The Association of Air Medical Services welcomes this first public meeting of the Air Ambulance Patient Billing Advisory Committee, and applauds the Department of Transportation on their work in organizing this important Committee. AAMS is honored to be part of the discussion on recommendations for sustainable solutions to billing issues that focus on patient access to lifesaving care. Patients should not be burdened by balance bills when their insurers refuse to adequately cover the costs of their emergency medical services. If these practices are allowed to continue, the entire emergency air ambulance system in the United States would be at risk. In 2019 alone, AAMS members reported the closure of 57 air ambulance bases, most of which are already in underserved rural areas. We must work on comprehensive economic solutions that include federal cost, quality of service, and claims data collection, as well as Medicare and Medicaid reform. AAMS will continue to work tirelessly on behalf of our over 300 members, their 10,000+ dedicated aviation and medical employees, and the over 360,000 emergency medical patients a year they transport.