To amend title XVIII of the Social Security Act to ensure appropriate payments for ambulance services under the Medicare program.

119th Congress Introduced by John Joyce and 7 co-sponsors

The bill aims to ensure Medicare ambulance payments match the true cost of services, improving reimbursement accuracy and reducing underpayment.

Introduced in House

Overview

HR 9970, introduced in the 119th Congress, seeks to amend Title XVIII of the Social Security Act to ensure appropriate payments for ambulance services under the Medicare program. The bill appears designed to address payment adequacy and alignment for ambulance providers, aiming to improve reimbursements and reduce underpayment or misalignment with actual costs.

Purpose and intent

Align Medicare payments for ambulance services with the costs of providing those services.

Ensure that ambulance providers receive appropriate reimbursement under the Medicare program, potentially reducing underpayment and administrative burdens.

Clarify or adjust payment methodologies to better reflect regional cost variations and service complexity.

Key provisions and changes (as described by the bill’s title and general intent)

Amend Title XVIII of the Social Security Act (Medicare) specifically related to ambulance services.

Establish or modify payment formulas to ensure “appropriate payments” for ambulance transport and related services.

Potentially address components such as base rates, mileage, urban/rural adjustments, and service levels (e.g., emergency vs. non-emergency transports).

May include provisions to reduce waste, fraud, and improper payments, or to improve data collection and reporting related to ambulance claims.

Could establish reporting, notification, or implementation timelines for new payment rules, though exact statutory text would specify these mechanics.

Who would be affected

Medicare beneficiaries who rely on ambulance services, ensuring their providers are reimbursed adequately.

Ambulance service providers (emergency and non-emergency), including for-profit and non-profit organizations, that bill Medicare for transport services.

Medicare Administrative Contractors (MACs) and other entities involved in processing ambulance claims and applying payment policies.

State Medicaid programs indirectly, if they reference Medicare payment methodologies or if Medicare changes influence crossover Medicaid reimbursements.

Procedural and timeline aspects

Referral: Referred to the House Committee on Energy and Commerce and the House Committee on Ways and Means for consideration, indicating a focus on both health program policy and fiscal/administrative implications.

Introduced: The bill was introduced and then promptly referred on 2026-07-27.

As a forthcoming bill, it would proceed through committee markup, potential amendments, and floor consideration, followed by potential reconciliation with Senate counterparts or passage depending on legislative strategy.

Practical implications

If enacted, ambulance providers could see changes in Medicare reimbursements that more accurately reflect the cost and complexity of ambulance transport.

The bill may necessitate updates to provider billing systems and claims processing to align with new payment methodologies.

Beneficiaries could experience more reliable access to ambulance services if underpayment issues are remedied, though overall impact would depend on the final enacted text and implementation details.

Further notes

The summary above reflects the bill’s stated objective to ensure appropriate payments for ambulance services under Medicare. The exact statutory text would specify the precise payment formula, regional adjustments, implementation timeline, and any interim rules.

For a complete understanding, review the bill’s full language, committee reports, and any subsequent amendments or policy clarifications introduced during the legislative process.