Why It Matters
The American Ambulance Association is lobbying on the Protecting Access to Ground Ambulance Medical Services Act. The House bill would extend temporary Medicare payment increases for ground ambulance services, while the American Ambulance Association sought higher percentages.
By the Numbers
The association’s in-house report, signed Oct. 27, listed $350,000 in third-quarter lobbying expenses, unchanged from the prior quarter and up $50,000 from the third quarter of 2025.
Across all registrants, third-quarter expenses totaled $530,000, unchanged from the second quarter and up $59,000 from the same quarter in 2025. Outside firms reported the following amounts:
- Lester Health Law PLLC: $60,000.
- Alston & Bird LLP: $70,000.
- Capitol Counsel LLC: $50,000.
The in-house team comprised Tristan North, senior vice president for government affairs, and Shawn Baird, vice president for state affairs and strategic advocacy.
Broader Context
Rep. Claudia Tenney (R-NY) introduced the House ambulance payment bill in March 2025, and Sen. Catherine Cortez Masto (D-NV) introduced the Senate version in May 2025. The House measure was referred to the Energy and Commerce and Ways and Means committees; the Senate measure went to the Finance Committee. Those referrals placed the proposals before committees in their respective chambers.
The association and other supporting organizations, including the International Association of Fire Chiefs and the National Rural Health Association, argue Medicare reimbursement does not cover costs in rural and underserved areas. The association also raised changes in ZIP code designations under the Medicare ambulance fee schedule following the 2020 Census and the need for a ZIP code designation appeals process.
On staffing, the association lobbied on the PARA-EMT Act, which supporters describe as addressing shortages through grants, veteran hiring pathways, and training support. It also lobbied for emergency medical service training programs and access to first responder benefits to address the shortage of paramedics and emergency medical technicians.
The House Appropriations Committee’s June 11 report on the fiscal 2027 labor, health, and education funding bill included funding and directed language related to emergency medical services and training authorities. The committee report accompanies a funding proposal; it is not itself an enacted appropriations law. The association lobbied on that measure and sought appropriations language supporting future federal collection of ground ambulance data.
Other disclosed priorities included support for the Ground Ambulance and Patient Billing Advisory Committee’s final report, disaster preparedness resources, and federal fuel excise tax relief for private ground ambulance organizations.
The Bottom Line
The Centers for Medicare and Medicaid Services expects to address ongoing ambulance data collection requirements in its 2028 physician fee schedule rulemaking.
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