,i  #aad? ,,congress  #a/ ,session  ,h4 
,r4 #hbb  ,,9 ,,! ,,h\se ,,(            
,,repres5tatives  ,febru>y #aj1 #bjae   
,mr4 ,sessions 7= himself1 ,mr4 ,meeks1 
,mr4 ,"y ( ,indiana1 & ,mr4 ,johnson (  
,ohio7 introduc$ ! foll[+ bill2 :i* 0   
ref]r$ to ! ,committee on ,en]gy &      
,comm]ce1 & 9 addition to ! ,committee  
on ,ways & ,means1 = a p]iod to be      
subsequ5tly det]m9$ by ! ,speak]1 9 ea* 
case = consid]ation ( su* provisions z  
fall )9 ! jurisdiction ( ! committee    
conc]n$  ,a ,,bill  ,to am5d title      
,,xviii ( ! ,social ,security ,act to   
require report+ ( c]ta9 data by provid]s
 & suppli]s ( air ambulance s]vices =   
purposes ( re=m+ reimbursem5ts = su*    
s]vices "u ! ,m$ic>e program1 & = o!r   
purposes4  #a4 ,f9d+s ,! ,congress f9ds 
! foll[+3 7#a7 ,air m$ical critical c>e 
transport is an ess5tial compon5t ( !   
heal?c>e sy/em4  7#b7 ,! pres5ce ( air  
m$ical s]vices 9 rural areas provides   
t5s ( millions ( rural ,am]icans )      
access to critical c>e )9 an h\r (      

injury4  7#c7 ,z an em]g5cy respond]1   
air m$ical provid]s mu/ ma9ta9 read9ess 
#bd h\rs a day & #g days a week4  7#d7  
,air m$ical provid]s transport all      
em]g5t pati5ts = :i* !y are dispat*$    
reg>dless ( insurance /atus or ability  
to pay4  7#e7 ,! air ambulance fee      
s*$ule "u ! ,m$ic>e program 0 fir/      
implem5t$ 9 #bjjb & develop$ ?r\gh      
negotiat$ rulemak+1 :i* requir$ ! new   
fee s*$ule to be creat$ 9 a budget      
neutral mann]4 ,z su*1 ! ,m$ic>e air    
ambulance fee s*$ule has nev] reflect$  
true co/s4  7#f7 ,s9ce ! implem5tation (
 ! air ambulance fee s*$ule "u ! ,m$ic>e
 program1 reimbursem5ts h only be5      
adju/$ by inflation>y updates av]ag+    
#b4b p]c5t a ye>4  7#g7 ,op]ational     
read9ess & safety enhancem5t co/s h gr[n
 at a f> fa/] rate ?an ! ,m$ic>e        
inflation>y updates1 creat+ a fundam5tal
 imbalance )9 ! air ambulance fee       
s*$ule4  7#h7 ,x is imp]ative t balance 
be re/or$ to ! air ambulance fee s*$ule 
to pres]ve access to timely c>e = t5s ( 

millions ( ,am]icans4  #b4 ,air         
,ambulance ,data ,report+ ,program      
,section #ahcd7l7 ( ! ,social ,security 
,act 7#db ,u4,s4,c4 #aciem7l77 is       
am5d$-- 7#a7 9 p>agraph 7#c77;,b71 by   
/rik+ subp>agraph 7,c7 & ins]t+         
subp>agraph 7,c7 & p>agraph 7#af72 &    
7#b7 by add+ at ! end ! foll[+ new      
p>agraphs3  7#af7 ,air ,ambulance ,data 
,report+ ,program  7,a7 ,r$uction 9     
update = failure to report  7i7 ,9 g5]al
 ,) respect to air ambulance s]vices    
furni%$ by a suppli] or provid] ( air   
ambulance s]vices dur+ #bjag or any     
subsequ5t ye>1 9 ! case ! suppli] or    
provid] does n submit data to !         
,secret>y 9 accordance ) subp>agraph    
7,c7 ) respect to su* ye>1 aft] det]m9+ 
! p]c5tage increase "u p>agraph         
7#c77;,b71 & aft] application ( p>agraph
 7#c77;,c71 ! ,secret>y %all r$uce su*  
p]c5tage increase = paym5ts "u ! fee    
s*$ule "u ?is subsection dur+ su* ye> by
 #b4j p]c5tage po9ts4  7ii7 ,special    
rule ,! application ( ?is subp>agraph   

may result 9 su* p]c5tage increase be+  
less ?an #j4j = a ye>1 & may result 9   
paym5t rates "u ! fee s*$ule "u ?is     
subsection = a ye> be+ less ?an su*     
paym5t rates = ! prec$+ ye>4  7,b7      
,noncumulative application ,any r$uction
 "u subp>agraph 7,a7 %all apply only )  
respect to ! ye> involv$ & ! ,secret>y  
%all n take into acc\nt su* r$uction 9  
comput+ ! paym5t am\nt "u ! fee s*$ule  
"u ?is subsection = a subsequ5t ye>4    
7,c7 ,submission ( data ,= #bjag & ea*  
subsequ5t ye>1 = purposes ( ?is         
p>agraph1 ea* suppli] or provid] ( air  
ambulance s]vices %all submit to !      
,secret>y data specifi$ "u subp>agraph  
7,d7 = ! report+ p]iod 7specifi$ by !   
,secret>y7 = ! ye>4 ,su* data %all be   
submitt$ 9 a =m & mann]1 & at a "t1     
specifi$ by ! ,secret>y = purposes ( ?is
 subp>agraph4  7,d7 ,data ,= purposes ( 
report+ data = air ambulance s]vices    
furni%$ dur+ a ye>1 ! data describ$ 9   
?is subp>agraph are co/ data on !       
foll[+3  7i7 ,ma9t5ance ( aircrafts4    

7ii7 ,m$ical supplies4  7iii7 ,fuel4    
7iv7 ,employee exp5ses4  7v7 ,recurr+   
tra9+ relat+ to aviation1 ma9t5ance1    
communication1 & cl9ical4  7vi7 ,r5t &  
utilities4  7vii7 ,communications4      
7viii7 ,travel4  7ix7 ,hull & aviation  
liability insurance1 life insurance1 &  
pr(essional malpractice insurance4  7x7 
,m>ket+4  7xi7 ,supplies4  7xii7        
,ov]head support4  7xiii7 ,aircraft     
own]%ip exp5ses4  7xiv7 ,safety         
enhancem5t capital co/s4  7xv7 ,safety  
enhancem5t recurr+ co/s4  7,e7 ,volunt>y
 report+ on quality measures ,n lat] ?an
 ,janu>y #a1 #bjah1 ! ,secret>y %all    
select no less ?an two quality measures 
) respect to :i* provid]s & suppli]s (  
air ambulance s]vices may volunt>ily    
submit to ! ,secret>y data4 ,9 select+  
su* measures1 ! ,secret>y %all consid] !
 foll[+3  7i7 ,v5tilator use 9 pati5ts )
 advanc$ airways4  7ii7 ,blood glucose  
*eck = alt]$ m5tal /atus4  7iii7 ,wave=m
 capnography = v5tilat$ pati5ts4  7iv7  
,fir/ attempt tra*eal tube success4  7v7

 ,,da% #a;,a-def9itive airway sans      
hypoxia_/hypot5sion on fir/ attempt4    
7vi7 ,v]ification ( tra*eal tube        
placem5t4  7vii7 ,m$ication errors on   
transport4  7viii7 ,rapid sequ5ce       
intubation protocol compliance4  7ix7   
,unplann$ dislodgem5ts ( !rapeutic      
devices4  7x7 ,rate ( s]i\s reportable  
ev5ts4  7xi7 ,m$ical equipm5t failure4  
7,f7 ,reports  7i7 ,by ,secret>y ,n lat]
 ?an ,july #a1 #bjai1 subject to clause 
7iii71 ! ,secret>y %all submit to       
,congress a report on ! data describ$ 9 
subp>agraph 7,e7 submitt$ to !          
,secret>y4  7ii7 ,by ,comptroll] ,g5]al 
,n lat] ?an ,july #a1 #bjai1 subject to 
clause 7iii71 ! ,comptroll] ,g5]al ( !  
,unit$ ,/ates %all submit to ,congress a
 report on ! data describ$ 9 subp>agraph
 7,d7 & subp>agraph 7,e7 submitt$ "u ?is
 p>agraph4 ,su* report %all include a   
recomm5dation on ! adequate am\nt (     
reimbursem5t "u ?is title to provid]s & 
suppli]s ( air ambulance s]vices =      
furni%+ su* s]vices t w\ld reflect      

op]ational co/s ( su* provid]s &        
suppli]s & pres]ve access to critical   
air m$ical s]vices & su* o!r            
recomm5dations z ! ,comptroll] ,g5]al   
deems appropriate4  7iii7 ,limitation ,!
 reports submitt$ "u subclauses 7i7 &   
7ii7 %all n include any in=mation t !   
,secret>y or ,comptroll] ,g5]al1        
respectively1 det]m9es is propriet>y4   
7#ag7 ,increase 9 paym5t = air ambulance
 s]vices ,9 ! case ( air ambulance      
s]vices furni%$ on or aft] ,janu>y #a1  
#bjaf1 & be=e ,janu>y #a1 #bjbj1 !      
,secret>y %all provide = a p]c5t        
increase 9 ! base rate ( ! fee s*$ule   
e/abli%$ "u ?is subsection--  7,a7 dur+ 
#bjaf1 by #bj p]c5t2 &  7,b7 dur+ #bjag 
?r\gh #bjai1 by #e p]c5t4  4