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Bi-Partisan Federal Legislation (H.R. 822) and its Senate companion bill (S. 1149) are designed to reform Medicare payments for patients flown by Emergency Medical Services (EMS) helicopters. Without this legislation, millions of Americans could lose timely access to critical healthcare. The legislation will build a payment system based upon actual cost data to ensure timely access to healthcare for the more than 80 million Americans who can only access Level 1 or Level 2 Trauma Centers, within an hour, through the use of EMS helicopters.


H.R. 822 was introduced by include Rep. Pete Sessions (R-TX), and is co-sponsored by Rep. Greg Meeks (D-NY), Rep. Todd Young (R-IN), and Rep. Bill Johnson (R-OH), and co-sponsored by 15 other Members of Congress. 

S. 1149 was introduced by Senator David Vitter (R-LA), and is co-sponsored by Senator Michael Bennet (D-CO), Senator Tim Scott (R-SC), and Senator Cory Gardner (R-CO).

The legislation takes a reasonable approach to:

  • Develop a system to collect data regarding the operational costs of a typical air ambulance base.
  • Provide for an independent government analysis of the collected data.
  • Establish ongoing reporting of industry-consensus clinical quality measures.
  • Provide reasonable immediate, but temporary, relief to providers while the data collection and analysis is occurring.

Quick Facts:

  • The air medical industry sits at the junction of two of the most heavily regulated industries in the world – aviation and healthcare.
  • EMS flight teams transport and treat approximately 400,000 of the nation’s most critically ill and injured patients annually.
  • EMS helicopters provide access to timely critical care for 82 million Americans who live more than an hour away from a Level 1 or 2 trauma center.  Between 1990 and 2005, 339 trauma centers in the United States closed, and between 1991 and 2011, 22% of America’s rural hospitals closed. Both trends are expected to continue, requiring patients to be transported longer distances to receive critical care.


  • EMS helicopters are most often utilized for trauma/head injuries, as well as time-dependent diseases such as heart attack, stroke, and non-trauma surgical emergencies such as AAA’s and GI bleeds.  A rapidly increasing “Baby Boomers” population, especially in rural areas, is contributing to the increased demand for EMS helicopters.
  • Transport by EMS helicopter is not appropriate for every patient and is used only when requested by a Doctor or a medically-trained first responder.
  • EMS helicopters are staffed with skilled pilots and highly-trained medical professionals who provide a high level of patient care enroute directly to the medical facilities best suited to treat a patient’s specific needs. The level of care during the transport cannot be underestimated when you’re dealing with the most critically ill and injured patients. Those patients must get to the right level-of-care during the “golden hour,” which can be the difference between an abbreviated successful recovery vs. needing extended and expensive long term care.


  • EMS flight teams must be ready to respond 24 hours-a-day, 365 days-a-year. The major costs of maintaining readiness are fixed and include aircraft costs, the costs of maintaining teams of trained, properly-licensed, experienced flight teams, as well as the safety improvements that ensure the highest-quality patient care is provided in the safest environment possible.
  • EMS helicopters transport every patient-in-need, without regard to their ability to pay.
  • Today, roughly 14% of Americans are uninsured or underinsured, 18% are covered by Medicaid, 35% by Medicare, and 33% have commercial insurance.


  • During the 10+ years of the current Medicare Air Ambulance Fee Schedule, air medical providers have seen inadequate inflationary updates. Rapidly rising operational costs over this same period has resulted in a Medicare reimbursement to cost shortfall of over 70%.