HR4792-119

What This Bill Does

The Protecting Air Ambulance Services for Americans Act changes the evidence base for Medicare air ambulance payment. It adds a new Social Security Act provision allowing the Secretary to revise the Medicare fee schedule for air ambulance services using data collected under section 106 of division BB of the 2021 Consolidated Appropriations Act and additional data required by the bill. Every three years, air ambulance providers and suppliers must submit fixed and operating costs per base, Medicare utilization, Medicare revenue, and any other information the Secretary finds appropriate. If the Secretary revises the fee schedule, the process must be transparent and consider stakeholder input. HHS must finalize and publish the 2021 air ambulance data-collection rule within six months. GAO must then study average annual operating costs per base, average cost per transport, payor mix, Medicare payment adequacy, geographic cost variation, and recommendations for improving the fee schedule.

Who Benefits and How

Air ambulance suppliers benefit if Medicare payment revisions reflect base operating costs, utilization, revenue data, and geographic cost differences. Rural Medicare beneficiaries benefit if better payment data helps maintain emergency air transport availability in high-cost areas. CMS payment officials benefit from recurring provider data and a GAO cost study before revising the fee schedule. Congressional health committees benefit from GAO recommendations on Medicare air ambulance payment adequacy.

Who Bears the Burden and How

Air ambulance providers must submit fixed-cost, operating-cost, utilization, revenue, and other required information every three years. HHS rulemaking staff must finalize the 2021 air ambulance data-collection rule within six months. GAO analysts must conduct the emergency air ambulance cost study after data collection begins. Medicare trust funds may bear higher or shifted payment costs if the fee schedule is revised upward for adequacy.

Key Provisions

• Authorizes Medicare fee schedule revisions for air ambulance services based on collected cost, utilization, and revenue data.
• Requires air ambulance providers and suppliers to submit additional data every three years.
• Requires HHS to finalize the 2021 air ambulance data-collection rule within six months.
• Requires GAO to study operating costs, transport costs, payor mix, Medicare payment adequacy, geographic variation, and fee-schedule improvements.