While 19 other states have already taken action, Massachusetts has an opportunity to lead with the nation’s most patient-friendly solution to limit surprise bills for emergency ground ambulance services. This reform – supported by consumer advocates, municipalities, providers – would give patients peace of mind that the care they need in a crisis won’t result in crushing, unexpected costs.

For nearly 20 years, temporary Medicare add-on payments (2 percent in urban areas, 3 percent in rural areas, and 22.6 percent in super rural regions) have provided crucial but still insufficient support. Even with these add-ons, Medicare reimbursement remains well below the true cost of service delivery. The temporary payments expired last fall before being reinstated only through January 30, 2026. Our message is direct: Congress must extend and increase these add-ons to 3.4 percent for urban services, 4.3 percent for rural services, and 26.7 percent for super rural areas. These levels are justified not only by longstanding underpayment but also by CMS’s own preliminary findings showing that the cost per Medicare transport significantly exceeds reimbursement.

Providers across the state are navigating severe recruitment and retention challenges, increased turnover, and heightened competition for qualified clinicians. We’re seeing an extraordinary number of paramedics leave EMS in favor of hospital settings in Massachusetts. We urged the delegation to support the PARA-EMT Act (H.R. 2220), which would provide federal funding for recruitment and training, reduce barriers for veterans seeking to become EMTs and paramedics, and commission a federal study to evaluate long-term workforce needs. We also asked for support of provisions in the Senate-passed National Defense Authorization Act that would streamline the transition of military medics into civilian roles.