A bipartisan bill introduced in the House would overhaul how Medicare pays ambulance providers, which some lawmakers say would prevent financial strain on emergency medical services (EMS) agencies in rural communities. The legislation, known as the Reimbursing Emergency Services for Critical Urgent Encounters (RESCUE) Act of 2026, would require the Centers for Medicare & Medicaid Services (CMS) to regularly update Medicare's ambulance fee schedule using current cost data rather than rates based on prior decades-old information. "EMS providers and first responders show up for our communities every single day, often in the most difficult moments imaginable, and they deserve a Medicare system that shows up for them in return," Representative August Pfluger (TX-11) said in a statement.
Outdated reimbursement rates could force EMS agencies to absorb the costs. A 2024 RAND Corporation report prepared for CMS found that ambulance agencies are paid more than $1,500 less than their costs per transport on average. Medicare's current reimbursement structure has remained largely unchanged since 2002 and relies on cost data collected in 1998, despite major changes in labor, fuel, and equipment costs.
The bill would update Medicare's ambulance payment system by requiring CMS to conduct regular updates to reimbursement rates based on current cost data. This would establish updated Medicare ambulance payment amounts beginning in 2028, and comprehensive reviews of ambulance payment rates would be required every three years. The law would also increase annual payment amounts in other years using inflation adjustments and expand Medicare ambulance data reporting requirements, including for air ambulance providers.
By adjusting cost every three years it would align cost increases with the services being provided,” Kevin Thompson, the CEO of 9i Capital Group and the host of the 9innings podcast, told Newsweek. The bill was introduced by Pfluger, a Republican from Texas, alongside a bipartisan group of lawmakers that includes Jill Tokuda, Beth Van Duyne, Kim Schrier, John Joyce, Brad Schneider, Claudia Tenney and Terri Sewell. So far, the bill has been referred to the House Energy and Commerce Committee and the House Ways and Means Committee.
An ambulance has to be staffed, equipped and ready before anyone calls 911,” Michael Ryan, a finance expert and the founder of MichaelRyanMoney.com, told Newsweek. Better reimbursement could make it easier to keep that capacity available.” The RESCUE Act was introduced late last month and has been referred to the House committees with jurisdiction over Medicare policy. The legislation must be approved by committee before advancing to the House floor for consideration.
For something like reimbursements that are still on the 2002 scale, this is way overdue,” Thompson said. Contact Newsweek editors on this story: Jason Lemon and Gray R.
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