Department of Veterans Affairs Delays Air Transportation Reimbursement Rule Until 2029

SOAR Campaign commends Senate Veterans Affairs Committee Chairman Jon Tester, Ranking Member Jerry Moran (R-KS), House Appropriations MilCon/VA Subcommittee Chairman John Carter (R-TX), House Veterans Affairs Committee Chairman Mike Bost (R-IL) House MilCon/VA Subcommittee Member Susie Lee (D-NV), and the Department of Veterans Affairs for their leadership

(Washington, D.C.) – The U.S. Department of Veterans Affairs (VA) has officially delayed implementation of critical cuts to reimbursement rates for emergency air medical transportation services until 2029. This decision allows more time for key stakeholders to collaborate with the VA and Congress in developing a long-term solution that safeguards access to emergency care for millions of Americans, particularly rural Veterans.

“SOAR thanks Chairman Tester, Ranking Member Moran, Chairman Carter, Chairman Bost, Representative Lee, and others for their tireless efforts and leadership to preserve access to emergency services for Veterans across the country.  We commend the VA for recognizing the devastating impact these cuts would have had on our nation’s Veterans and taking decisive action,” said PJ Amartey, spokesperson for Save Our Air Medical Resources (SOAR) Campaign.  “This four-year delay provides a much-needed window for developing a workable solution that ensures the continued availability of lifesaving air medical transportation services.”

Originally set to take effect in February 2025, the VA’s rule would have drastically reduced reimbursement rates for air ambulance providers, aligning them with the outdated Medicare rates that currently cover less than half the actual cost of emergency patient transport. These deep cuts would have led to the closure of many air ambulance bases, disproportionately affecting Veterans in rural areas who depend on these services during critical medical and mental health emergencies.

For over a year, Representative John Carter (R-TX), Senator Jon Tester (D-MT), Senator Jerry Moran (R-KS), Representative Michael Bost (R-IL), and other members of Congress, in collaboration with Veterans Support Organizations (VSOs), have led bipartisan efforts to protect access to air ambulance services. The bipartisan VA Emergency Transportation Access Act, introduced by Senator Tester, seeks to ensure the VA conducts a rigorous review process and consults with Veterans and healthcare providers before making any cuts to reimbursement rates. VSOs, including The American Legion, Disabled American Veterans, Jewish War Veterans, Paralyzed Veterans of America, and Wounded Warrior Project, have voiced their support for the bill, testifying before Congress to express how important this legislation is for protecting access to care. This legislation is critical to protecting air medical services that are often the only lifeline for Veterans and rural communities facing medical crises.

Despite the decision to delay cuts, it is imperative that Congress advance the VA Emergency Transportation Act so that a date-based resolution to reimbursement rates may be reached and the possibility of air ambulance base closures no longer lingers and threatens healthcare access for millions.

“Rural America is grappling with a healthcare care crisis,” added Amartey. “Rural hospitals closures have left over 85 million Americans, including 4 million Veterans, without nearby emergency care. Air ambulance services have become an indispensable lifeline, and the VA Emergency Transportation Access Act is a practical, bipartisan solution that guarantees no Veteran is left behind when they need urgent medical care. This delay allows us the opportunity to advocate for this bill and secure fair reimbursement rates for the providers delivering this crucial service.”

For more information on the potential impact of the VA’s planned cuts and ongoing efforts to preserve access to air medical services, click HERE.

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Save Our Air Medical Resources (SOAR) is a national campaign dedicated to preserving access to emergency air medical services across the country, especially in rural communities.

PJ Amartey, Spokesperson, SOAR Campaign

media@soarcampaign.com

U.S. Senate and House Committees Take Action to Protect Air Medical Transport

SOAR Campaign expresses gratitude to Representative John Carter (R-TX), Senators Jerry Moran (R-KS), Jon Tester (D-MT), John Boozman (R-AR), and others for their leadership 

(Washington, D.C.) –The U.S. Senate and House Appropriations Committees have advanced critical legislation that prevents the U.S. Department of Veterans Affairs (VA) from cutting reimbursement rates for emergency air medical services.  

This legislative effort, led by Representative John Carter (R-TX) and Senators John Boozman (R-AR), Jon Tester (D-MT) and Jerry Moran (R-KS), seeks to ensure that over 4.4 million Veterans in rural communities across the country retain access to lifesaving emergency care as the VA's proposed cuts are set to go into effect in February 2025. 

“SOAR is deeply thankful to Representative Carter, Senators Moran, Tester, and Boozman for recognizing the critical impact these cuts will have on Veterans’ access to care and for taking steps to stop them,” said PJ Amartey, SOAR spokesperson. “With this language now included in both the House and Senate bills, we are one step closer to permanently safeguarding the emergency medical services that Veterans across the country rely on. Air ambulances save lives, and we call on the rest of Congress to join this bipartisan effort.” 

The VA's proposed cuts would drastically reduce reimbursement rates for emergency air ambulance services, resulting in providers being reimbursed at less than half the actual cost of transporting patients, potentially leading to widespread closures of air ambulance bases.  

While the Senate and House appropriations bills will temporarily stop the VA’s cuts, Congress is considering bipartisan, bicameral legislation the VA Emergency Transportation Access Act to provide a long-term solution.  

“Timely air ambulance transportation is often the difference between life and death following a traumatic injury,” Amartey continued. “Passing the VA Emergency Transportation Access Act will require the VA to thoroughly assess the consequences of its proposed cuts, consult with Veteran Service Organizations (VSOs) and medical providers, and conduct a rigorous review process to ensure that Veterans do not lose access to critical emergency care.” 

For more information on the potential impact of the VA’s planned cuts, click HERE. 

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Save Our Air Medical Resources (SOAR) is a national campaign dedicated to preserving access to emergency air medical services across the country, especially in rural communities. 

 PJ Amartey, Spokesperson, SOAR Campaign

media@soarcampaign.com

Op-Ed: An air ambulance saved this Veteran's life, but VA plans to cut access

On June 28, 2024, Army Veteran Dan McKeaney retold the story of his air ambulance rescue after he sustained critical injuries in a motorcycle accident. The story was featured in USA Today:

In 2022, I nearly lost my life in a motorcycle accident. While taking a Veterans’ ride with my wife, Jeri, one of our tires suddenly blew out as we made our way from Phoenix to Las Vegas. My wife suffered a concussion and severe facial lacerations. My injuries were more serious as I sustained multiple fractured ribs, a collapsed lung, a bruised heart, a lacerated spleen, a torn meniscus and a high-grade concussion. Shortly after, an air ambulance team arrived and transported me to a hospital in Las Vegas to receive lifesaving care.

While my wife’s injuries healed, mine were so severe that I needed to be placed into a three-and-a-half-week, medically-induced coma. Thankfully, I have since made a full recovery. But there is no doubt in my mind I would have died that day had it not been for the first responders and air ambulance coming to the scene of my crash, quickly administering care and saving my life.

Click here to continue reading Dan McKeaney’s op-ed.

Op-ed: Don't leave rural Veterans behind

On May 17, 2024, Navy Veteran Robert Vanbrocklin and Army Veteran Dan McKeany’s air ambulance stories were featured in the Washington Post:

Rural America faces a deepening health care crisis. With over 85 million residents, including 4.7 million Veterans, these communities experience significant health disparities compared to urban areas. Economic pressures and shrinking health care networks are leading to the loss of both rural hospitals and specialty care physicians. This alarming trend includes the closure of over 136 rural hospitals since 2010.1

This makes air ambulances, which provide vital emergency transport, an increasingly critical lifeline for rural America to get access to the nearest hospital or trauma center.

Unfortunately, despite this reality, the U.S. Department of Veterans Affairs (VA) is considering a policy change that will leave even more Veterans, particularly those in rural areas, without access to emergency care when they need it most.

Click here to read about Robert and Dan’s stories and why SOAR is fighting to protect access to air emergency medical services.

US Senate Passes Legislation To Stop VA Cuts for Air Medical Transport

SOAR Campaign applauds Senators Jerry Moran (R-KS), Jon Tester (D-MT), John Boozman (R-AR), and others for their critical leadership

(Washington, D.C.) – Last week, the U.S. Senate passed bipartisan legislation to preserve access to emergency air medical services for Veterans. The Military Construction, Veterans Affairs, and Related Agencies appropriations bill included an amendment that blocks the U.S. Department of Veterans Affairs (VA) from cutting reimbursement rates for emergency air medical transport services.

Sponsored by VA Committee Ranking Member Jerry Moran and co-sponsored by VA Committee Chairman Jon Tester and MilCon/VA Appropriations Subcommittee Ranking Member John Boozman along with Senators Dan Sullivan (R-AK), Steve Daines (R-MT), and Mike Crapo (R-ID), the appropriations amendment would prevent more than 4.7 million Veterans in rural communities across the country from losing critical access to lifesaving emergency care when the VA's arbitrary rate reduction is set to go into effect in February 2024.

“SOAR is grateful to Senators Moran, Tester, Boozman, Sullivan, Daines, Crapo, and the entire U.S. Senate for supporting and passing an amendment which prioritizes protecting Veteran access to emergency medical services,” said SOAR Spokesperson PJ Amartey. “This amendment language preserves a critical lifeline for the 4.7 million Veterans who call rural America home, and we applaud them for their important leadership.”

The VA's proposed rule would have slashed reimbursement rates for emergency ambulance services to Medicare levels, which haven’t been updated in over two decades and no longer reflect the true cost of a transport. This would force many air ambulance providers to reduce or eliminate services, especially in rural areas, disproportionately harming vulnerable populations that rely on them for life-saving care.

“Any change to the reimbursement rate must be based on the actual cost of providing these lifesaving services,” added Amartey. “This delay gives Centers for Medicare and Medicaid Services time to produce its comprehensive cost data report and update the Medicare reimbursement rate.”

More information about the unfair government reimbursement structure can be found HERE.

Save Our Air Medical Resources (SOAR) is a national campaign dedicated to preserving access to emergency air medical services across the country, especially in rural communities.

The SOAR Campaign Voices Support For House Bill Protecting Access to Emergency Services for Veterans

For Immediate Release

September 22, 2023

Contact: media@soarcampaign.com

(Washington, D.C.) – U.S. Representative Mike Bost (R-IL) introduced the VA Emergency Transportation Access Act to preserve access to air ambulance service for Veterans.

“Air medical is a lifeline, especially for the 4.7 million rural Veterans living hours away from the nearest medical center who rely on air ambulances for transport in emergencies,” said SOAR spokesperson PJ Amartey. “SOAR thanks Representative Bost for introducing this legislation and showcasing support for fair reimbursement to ensure Veterans have access to air medical services in their time of need.”

The House bill ensures the U.S. Department of Veterans Affairs (VA) provides fair reimbursement for emergency air medical services. In February 2024, the VA plans to cut its reimbursement rate for emergency air medical services by aligning it with Medicare, which currently covers less than 50 percent of the costs associated with providing air transport. These cuts will force air medical bases to shut down, limiting access to lifesaving transport for rural Veterans and their communities.

If passed, the legislation would require the VA to conduct a rigorous review process before proceeding with any cuts, including:

• Consideration of the economic and access to care impacts of potential rate cuts.

• Consultation with medical experts, CMS, Veterans Service Organizations, and other key stakeholders.

• Confirmation that rates reflect the true costs of providing air medical transport.

“The VA Emergency Transportation Access Act is a commonsense solution that would ensure Veterans have access to air ambulance transport – whether planned or in an emergency… We applaud your leadership on this issue and look forward to working with you, the VA, and our nation’s Veterans to ensure access to lifesaving air medical services is preserved,” said the SOAR Campaign in a letter supporting the legislation.

The Senate bill was recently introduced by U.S. Senators Jon Tester (D-MT), Jerry Moran (R-KS), Patty Murray (D-WA), and John Boozman (R-AR).

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About Save Our Air Medical Resources (SOAR)

Save Our Air Medical Resources (SOAR) is a national campaign dedicated to preserving access to emergency air medical services for Americans across the country. Official partners of the SOAR Campaign include industry experts, in-flight paramedics and nurses, and patients who rely on emergency services. To learn more about SOAR visit https://www.soarcampaign.com/

The SOAR Campaign Voices Support For New Legislation Protecting Access to Emergency Services for Veterans

For Immediate Release

September 13, 2023

Contact: media@soarcampaign.com

(Washington, D.C.) – U.S. Senators Jon Tester (D-MT), Jerry Moran (R-KS), Patty Murray (D-WA), and John Boozman (R-AR) announced introduction of the VA Emergency Transportation Access Act. If passed, this bipartisan legislation would ensure the millions of Veterans living in rural areas continue to have access to lifesaving air medical transport.

“This legislation is an important step forward in protecting access to critical health care resources for Veterans,” said SOAR spokesperson PJ Amartey. “SOAR thanks Senators Tester, Moran, Murray, and Boozman for introducing this legislation and continuing to fight to ensure access to lifesaving air medical services for our nation’s Veterans.”

Earlier this year, the U.S. Department of Veterans Affairs (VA) announced that beginning in February 2024, the VA would implement significant cuts to its reimbursement rate for emergency air medical services by aligning its reimbursement rate with Medicare, which currently covers less than 50 percent of the costs associated with providing air transport. These cuts will force air medical bases to shut down, limiting access to lifesaving transport for the 4.7 million Veterans living in rural communities.

The VA Emergency Transportation Access Act offers a solution to this problem with the goal of protecting access to lifesaving emergency services for Veterans. If passed, the legislation would require the VA to conduct a rigorous review process before proceeding with any cuts, including:

• Consideration of the economic and access to care impacts of potential rate cuts.

• Consultation with medical experts, CMS, Veterans Service Organizations, and other key stakeholders.

• Confirmation that rates reflect the true costs of providing air medical transport.

“The VA Emergency Transportation Access Act is a commonsense solution that would ensure Veterans have access to air ambulance transport – whether planned or in an emergency,” the SOAR Campaign said in a letter. “For Veterans who live long distances from medical care, this bill provides a lifeline during the most critical moments.”

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About Save Our Air Medical Resources (SOAR)

Save Our Air Medical Resources (SOAR) is a national campaign dedicated to preserving access to emergency air medical services for Americans across the country. Official partners of the SOAR Campaign include industry experts, in-flight paramedics and nurses, and patients who rely on emergency services. To learn more about SOAR visit https://www.soarcampaign.com/

Support Legislative Proposal to Stop VA Cuts

Air ambulances are often referred to as ‘flying ICUs’ because they are equipped to provide critical in-flight care and can respond to emergencies quickly, especially in remote and hard-to-reach places. They are a key resource for more than 85 million rural Americans, including 4.7 million Veterans living in remote communities lacking nearby access to a hospital or medical center.

Earlier this year, the U.S. Department of Veterans Affairs (VA) announced cuts to its reimbursement rate for emergency medical services. This change – set to go into effect in February 2024 – will lower the VA’s reimbursement rate to be in line with the Medicare rate, which hasn’t been updated in over 20 years and only covers a fraction of the true costs associated with air transport. If the VA moves forward with these cuts, the financial challenges for air providers will only worsen, and many air medical bases will be forced to close, jeopardizing access to lifesaving medical care for our nation’s Veterans.

Unfortunately, the VA’s response to criticism that the cuts would hurt Veterans is to propose that ambulance providers negotiate separate contracts with each VA medical facility. This proposal, however, only applies to Veterans who are transported to VA facilities and are scheduled in advance. This is seriously misguided and doesn’t consider the unpredictable nature of emergency air medical transports. Air ambulance crews are typically directed to transport patients to the closest medical center to ensure timely lifesaving treatment, and it is not a guarantee that a VA facility will always be the closest option. So, even if ambulance providers contracted with the VA, in reality, only 1% of Veterans will be covered by this proposal, leaving nearly all Veterans uncovered and further limiting access to emergency services in rural areas.

We must pursue commonsense solutions that ensure Veterans have access to emergency care during their time of need. That’s why SOAR and our partners support legislative proposals to stop these cuts.

SOAR Participates in Rural Progress Summit and Discusses Obstacles Rural America Faces in Accessing Health Care

The Save Our Air Medical Resources (SOAR) Campaign recently participated in the One Country Project’s second annual Rural Progress Summit to discuss the challenges facing rural America in accessing quality, affordable health care in the midst of under-reimbursement from government payors.

During the three-day event, a diverse group of industry specialists, policymakers, and rural advocates gathered to discuss important issues and explore policy-making opportunities for rural communities in America.

The second day of the event featured a panel titled “Delivering Healthcare in Rural America” examining the challenges of delivering affordable and accessible health care to rural communities. Carolyn Mayle, Vice President of Government Affairs at Air Methods, highlighted the risks that federal cuts pose to patients.

Alabama House Minority Leader Anthony Daniels moderated the session and shared that in the last ten years, approximately 17 hospitals have been forced to close in Alabama. This follows a national trend of rural hospitals struggling to remain open, with over 130 rural hospital closures since 2010.

When asked about the biggest health care challenges facing rural America, Mayle said, “The Medicare reimbursement challenge is a huge issue across the board for many health care providers. We support policies to help preserve and buttress rural hospitals... but what we have been seeing with rural hospital closures and the restriction of certain services and specialty positions in those rural hospitals is that we are busier than ever, and it is putting a huge strain on our system.” 

Medicare currently reimburses air medical providers at less than 50 percent of the actual costs associated with air transport. This endangers access to emergency services, with providers struggling to preserve access to lifesaving air medical flights for Americans in rural communities.

In addition to low reimbursement from Medicare and other government providers, the U.S. Department of Veterans Affairs (VA) recently announced cuts to its reimbursement rate, aligning it with the Medicare rate effective February 2024. This change will have a significant impact on Veteran’s access to air ambulance transport. In 2022 alone, Air Methods transported over 1,400 Veterans, and 30 percent of its workforce is comprised of Veterans who work in positions such as helicopter pilots or clinicians. 

“The challenge we have right now is that the VA has proposed changing the reimbursement of how they pay us… and then going to Medicare,” said Mayle. “This would be great if Medicare paid us closer to what our costs are. But our Medicare reimbursement right now has not been updated in over 20 years.”

Mayle said that if the VA’s proposal goes forward, it could deeply hurt Veteran access to air medical services, as bases risk being closed, particularly in rural parts of America where lower-income populations tend to live.

In addition to this panel, One Country Project and SOAR conducted a poll to gather voters’ views on access to emergency care in rural areas and rural health care. Despite overwhelming support for quality and affordable health care for all Americans, only a third agreed that the quality of health care in rural communities was adequate. Furthermore, a majority of voters (84%) supported increasing the Medicare reimbursement rate for emergency air medical services so it is aligned with the actual cost of transporting patients.

Mayle discussed the bipartisan Protecting Air Ambulance Services for Americans Act that was recently introduced in the House and Senate. If passed, this legislation would give CMS the ability to use industry cost data to make long-awaited updates to the Medicare reimbursement rate, preserving access to lifesaving flights for millions of rural Americans.

Voters Nationwide Want Better Government Reimbursement Rates for Air Ambulance Service

A recent poll from One Country Project (OCP) outlines voters’ views on access to emergency care in rural areas and rural health care. The results overwhelmingly support the need for quality, affordable health care for all Americans, but only a third of voters think that the quality of health care in rural communities is sufficient.

According to the poll’s findings:

• 95% of voters agree that quality, affordable health care should be accessible to all Americans, regardless of where they live.

• 6 in 10 voters (59%) rate health care in the U.S. as excellent or good, but only a third of voters (36%) say the same thing about health care in rural or remote communities in the U.S.

• 96% of voters want rural communities to have access to lifesaving emergency medical care, but nearly two-thirds (64%) rate the quality of the emergency medical system in rural communities as not so good or poor.

• 96% of voters agree that emergency air medical transportation is an important life-saving service, including 74% who strongly agree.

• 96% of voters agree Americans who live in remote or rural areas must be able to be transported to a hospital quickly when they need to be.

Despite nearly unanimous agreement about the importance of access to lifesaving emergency medical care, the air medical industry is facing many challenges due to how it is reimbursed by government insurers for providing services.

Medicare currently reimburses air medical providers at 50 percent of the true cost of providing transport. This inadequate reimbursement has plagued the industry for years, creating severe financial challenges and making it nearly impossible to continue operating air medical bases. What’s more, the U.S. Department of Veterans Affairs (VA) recently announced cuts to its reimbursement rate for air medical transport, bringing it in line with the Medicare rate effective February 2024.

When asked about reimbursement rates for air medical transport, the poll found that:

• 84% of voters support increasing the rate that Medicare reimburses for emergency air medical services, so it is aligned with the actual cost of transporting patients.

•  97% of voters agree that we have an obligation to ensure that veterans have access to quality health care.

• 84% of voters oppose the VA’s proposed funding cuts for emergency air medical services for veterans.

Voters nationwide have spoken and it’s time for Congress and the VA to act – the health of rural America is counting on it.

Fortunately, a solution exists. Earlier this month, U.S. Senators Michael Bennet (D-CO) and Marsha Blackburn (R-TN) and Representatives Ron Estes (KS-04) and Suzan DelBene (WA-01) announced introduction of the Protecting Air Ambulance Services for Americans Act of 2023. If passed, this legislation would give the Centers for Medicare and Medicaid Services the authority to update the air ambulance fee schedule to reflect the true cost of providing air medical transport. Now, it’s up to Congress to pass this legislation and preserve access to lifesaving air medical flights.

View the full survey results here.

The SOAR Campaign Leads Coalition of Health Care Providers, Advocates, and Rural Organizations Calling on Congress to Preserve Access to Air Ambulance Service

FOR IMMEDIATE RELEASE:  

June 2, 2023

Contact: media@soarcampaign.com

(Washington, D.C.) – Today, the Save Our Air Medical Resources (SOAR) Campaign, Brain Injury Association of America, Consumer Action, Florida Chapter of the American Academy of Pediatrics, Florida Rural Health Association, National Grange, National Rural Health Association, and Rural Minds urged Congress to take action and empower the Centers for Medicare and Medicaid Services (CMS) to update the Medicare reimbursement rate for emergency air medical services.

 CMS established the ambulance fee schedule in 2002 using limited data from 1998. According to the letter, the rate has not been meaningfully re-assessed in 24 years and does not reflect the current cost of providing air medical transport. Air ambulance providers are reimbursed at less than 50 percent of the actual cost of emergency transport for Medicare patients, which has a significant impact on the air medical industry since Medicare beneficiaries account for nearly 40 percent of all transports.

 “Getting the reimbursement level correct is a matter of life and death,” the letter states. “Medicare’s vast under-reimbursement rate will force bases to shut down, leaving millions of lives at risk. In rural communities, where hospital closures have already left millions of Americans far from care and more than 600 additional hospitals are at risk of closing, this issue poses significant threats to the health care outcomes of residents.”

 In addition to outdated Medicare reimbursement rates, the U.S. Department of Veterans Affairs recently announced cuts to its reimbursement rate starting in 2024, adding additional strain to the air medical industry and threatening access to lifesaving flights for thousands of Veterans.

 To fix the longstanding under-reimbursement, the coalition is urging Congress to ensure CMS uses the cost data it was required to collect under the No Surprises Act to update the air ambulance fee schedule. This would allow emergency air medical providers to continue providing lifesaving transport for millions of Americans, especially those living in rural areas that lack access to a nearby hospital or medical center.

 This letter comes just weeks after Representatives Ron Estes (KS-04) and Suzan DelBene (WA-01) and Senators Michael Bennet (D-CO) and Marsha Blackburn (R-TN) introduced bipartisan bicameral legislation to update the Medicare reimbursement rate.

 Read the full letter here.

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 About Save Our Air Medical Resources (SOAR)

Save Our Air Medical Resources (SOAR) is a national campaign dedicated to preserving access to emergency air medical services for Americans across the country. Official partners of the SOAR Campaign include industry experts, in-flight paramedics and nurses, and patients who rely on emergency services. To learn more about SOAR visit https://www.soarcampaign.com/

The SOAR Campaign Voices Support for New Bipartisan, Bicameral Medicare Reimbursement Legislation

FOR IMMEDIATE RELEASE:  

June 1, 2023

Contact: media@soarcampaign.com

(Washington, D.C.) – U.S. Senators Michael Bennet (D-CO) and Marsha Blackburn (R-TN) and Representatives Ron Estes (KS-04) and Suzan DelBene (WA-01) announced introduction of the Protecting Air Ambulance Services for Americans Act of 2023 to modernize Medicare reimbursement rates for air ambulance service. If passed, these bills would give the Centers for Medicare and Medicaid Services (CMS) the authority to update the Medicare reimbursement rates for emergency air medical services based on data collected by HHS.

“This bipartisan legislation will help preserve access to air medical services across the country, especially in rural areas,” said SOAR spokesperson PJ Amartey. “SOAR thanks Senators Bennet and Blackburn and Representatives Estes and DelBene for introducing these bills to ensure patients, particularly seniors, will have access to lifesaving flights.”

Currently, Medicare covers less than 50 percent of what it costs to transport a patient. This rate is determined by the air ambulance fee schedule that was last updated in 2002. The rate has not been adequately reassessed in over 20 years and does not take into account inflation, rising medical costs, and other factors that have increased the cost of providing air medical transport.

The legislation specifically gives CMS the authority to revise the air ambulance fee schedule using two years of cost data currently being collected under the No Surprises Act and additional data relating to operating costs for air ambulance bases, utilization by Medicare beneficiaries, and Medicare revenue received from air medical providers.

"With rural hospitals and air ambulance bases closing, patients are losing access to health care,” said Amartey. “This legislation will provide certainty for families living in rural communities who rely on air ambulances in an emergency.” 

The legislation also requires the Government Accountability Office to submit a study within one year of CMS receiving cost data that analyzes average costs per base and transport, the payor mix for air ambulance services, adequacy of Medicare reimbursement, geographic variations in costs of providing services, and recommendations on improving the fee schedule.

To learn more, visit SOAR’s website: https://www.soarcampaign.com/

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About Save Our Air Medical Resources (SOAR)

Save Our Air Medical Resources (SOAR) is a national campaign dedicated to preserving access to emergency air medical services for Americans across the country. Official partners of the SOAR Campaign include industry experts, in-flight paramedics and nurses, and patients who rely on emergency services. To learn more about SOAR visit https://www.soarcampaign.com/

Inadequate Government Reimbursement Jeopardizing Health of Rural America

Now more than ever, air ambulances are a critical component of the rural health care landscape. Inflation, rising medical costs, COVID-19, and workforce challenges have left rural hospitals on the brink, forcing many to close. According to a recent report from the American Hospital Association, more than 136 rural hospitals have closed since 2010.

In these communities where health care access is limited, air ambulances fill the gaps traveling faster and covering more distance than ground ambulances, while providing life-saving care on board, which vastly improves patient outcomes after experiencing a heart attack, stroke, or another life-threatening emergency. For millions of Americans living in communities without a nearby hospital, air ambulances not only provide lifesaving care but peace of mind.

Despite their importance in keeping rural America safe, air ambulances are in grave danger. For years, the air medical industry has been plagued by inadequate reimbursement by Medicare, Medicaid, and other forms of government health insurance. On average, Medicare covers less than 50 percent of the costs associated with transporting a patient. This rate is determined by the air ambulance fee schedule which was established in 2002 by the Centers for Medicare and Medicaid Services (CMS), using data from a 1998 cost pool. The rate has not been re-assessed in 24 years and does not reflect the current cost of air medical transport. Since Medicare beneficiaries account for nearly 40 percent of all air medical transports, the industry is stretched thin and facing significant financial challenges.  

On top of dramatically low reimbursement from government payors, the U.S. Department of Veterans Affairs (VA) recently announced that effective February 2024, the VA will align its reimbursement rate with the Medicare rate which, as stated, is far below the actual cost of providing air transport. This will result in a significant cut to the reimbursement rate for Veteran’s emergency air medical services.

Air ambulance providers want to continue providing care, but with the continued downward financial pressures from government payors, it is becoming increasingly difficult to keep bases open. Air medical bases are being forced to close, leaving rural communities without access to nearby medical care.

That’s why SOAR is asking for a few things in order to preserve air ambulance service for Veterans, seniors, and rural Americans.

1. CMS must utilize transport cost data to update the air ambulance fee schedule – a long overdue change that will preserve access to lifesaving air medical for Veterans and rural residents. Under the No Surprises Act, CMS is required to collect this comprehensive cost data from air medical providers, something the industry is more than willing to provide. This data will be incredibly helpful in modernizing reimbursement rates to reflect the true cost of providing service.

2. The VA must reconsider its decision and delay cuts until CMS updates its rates. The issue of Medicare and VA reimbursement are inextricably tied to one another and proceeding with the cuts before another federal agency has time to do its job would be the height of government disfunction.

If you are interested in preserving access to air medical services, please reach out to media@soarcampaign.com.

VA Announces Cuts to Air Ambulance Payments, Threatening Emergency Services Across America

SOAR Campaign Calls on VA to Reverse Course and Congress to Intervene

(Washington DC) – Today, the Department of Veterans Affairs (VA) announced significant cuts to its reimbursement rate for emergency air medical services, putting thousands of Veterans lives at risk.

The VA advanced the rule despite objections from more than 30 Veterans Service Organizations, including the American Legion, and opposition from Senators Tester, Moran, Heinrich, Boozman, Schatz, Hirono, Daines, Bennet, and Hickenlooper, along with Representatives Wasserman Schultz, Bost, Bishop, Valadao, and others.

“This is a dark day for Veterans and rural Americans who rely on air ambulances to transport them during a medical emergency,” said PJ Amartey, spokesperson for the SOAR campaign. “This decision puts Veterans lives at risk and threatens rural communities that are already struggling with a lack of access to quality health care. We call on the VA to reverse its decision immediately and Congress to intervene.”

The VA has stated it will cut its reimbursement rate to align with the Medicare rate starting in February 2024. The timing is problematic because the Centers for Medicare and Medicaid Services will be in the middle of analyzing transport cost data from air medical providers which will provide the necessary data for any Medicare rate update.

“The VA needs to delay this rule until CMS can produce its report,” added Amartey. “Both the VA and CMS need to base their reimbursements on the actual cost of providing these lifesaving services.”

The Medicare reimbursement rate has not been updated in over 20 years and covers less than 50 percent of the cost of a transport. More information about the unfair government reimbursement structure can be found HERE.

 Save Our Air Medical Resources (SOAR) is a national campaign dedicated to preserving access to emergency air medical services across the country, especially in rural communities.

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Op-Ed: The VA’s Plan to Cut Air Ambulance Rates Could Jeopardize the Lives of Veterans

Each year, roughly 2.5 million Americans sustain a traumatic brain injury (TBI). TBIs are an alteration in brain function caused by an external force, and they can range from mild injuries, commonly referred to as concussions, to more severe injuries that can lead to permanent disability and have significant, lasting impacts on a person’s life. Whether a person sustains a severe brain injury in a car accident or in military combat overseas, getting fast treatment at an appropriate medical facility is essential for preserving brain function and improving long-term outcomes.

Unfortunately, access to health care is disappearing across many parts of the U.S. Nowhere is this more evident than in rural America. From 2010 to 2021, 136 rural hospitals closed. These facilities often serve as the cornerstone of their communities, providing quality health care close to home. Once a rural hospital closes its doors, residents are left hours away from the nearest medical center. This is particularly dangerous after sustaining a brain injury when time is of the essence to provide the best possible treatment and pathways to recovery.

 This is why air ambulances are so critical for rural communities.

 Air ambulances and their crews are ready to deploy at a moment’s notice. When called by an EMT or physician, they arrive within minutes at the scene of a medical emergency and provide transport to the closest, most appropriate hospital or medical facility. Designed for saving lives, these aircrafts operate like mobile intensive care units, with flight crews trained to put patients on ventilators, administer blood transfusions, and conduct other complex procedures to treat critically ill and injured patients while being airborne to the hospital.

 Preserving access to lifesaving flights is incredibly important for anyone who needs them, but especially for people in rural America because they must travel greater distances to reach medical care. Unfortunately, air ambulance access is at risk because government payors are under-reimbursing for each flight. Currently, Medicare reimburses providers at less than 50 percent of the cost of transporting a patient, and Medicaid reimburses even less. Now, the Department of Veterans Affairs (VA) is on the verge of making matters worse by cutting its reimbursement rate to match Medicare.

 The VA’s proposed cut is dangerous. Already, the unsustainable reimbursement structure is forcing air medical bases to close, leaving millions of Veterans and their neighbors in rural communities farther and farther from help in an emergency. If the VA goes through with this cut, Veterans, particularly those in rural areas, will be at risk, and those depending on emergency air transport could lose their lives.

 Our organization represents people with brain injuries, some of whom have brain injuries sustained due to combat, and we are urging the VA not to move forward with this dangerous cut. 25% of all veterans live in rural America, and with more than 600 rural hospitals at risk of closing in the near future and air ambulances already having faced closures, the health Veterans of rural America hangs in the balance. Our nation’s Veterans put their lives on the line to protect and serve our country, and we must guarantee access to the lifesaving health resources they earned and deserve.

 (Susan Connors is President and Chief Executive Officer of the Brain Injury Association of America)

SOAR Commends Senators Martin Heinrich and John Boozman for Protecting Rural Patients and Veterans

The SOAR Campaign commends Senators Martin Heinrich and John Boozman for protecting rural patients and Veterans, and we echo their concerns about the U.S. Department of Veterans Affairs’ (VA) proposal to cut reimbursement rates for emergency air medical services. If the VA goes through with making these cuts, air ambulance bases across the country will be forced to close, leaving millions of Veterans, particularly those in rural and underserved communities, without access to lifesaving air medical flights. We must protect our nation’s Veterans and ensure this rule does not go into effect as drafted.

SOAR Campaign Comments on No Surprises Act Final Rule & Raises Alarm about Government Reimbursement

The U.S. Departments of Health and Human Services, Labor, and the Treasury have issued a highly anticipated final rule relating to implementation of the No Surprises Act (NSA). As you know, SOAR has been a long supporter of the NSA because it removes patients from the middle of any billing dispute between medical providers and insurers, thereby protecting patients from “balance bills.” While there are encouraging improvements to the final implementation rule compared to the previous iterations, SOAR is concerned that it does not go far enough in holding insurance companies accountable to a fair Independent Dispute Resolution process. Many health plans have used numerous tactics to both delay and decrease reimbursement, which has resulted in base closures, greatly impacting patients’ access to emergency services. We plan to continue monitoring the rollout of the NSA in the coming months to ensure patients are protected.

As always, our goal is to preserve access to air medical services for patients across the country, especially those in rural and underserved areas. To that end, as we turn our attention from the NSA to other issues, there are numerous challenges facing the air medical industry and threatening its ability to continue providing lifesaving service. Chiefly among them is the reimbursement rate by government payors.

Air ambulance providers are currently reimbursed at less than 50 percent of the actual cost of flights for Medicare transports. Given that 40 percent of all air medical patients are covered by Medicare, this significantly and adversely impacts the ability of air medical providers to operate.

Unfortunately and at the same time, the U.S. Department of Veterans Affairs is preparing to cut its reimbursement rate for emergency air medical services in early 2023, which, combined with the low Medicare reimbursement rates, could force more bases to close and will have a significant impact on the access to emergency flights, particularly for the 85 million rural Americans who live miles away from the nearest medical center.

SOAR will continue to push for the much-needed updates to Medicare and fight to stop the VA from cutting its rate – our communities are counting on it.

The SOAR Campaign Leads Coalition to Urge the Administration to Adjust Implementation of the No Surprises Act

The Save Our Air Medical Resources (SOAR) Campaign, Brain Injury Association of America, Florida Chapter of the American Academy of Pediatrics, Florida Rural Health Association, International College of Advanced Practice Paramedics, National Rural Health Association, Rural Minds, and Society of Trauma Nurses are calling on Congress to urge the Administration to adjust implementation of the No Surprises Act (NSA).

Read the full letter here.

Op-Ed: On the ground and in the skies, workforce shortages are devastating rural health care in Indiana and beyond

Workforce shortages in the health care industry are dire - 1 in 5 health care workers are leaving the industry. From the exhaustion of fighting a deadly virus to long hours and low pay, the pain has been felt in emergency rooms, nursing homes, and everywhere else across the spectrum of care – including the air ambulance industry. Facilities and providers struggle to replace a workforce with such specialized skills and training and unfortunately for rural America, including areas of Indiana, the repercussions are amplified since much of the population relies on air ambulances to fill the gap as rural hospitals close at alarming rates and the nation faces a simultaneous dearth of trained pilots.

 Air ambulance bases are staffed by EMTs, critical care nurses, and pilots who can operate fixed-wing and rotor-wing aircrafts. These “flying ICUs” provide a very high level of care in emergencies and help the millions of Americans who live more than thirty minutes from an emergency room and the 1 in 4 Americans who live more than an hour from a Level 1 or 2 trauma center access life-saving care. Because of the heavy reliance on air ambulances, rural America is facing the devastating effects of health care worker and pilot shortages both on the ground and in the skies throughout Indiana and beyond. 

 The issue is deadly serious.

 Ninety percent of air ambulance transfers are for stroke, heart attack, or traumatic injury. Trauma doctors refer to the “Golden Hour” as the first hour after a traumatic injury because the right kind of medical care received during this critical window can lead to vastly better outcomes for the patient – saving their life or preserving brain function and future quality of life. Without air ambulance providers, Americans in rural areas have literally no way to get to trauma centers within this time-sensitive window.

 Air ambulances have also played a critical role during the pandemic by transporting patients between facilities as hospital beds in smaller rural areas filled up fast. These inter-facility transports are becoming increasingly more common. And as rural hospitals continue to shutter – closures hit a record high in 2020 – fewer hospitals mean getting to the right facility for treatment becomes harder and harder for rural residents who must travel greater distances. Air ambulances are there to fill the gap, but only if there are enough trained staff to keep bases open.

 Fortunately, our leaders in Congress are working to address the serious workforce shortages in the health care industry, including Indiana’s own Senator Mike Braun who is a Ranking Member on the HELP Subcommittee on Employment and Workplace Safety. The subcommittee recently held a hearing examining the health care workforce shortages and how we can revitalize and diversify the workforce we will need in the coming decades. During the hearing, Sen. Braun acknowledged the unique challenge for Indiana and other rural states struggling with health care workforce shortages, and said "it will take more than just spending money."

 The Senator is right: we need better ideas and innovative solutions to solve the workforce shortages.

 If we are going to make a dent in the daunting rural workforce shortages, we must listen to the voices of all health care stakeholders, from nurses, physicians, and medical assistants to the trained pilots and critical care nurses who staff emergency air ambulance flights. That’s why the Save Our Air Medical Resources (SOAR) Campaign stands ready to work side by side with our leaders on Capitol Hill as a partner to address this complicated issue. We thank Senator Braun for his actions to date and urge all our lawmakers to prioritize addressing the critical shortages today and creating a pipeline of talent to take us into the future.

 PJ Amartey is spokesperson for the Save Our Air Medical Resources (SOAR) Campaign.

SOAR Thanks Rep. Jimmy Gomez for Advocating for Marginalized Communities Across the Country

Marginalized communities in California and across the country experience health disparities. Save Our Air Medical Resources (SOAR), a national campaign dedicated to preserving access to emergency air medical services, would like to thank Congressman Jimmy Gomez (D-CA) for being a tireless advocate for these communities and launching the U.S. House Ways and Means Committee’s Racial Equity Initiative to tackle health inequities.

 For communities that lack access to critical services like a trauma center, air ambulances provide swift transport to the nearest appropriate facility. If Medicare reimbursement rates are not raised to cover the cost of transport, air bases will be forced to shut down, leaving millions of Americans at risk.

 SOAR shares Rep. Gomez’s vision for a more equitable America and looks forward to working together to address health disparities and advocate for marginalized communities in Los Angeles County and beyond.