,,ii  #aagth ,,congress  #ast ,session  
,s4 #bjcg  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,june #aj1     
#bjba,ms4 ,cortez ,masto 7for herself1  
,ms4 ,collins1 ,ms4 ,stabenow1 ,mr4     
,cassidy1 ,mr4 ,leahy1 and ,mr4         
,sanders7 introduced the following bill2
 which was read twice and referred to   
the ,committee on ,finance  ,a ,,bill   
,to amend title ,,xviii to strengthen   
ambulance services furnished under part 
,b of the ,medicare program4  #a4 ,short
 title2 table of contents  7a7 ,short   
title ,this ,act may be cited as the    
,protecting ,access to ,ground          
,ambulance ,medical ,services ,act of   
#bjba4  7b7 ,table of contents ,the     
table of contents for this ,act is as   
follows3 ,sec4 #a4 ,short title2 table  
of contents4,title ,i--,protect ,access 
to ,high ,quality ,ambulance ,care,sec4 
#aja4 ,protecting patient access to     
ground ambulance services4,title        
,,ii--,protect ,access to ,ground       
,ambulance ,services in ,rural          

,america,sec4 #bja4 ,protecting access  
to ambulance services in rural and low  
population density areas4  ,i ,protect  
,access to ,high ,quality ,ambulance    
,care  #aja4 ,protecting patient access 
to ground ambulance services ,section   
#ahcd7l7 of the ,social ,security ,act  
7#db ,u4,s4,c4 #aciem7l77 is amended--  
7#a7 in paragraph 7#ab77;,a71 by        
striking #bjbc and inserting #bjbh2 and 
7#b7 in paragraph 7#ac77;,a71 by        
striking #bjbc each place it appears and
 inserting #bjbh in each such place4    
,,ii ,protect ,access to ,ground        
,ambulance ,services in ,rural ,america 
#bja4 ,protecting access to ambulance   
services in rural and low population    
density areas ,section #ahcd7l77#ab7 of 
the ,social ,security ,act 7#db         
,u4,s4,c4 #aciem7l77#ab77 is amended by 
adding at the end the following new     
subparagraphs3  7,c7 ,exception for     
,rural and ,qualified ,rural ,areas ,the
 ,secretary shall deem an area          
designated as a rural or qualified rural

 area under this paragraph that would   
otherwise no longer receive such        
designation to retain its previous      
designated status if there are #a1jjj or
 fewer individuals per square mile in   
the area4  7,d7 ,right to ,appeal ,rural
 ,areas and ,qualified ,rural ,areas    
,the ,secretary shall establish an      
administrative appeals process to allow 
ambulance services providers and        
suppliers to seek reconsideration of a  
change in a ,,zip code's status as a    
rural or qualified rural area during the
 first #ab months after the ,secretary  
finalizes a change in the designation   
made under this paragraph4  4