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RESCUE Act of 2026

Introduced Jul 27, 2026 · Last action Jul 27, 2026 Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.

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Summary

This legislation is called the RESCUE Act of 2026. It is being reviewed by a committee.

Full bill text

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 9970 Introduced in House (IH)]

<DOC>

119th CONGRESS
  2d Session
                                H. R. 9970

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

_______________________________________________________________________

                    IN THE HOUSE OF REPRESENTATIVES

                             July 27, 2026

 Mr. Pfluger (for himself, Ms. Tokuda, Ms. Van Duyne, Ms. Schrier, Mr.
   Joyce of Pennsylvania, Mr. Schneider, Ms. Tenney, and Ms. Sewell)
 introduced the following bill; which was referred to the Committee on
   Energy and Commerce, and in addition to the Committee on Ways and
 Means, for a period to be subsequently determined by the Speaker, in
   each case for consideration of such provisions as fall within the
                jurisdiction of the committee concerned

_______________________________________________________________________

                                 A BILL

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

    Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Reimbursing Emergency Services for
Critical Urgent Encounters Act of 2026'' or ``RESCUE Act of 2026''.

SEC. 2. AMBULANCE SERVICES PAYMENTS.

    Section 1834(l) of the Social Security Act (42 U.S.C. 1395m(l)) is
amended--
            (1) in paragraph (1)--
                    (A) by inserting ``, for years before 2027,'' after
                ``under this part through''; and
                    (B) by inserting ``(and for each year, beginning
                with 2027, by regulation)'' after ``title 5, United
                States Code,'';
            (2) in paragraph (2)(D), by inserting ``and, beginning for
        2028, in accordance with paragraph (18), determine and apply
        updated payment amounts (as defined in subparagraph (A)(ii) of
        such paragraph) and the adjustments described in such
        paragraph'' after ``and other relevant factors'';
            (3) in paragraph (3)--
                    (A) in subparagraph (B)--
                            (i) by inserting ``(before 2028)'' after
                        ``each subsequent year''; and
                            (ii) by striking ``and'' after the
                        semicolon;
                    (B) in subparagraph (C)--
                            (i) by inserting ``(before 2028)'' after
                        ``each subsequent year''; and
                            (ii) by striking the period at the end and
                        inserting a semicolon; and
                    (C) by inserting at the end the following:
                    ``(D) for services furnished in 2028, substitute
                the updated payment amounts (as defined in paragraph
                (18)(A)(ii)) for such services as the payment amounts
                provided under the fee schedule for such services; and
                    ``(E) set the payment amounts provided under the
                fee schedule for services furnished in 2029 and each
                subsequent year at amounts equal to the payment amounts
                under the fee schedule for services furnished during
                the previous year, updated by the adjustments or
                increase applicable to such year in accordance with
                clause (ii) or (iii), respectively, of paragraph
                (18)(B).'';
            (4) in paragraph (4), by inserting ``including for purposes
        of carrying out the provisions of paragraph (18),'' after
        ``under this subsection,'';
            (5) in paragraph (15), by striking ``the preceding
        provisions of'' after ``amount otherwise applicable under'';
            (6) in paragraph (17)--
                    (A) in subparagraph (D)--
                            (i) in clause (i)--
                                    (I) by inserting ``(or, in the case
                                of a provider or supplier of air
                                ambulance services, beginning January 1
                                of the year subsequent to the first
                                year for which such providers and
                                suppliers are required to submit
                                information pursuant to subparagraph
                                (E)(ii)(II)),'' after ``Beginning
                                January 1, 2022,'';
                                    (II) by redesignating subclauses
                                (I) and (II) as items (aa) and (bb),
                                respectively, and moving the margin of
                                each such item, as redesignated, 2 ems
                                to the right;
                                    (III) by striking ``(as defined in
                                clause (ii)) to a provider or supplier
                                of ground ambulance services'' and
                                inserting ``(as defined in clause
                                (ii))--
                    ``(I) to a provider or supplier of ground ambulance
                services'';
                                    (IV) by striking at the end the
                                period and inserting ``; and''; and
                                    (V) by adding at the end the
                                following new subclause:
                                    ``(II) to a provider or supplier of
                                air ambulance services that--
                                            ``(aa) is required to
                                        submit information for a year
                                        determined by the Secretary
                                        under subparagraph (E)(ii)(II);
                                        and
                                            ``(bb) does not
                                        sufficiently submit such
                                        information, as determined by
                                        the Secretary.'';
                            (ii) in clause (ii)--
                                    (I) by inserting ``or a provider or
                                supplier of air ambulance services''
                                after ``with respect to a provider or
                                supplier of ground ambulance
                                services'';
                                    (II) by striking ``made a
                                determination under clause (i)(II)''
                                and inserting ``made--
                    ``(I) in the case of a provider or supplier of
                ground ambulance services, a determination under clause
                (i)(I)(bb)'';
                                    (III) by striking at the end the
                                period and inserting ``; or''; and
                                    (IV) by adding at the end the
                                following new subclause:
                                    ``(II) in the case of a provider or
                                supplier of air ambulance services, a
                                determination under clause (i)(II)(bb)
                                that the provider or supplier of air
                                ambulance services failed to
                                sufficiently submit information as
                                described in clause (i)(II)(aa).'';
                            (iii) in clause (iii)--
                                    (I) by inserting ``of ground
                                ambulance services or a provider or
                                supplier of air ambulance services''
                                after ``may exempt a provider or
                                supplier''; and
                                    (II) by inserting ``or provider or
                                supplier of air ambulance services,
                                respectively,'' after ``ability of the
                                provider or supplier of ground
                                ambulance services''; and
                            (iv) in clause (iv), by inserting ``or air
                        ambulance services'' after ``ground ambulance
                        services'';
                    (B) in subparagraph (E)--
                            (i) in clause (ii)--
                                    (I) by striking ``shall require''
                                and inserting ``shall--
                    ``(I) require'';
                                    (II) by striking at the end the
                                period and inserting ``; and''; and
                                    (III) by adding at the end the
                                following new subclause:
                                    ``(II) require providers and
                                suppliers of air ambulance services to
                                submit, in such form and manner and at
                                such time as specified by the Secretary
                                in accordance with clause (iii),
                                information described in section
                                106(a)(2) of the No Surprises Act for
                                years after the last NSA reporting year
                                (as defined in clause (iv)) as the
                                Secretary determines appropriate, but
                                in no case less often than once every 3
                                years.''; and
                            (ii) by adding at the end the following new
                        clauses:
                            ``(iii) Application to air ambulance
                        services.--In carrying out clause (ii)(II), the
                        Secretary--
                                    ``(I) may, as the Secretary
                                determines appropriate, use the data
                                collection system under subparagraph
                                (A) to provide for a single process for
                                the submission of information under
                                this paragraph, including information
                                described in such clause with respect
                                to providers and suppliers of air
                                ambulance services; and
                                    ``(II) shall, to the greatest
                                extent practicable, align the years for
                                which information is required to be
                                submitted under such clause with the
                                years for which information is required
                                to be submitted under clause (ii)(I).
                            ``(iv) Last nsa reporting year.--For
                        purposes of clause (ii)(II), the term `last NSA
                        reporting year' means the year with respect to
                        which information is required to be submitted
                        under section 106(a)(1)(B) of the No Surprises
                        Act.''; and
                    (C) in subparagraph (F)(i), by striking
                ``thereafter,, such'' and inserting ``thereafter,
                such''; and
            (7) by adding at the end the following:
            ``(18) Updating fee schedule to reflect most recently
        available data.--
                    ``(A) Initial review and revisions.--
                            ``(i) In general.--To improve the valuation
                        of ground ambulance services and air ambulance
                        services under this subsection the Secretary
                        shall review the relative value units,
                        conversion factor, air ambulance base rates,
                        and the mileage rates applied under the fee
                        schedule under this subsection and shall, by
                        regulation and taking into account the
                        information required under subparagraph (C),
                        make such adjustments as are necessary to
                        ensure that such relative value units,
                        conversion factor, base rates, and mileage
                        rates that are applied under the fee schedule
                        for 2028 with respect to ground ambulance
                        services and with respect to air ambulance
                        services, as applicable, reflect the costs
                        (including labor-related costs and costs
                        related to uncompensated care), expenses, and
                        resources used in furnishing the respective
                        ambulance service.
                            ``(ii) Updated payment amounts defined.--
                        For purposes of this subsection, the term
                        `updated payment amounts' means the payment
                        amounts determined, with application of the
                        adjustments pursuant to clause (i), under the
                        fee schedule under this subsection for 2028.
                    ``(B) Ongoing review and adjustments.--
                            ``(i) Triennial review.--For each data-
                        based adjustment year (as defined in clause
                        (iv)), with respect to ground ambulance
                        services and with respect to air ambulance
                        services, the Secretary shall review the
                        relative value units, conversion factor, air
                        ambulance base rates, and the mileage rates (or
                        any successor to or replacement for such units,
                        factor, or rates, including under any payment
                        methodology developed pursuant to this
                        subsection that is different from the
                        methodology in effect as of the date of
                        enactment of this paragraph), as applicable to
                        the respective services, established under the
                        fee schedule under this subsection.
                            ``(ii) Triennial adjustments based on
                        updated factors and data.--For determining
                        payment amounts under the fee schedule under
                        this subsection for ground ambulance services
                        and air ambulance services furnished during a
                        data-based adjustment year, the Secretary
                        shall, based on the review under clause (i)
                        with respect to such year and taking into
                        account the information required under
                        subparagraph (C), by regulation adjust the
                        number of relative value units, conversion
                        factor, air ambulance base rates, mileage rates
                        (or any successor to or replacement for such
                        units, factor, or rates, including under any
                        payment methodology developed pursuant to this
                        subsection that is different from the
                        methodology in effect as of the date of
                        enactment of this paragraph), or any
                        combination thereof, as applicable to the
                        respective services, to take into account
                        changes in medical practice, changes in
                        technology, the addition of new services, new
                        data on relative value components, new cost
                        data (including on labor-related costs and
                        costs related to uncompensated care), and other
                        relevant information and factors. The Secretary
                        shall publish in the Federal Register an
                        explanation of the basis for such adjustments
                        made for a data-based adjustment year.
                            ``(iii) Adjustments for years that are not
                        data-based adjustment years.--Beginning with
                        2029, with respect to a year that is not a
                        data-based adjustment year, for determining the
                        payment amounts under the fee schedule under
                        this subsection for ground ambulance services
                        and air ambulance services furnished during
                        such year, such payment amounts for such
                        services furnished during such year shall be
                        computed by increasing the payment amounts
                        determined under this subsection for such
                        services furnished during the previous year by
                        the percentage increase in the consumer price
                        index for all urban consumers (U.S. city
                        average) for the 12-month period ending with
                        June of the previous year.
                            ``(iv) Data-based adjustment year
                        defined.--For purposes of this subparagraph,
                        the term `data-based adjustment year' means
                        2031 and each third year thereafter.
                    ``(C) Use of information.--For purposes of
                subparagraph (A) and clauses (i) and (ii) of
                subparagraph (B), the Secretary shall use the most
                recently available data related to ground ambulance
                services and air ambulance services for which payment
                is made under the fee schedule under this subsection,
                including (as applicable to the respective services)
                information collected or obtained pursuant to paragraph
                (17), information collected or obtained pursuant to
                section 106 of the No Surprises Act, and such other
                information specified by the Secretary on costs
                (including labor-related costs and costs related to
                uncompensated care), expenses, and resources directly
                or indirectly related to furnishing such respective
                services. In applying the previous sentence with
                respect to air ambulance services, in the case that
                information collected or obtained pursuant to section
                106 of the No Surprises Act is not available, the
                Secretary shall instead use such other comparable
                information (as identified by the Secretary in
                consultation with the organizations described in
                paragraph (4)) on such costs, expenses, and resources
                related to furnishing air ambulance services.
            ``(19) Stakeholder consultation for continued assessment
        for modifications to improve fee schedule.--Not later than
        December 31, 2028, the Secretary shall convene experts and
        stakeholders, including organizations described in paragraph
        (4), to assess the fee schedule applied under this subsection
        for ground ambulance services and for air ambulance services
        and the adequacy of payments for such respective services under
        such fee schedule and to submit, not later than July 1, 2029,
        to the Secretary and Congress recommendations for modifications
        to such fee schedule, including the payment methodology under
        the fee schedule, to improve the valuation of such respective
        services under this subsection.''.
                                 <all>

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Status

In Committee

  1. 1Introduced
  2. 2Committee
  3. 3Floor
  4. 4Passed
  5. 5Signed

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