Advocacy
The American Ambulance Association continues to press the Congress and federal agencies to secure the resources and financial support needed for ambulance service organizations, paramedics, and EMTs to effectively serve and protect their communities. The AAA invites you to become involved with our efforts on Capitol Hill.
Help support the AAA’s efforts by contacting your members of Congress today!
2025 Priorities
Medicare Ambulance Relief
EMS Workforce Shortage
Payment Reform
The AAA successfully pushed for the inclusion of Medicare extenders in the Continuing Resolution (CR) signed by President Trump on March 15th, 2025. This CR includes Ambulance Medicare Add-On Payments at their current rates (2% urban, 3% rural, and 22.6% super rural), which will expire on September 30th, 2025. As of March 18th, the Protecting Access to Ground Ambulance Medical Services Act (H.R. 2232) has been reintroduced. This legislation would extend the temporary Medicare ambulance add-on payments at their current levels until January 1, 2028. It is essential that we urge members of Congress to act now so ambulance providers can continue to deliver vital services to their communities.
The ongoing EMS workforce shortage crisis is a top priority of the AAA. As of March 18, 2025, the Preserve Access to Rapid Ambulance Emergency Medical Treatment Act (PARA-EMT Act). H.R. 2220 has been reintroduced. This bill proposes $50 million in funding for a grant training program aimed at recruiting and training paramedics and EMTs, easing the transition for veteran medics into civilian EMS roles, and requests that the Secretary of Labor conduct a study on the EMS workforce shortage. Passing this bill is crucial to tackling the EMS staffing crisis and creating lasting, meaningful change for ambulance services nationwide.
In 2018, the AAA led efforts to have Congress direct the Centers for Medicare and Medicaid Services (CMS) to collect operational and financial data from ground ambulance services through a survey. The goal was to use this data to permanently integrate add-on payments into ambulance rates and make data-driven updates to the fee schedule that more adequately support ambulance providers. CMS has since transmitted the raw data to the Medicare Payment Advisory Commission (MedPAC), which will analyze the data and issue recommendations by Summer 2026. We are now nearing a point where reform is within reach, ensuring that data collection continues and ambulance payment extensions are not only maintained but increased.
Balance Billing
The AAA effectively raised awareness in Congress about the harmful impact of balance billing on both patients and ambulance service providers, highlighting the urgent need to remove patients from the middle and ensure sustainable access to EMS for all Americans. In response, Congress established the Ground Ambulance and Balance Billing Advisory Committee to tackle this critical issue. The committee has completed its work and submitted its findings and recommendations to Congress. The AAA will continue to collaborate with key lawmakers to push for policies that safeguard both patients and providers, ensuring that EMS remains accessible and sustainable for all.
Balance Billing Toolkit
Through membership, AAA members have access to a comprehensive balance billing toolkit, featuring resources tailored to state-level issues.
535 Plan
American Ambulance Association President, Jamie Pafford-Gresham, places great value on fostering meaningful relationships with lawmakers and their staff. She is committed to ensuring AAA establishes a presence in every Congressional office, with the goal of AAA members meeting with all 535 offices during the 119th Congress. AAA seeks to educate policymakers on the challenges and opportunities facing EMS and mobile healthcare, ensuring that our issues remain top-of-mind as legislation progresses. By building these relationships and maintaining open lines of communication, we believe we can drive impactful policy changes that will support the growth, sustainability, and effectiveness of mobile healthcare.
AAA members can now self-report their Congressional meetings to help us make progress toward this goal!
Advocacy Resources
The AAA has created leave-behinds on key topics like Medicare Ambulance Relief, EMS Workforce Shortage, Balance Billing, and State-Level Issues to help educate lawmakers on the challenges our members face. Download these documents to support and strengthen your advocacy efforts!
State-Level Leave-Behinds