The RESCUE Act of 2026 updates Medicare payment rates for ground and air ambulance services to better reflect actual operational costs while mandating new data reporting requirements for air ambulance providers.
August Pfluger
Representative
TX-11
The RESCUE Act of 2026 updates Medicare payment rates for ground and air ambulance services to better reflect the actual costs of providing emergency care. The bill mandates regular rate adjustments based on current operational data, expands cost-reporting requirements for air ambulance providers, and establishes a stakeholder commission to ensure the long-term adequacy of ambulance service reimbursement.
RESCUE Act of 2026 Mandates Medicare Ambulance Rate Hikes and Air Transport Cost Reporting Starting in 2028
The RESCUE Act of 2026 is stepping in to overhaul how Medicare pays for ambulance rides, a system that hasn't always kept pace with the actual cost of fuel, specialized staff, and life-saving equipment. Starting in 2028, the bill requires the Secretary of Health and Human Services (HHS) to ditch outdated math and set new payment rates based on the most recent data available. This isn't just a one-time fix; the bill mandates annual inflation adjustments based on the Consumer Price Index (CPI-U) and triggers a deep-dive review of the fee schedule every three years starting in 2031 to account for new medical tech and changing costs.
Modernizing the Emergency Tab
For years, ground and air ambulance providers have argued that Medicare reimbursements don't cover the bill for a 2 a.m. emergency call. Under Section 2, the government must recalibrate 'relative value units' and 'conversion factors'—the complex formulas that determine the final check. For someone living in a rural area where the nearest hospital is 40 miles away, this matters because it helps ensure the local EMS station can afford to keep the lights on and the sirens ready. By tying future raises to the CPI-U, the bill attempts to shield these essential services from being eaten alive by inflation.
Bringing Air Ambulances Into the Light
Air ambulances—those life-saving but notoriously expensive helicopters—are getting some new homework. The bill expands cost-reporting requirements to air providers, forcing them to turn over operational data to HHS at least once every three years. To make sure they comply, the bill includes a sharp 10% payment penalty for any provider that fails to submit their data. This move is designed to pull back the curtain on why air transport costs what it does, using the same transparency standards established in the No Surprises Act.
Expert Oversight and Future-Proofing
Because healthcare moves fast, the bill doesn't want the 2028 rules to become obsolete by 2030. It mandates the creation of a stakeholder group—including the people actually running ambulance services—to huddle up by the end of 2028. They are tasked with handing Congress a formal set of recommendations by July 2029 on how to further improve the payment system. While the bill relies on HHS to interpret 'actual costs' correctly, the goal is a more sustainable system where the reimbursement matches the reality of modern emergency medicine.