Emergency Ambulance Operators Alliance, whose members include Acadian Ambulance Service, Apollo MedFlight, Falck USA, Global Medical Response, Life Flight Network and PHI Air Medical. According to the EAOA, Medicare's outdated payment policies have not evolved with the changes in healthcare needs, standards and costs.
The Association of Air Medical Services (AAMS) is also supporting the RESCUE Act of 2026. "Medicare reimbursement is insufficient and more than 20 years outdated,” said Jana Williams, AAMS President and CEO. “The RESCUE Act, the second bill introduced in less than a year aimed at updating the Medicare fee schedule for air ambulances, demonstrates Congress’ growing resolve to solve this long-standing challenge.”
Other EMS and fire professional associations are reviewing the RESCUE Act and considering how to best support the bill to ensure it gets committee hearings and a chance at a House vote.
"Kudos to those who were able to get the bill introduced. The RESCUE Act finally acknowledges that the ambulance fee schedule is outdated," Matt Zavadsky, EMS/Mobile Healthcare Consultant said. "We should all support the financial sustainability of our EMS system."
What Reimbursement Shortfalls Mean for Ambulance Services
Currently, Medicare reimburses for patient transport, which often falls short of the actual cost of service and contributes little to nothing to an EMS agency’s readiness costs. Personnel, vehicles and equipment need to be available 24/7 regardless of the number of patients they respond to and transports they conduct.
The funding shortfall isn't hypothetical. St. Joseph's Ambulance Service in West Virgina, which employed 83 full- and part-time staff, closed in March 2025. According to a statement the company's president cited, "Medicare and Medicaid reimbursements not keeping pace with the company's costs for providing service as the driving force in the decision (to close)."
SJAS also mentioned recruitment and retention issues as contributing factors to their closure. Other news reports, like these from Alabama, Michigan, and Pennsylvannia, report that the combination of inadequate Medicare reimbursement, rising costs for equipment and supplies, and staffing challenges put their existence at risk.
Lynn Weber, Director of Clinton Area Ambulance Service Authority, described the EMS readiness funding problem to WILX, “Medicare and Medicaid (is) 70% of our calls, and they reimburse us significantly less than what it costs us to provide the service. There’s a cost to readiness. Some days we may have two calls; some days we might have 15 or 20 calls. Our fixed costs are always the same.”
The EAOA and the RESCUE Act co-sponsors believe that without updating the Medicare payment structure many agencies will have no choice but to reduce services, increase response times or reduce coverage areas. Ambulance operators of all sizes are impacted by the current Medicare funding formula.
"Global Medical Response’s commitment to delivering care at a moment’s notice requires operational readiness, but current Medicare reimbursement falls short of supporting what is required to properly serve,” said Nick Loporcaro, board chair and CEO of Global Medical Response. “Inadequate payment policies threaten the sustainability of EMS nationwide."
Why Rural Communities Face Greater Risk
Rural communities, often already underserved by hospitals and health clinics, will most feel the impact of the Medicare status quo.
“For people living in rural America, medical care isn't always around the corner; it often requires long drives or emergency flights, especially to reach specialized treatment,” Rep. Jill Tokuda said. “We cannot allow outdated Medicare payment rates to jeopardize the air and ground ambulance services our rural and remote communities rely on."
How EMS Professionals Can Advocate for EMS
Paramedic Daniel Kreutler believes our House representatives want to hear from the people who are not only their constituents but also serve their constituents. Kreutler is an NAEMT advocacy coordinator, the EMS Advocator on TikTok, and wants EMS providers to get involved in improving the profession through advocacy.
"Reach out to your Congress member by phone," Kreutler said. "Make it short, identify yourself as a constituent, state your ask, how it affects you and why it is important."
What Happens Next
Ultimately, the most important impact of passing the RESCUE Act will be maintaining and improving access to EMS through ensuring well-trained and well-equipped ground and air EMS providers are ready to respond to emergencies anywhere, anytime.
Learn more about the EMS financial crisis, download the EAOA RESCUE Act fact sheet and follow H.R.9970 - RESCUE Act of 2026 progress on Congress.gov.
