March 7, 2025

Re: Medicaid Supplemental Payments for Ground Ambulance Services

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

On behalf of 31 state ambulance and emergency medical services (EMS) associations, we ask for your continued support for Medicaid supplemental payment programs that provide critical support to EMS providers.

Ambulance service providers face financial pressures and risk closure at an alarming rate in every state. 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 supplemental payment programs focus on improving rural access to care by driving dedicated resources to those communities.

We are deeply concerned by recent proposals that would severely reduce critical Medicaid reimbursement by reducing provider assessments and mandating the use of artificial caps on supplemental payments that would prevent rates from covering costs.

EMS and ambulance service providers, rural hospitals, and safety-net health clinics will close without continued funding that Medicaid supplemental payment funds provide.

Our ambulance associations are eager to collaborate with the Congress and the Administration on solutions that sustain Medicaid financing and ensure ambulance service providers 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,

Alabama Association of Ambulance Services

Arkansas Ambulance Association

California Ambulance Association

EMS Association of Colorado

Georgia Ambulance Providers Association

Kentucky Ambulance Providers Association

Louisiana Ambulance Alliance

Massachusetts Ambulance Association

Michigan Association of Ambulance Services

Minnesota Ambulance Association

Mississippi Ambulance Alliance

Missouri Ambulance Association

Montana Ambulance Association

Nevada Ambulance Association

New Hampshire Ambulance Association

Medical Transportation Association of New Jersey

United New York Ambulance Network

Ohio Ambulance & Medical Transportation Association

Oklahoma Ambulance Association

Oregon State Ambulance Association

Ambulance Association of Pennsylvania

South Carolina EMS Association

Tennessee Ambulance Service Association

Texas Ambulance Association

Texas EMS Alliance

Vermont Ambulance Association

Virginia Ambulance Association

Washington Ambulance Association

West Virginia EMS Coalition

Professional Ambulance Association of Wisconsin

Wyoming EMS Association