Protecting Access to Ground Ambulance Medical Services Act of 2025

H.R. 2232/S. 1643, Protecting Access to Ground Ambulance Medical Services Act H.R. 2538/S. 3145, Comprehensive Alternative Response for Emergencies (CARE) Act Issues regarding the reimbursement of treatment in place care provided by EMS Proposed rule on Medicaid Managed Care State Directed Payments and Medicaid Fee-For-Service Targeted Medicaid Practitioner Payments (CMS-2449-P) [CMS-2026-1916-0001]

Client expense: $10,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

H.R. 9260, Labor, Health and Human Services, and Education FY 2027 Appropriations relating to the National Institute for Occupational Safety and Health's (NIOSH) National Firefighter Registry for cancer, the Supporting and Improving Rural EMS Needs (SIREN) grant, NIOSH's Firefighter Fatality Investigation and Prevention Program (FFFIPP), NIOSH's National Personal Protective Technology Laboratory, and the World Trade Center Health Program. H.R. 1902, HERO Act H.R. 3791, EMS Counts Act Issues relating to the reversing staff reductions and the preservation of programs within the National Institute for Occupational Safety and Health, including the National Firefighter Registry for Cancer, Fire Fighter Fatality Investigation Prevention Program, WTC Health, National Personal Protective Technology Laboratory, the Respirator Approval Program, Emergency Response Support, and Health Hazard Evaluation Program. H.R. 2232/S. 1643, Protecting Access to Ground Ambulance Medical Services Act H.R. 2538/S. 3145, Comprehensive Alternative Response for Emergencies (CARE) Act H.R. 10116/S. 4819, Lifeline for First Responders Act Issues relating to volunteer firefighter status being added to the U.S. Standard Certificate of Death Issues related to the preservation of staff and funding at National Highway Traffic Safety Administrations (NHTSA) Office of Emergency Medical Services (EMS)

Client expense: $10,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Highway Traffic Safety Administration (NHTSA), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)

H.R.2232 and S.1643, Protecting Access to Ground Ambulance Medical Services Act of 2025, Medicare and Medicaid policies relating to ground and air ambulance services, including supplemental relief for ambulance providers.

Client expense: Not reported · Firm income: $20,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.2232 and S.1643, Protecting Access to Ground Ambulance Medical Services Act of 2025, Medicare and Medicaid policies relating to ground and air ambulance services, including supplemental relief for ambulance providers.

Client expense: Not reported · Firm income: $20,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislation and regulation impacting ground ambulance and emergency medical services including funding, reimbursement, training, workforce. Seek equitable coverage for all paramedics and emergency medical technicians on workforce issues. Legislation to amend title XVIII to protect patient access to ground ambulance services under part B of the Medicare program through stabilized and increased reimbursement (H.R.2232/S.1643). The Preserve Access to Rapid Ambulance Medical Treatment Act (H.R.2220) and the PARA-EMT Act; The Comprehensive Alternative Response for Emergencies (CARE) Act (H.R.2538/S.3145); Appropriations requests for grant funding under the ASPR; NDAA - military to civilian workforce transition; Relief for private ground ambulance providers from the federal fuel tax (TAX).

Client expense: Not reported · Firm income: $70,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislation and regulation impacting ground ambulance and emergency medical services including funding, reimbursement, training, workforce. Seek equitable coverage for all paramedics and emergency medical technicians on workforce issues. Legislation to amend title XVIII to protect patient access to ground ambulance services under part B of the Medicare program (H.R.2232/S.1643); Appropriations requests for grant funding under the ASPR; NDAA - military to civilian workforce transition; Relief for private ground ambulance providers from the federal fuel tax (TAX).

Client expense: Not reported · Firm income: $70,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues relating to reimbursement for emergency medical services and ground ambulance transport for Medicare and Medicaid patients. Issues relating to reimbursement of fire and EMS departments for mobile integrated health programs; treatment of patients in place; the reimbursement of blood products by EMS providers; and transportation of patients to alternate destinations of care. Issues relating to fire safety of home oxygen systems and reimbursement for the installation of thermal fuses. The Comprehensive Alternative Response for Emergencies Act (H.R. 2538/S. 3145), provisions to relating to reimbursement of fire and EMS departments for treating Medicare patients in place. The Protecting Access to Ground Ambulance Medical Services Act (H.R. 2232/S. 1643), provisions to extend the add-on payments for ambulance transport of Medicare patients. Issues relating to state participation in the Ground Emergency Medical Transportation program. The Reimbursing Emergency Services for Critical Urgent Encounters Act of 2026 (H.R. 9970), issues relating to Medicare reimbursement for patient transport by ambulance.

Client expense: $30,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE

The FY 2027 Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act (H.R. 9260), provisions to fund the following programs at the U.S. Department of Health and Human Services: - National Institute for Occupational Safety and Health's National Firefighter Registry for Cancer. - National Institute for Occupational Safety and Health's Fire Fighter Fatality Investigation and Prevention Program. - National Institute for Occupational Safety and Health's National Personal Protective Technology Laboratory. - World Trade Center Health Program. - Funding for the SIREN grant program for rural EMS. Issues relating to the supply chain and delivery and cost of fire and EMS apparatus and equipment. Issues relating to the Ground Emergency Medical Transportation program. Fighting Post-Traumatic Stress Disorder Act (S. 825), provisions to provide behavioral health resources to first responders at the U.S. Department of Justice. Issues relating to fire safety in home oxygen systems and reimbursement for the installation of thermal fuses. The Protecting Access to Ground Ambulance Medical Services Act (H.R. 2232/S. 1643), provisions to extend the add-on payments for ambulance transport of Medicare patients. Issues relating to the staffing reductions at the National Firefighter Registry for Cancer, Fire Fighter Fatality Investigation, WTC Health, and Prevention Program and National Personal Protective Technology Laboratory. Issues relating to firefighter cancer. Issues relating to the acquisition of medications and medical equipment used by EMS. The Comprehensive Alternative Response for Emergencies Act (H.R. 2538/S. 3145), provisions to reimburse fire and EMS departments for treating Medicare patients in place. The Community Paramedicine Act (H.R. 4011), provisions to fund Community Paramedicine and Mobile Integrated Health (CP/MIH) programs. The EMS Counts Act (H.R. 3791), provisions to direct the Bureau of Labor Statistics to accurately count the number of EMS practitioners in the United States. Issues relating to the reimbursement of blood products by EMS providers. Issues relating to the reimbursement of emergency medical service and ground ambulance transport provided to Medicare and Medicaid patients. Issues relating to the National EMS Advisory Council and its reformulation. Issues relating to electronic patient care reporting systems. The Reimbursing Emergency Services for Critical Urgent Encounters Act of 2026 (H.R. 9970), issues relating to Medicare reimbursement for patient transport by ambulance. Issues relating to the implementation of the Protecting Patient Access to Emergency Medications Act (P.L. 115-83) and the storage of medicines by fire and EMS departments. Issues relating to building and safety standards in healthcare facilities. Issues related to fire-based air ambulance services.

Client expense: $30,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Highway Traffic Safety Administration (NHTSA), SENATE

Medicare and Medicaid policies relating to ground and air ambulance services, including workforce shortage issues, and supplemental relief for ambulance providers; H.R.2232/S.1643, Protecting Access to Ground Ambulance Medical Services Act of 2025.

Client expense: Not reported · Firm income: $20,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare and Medicaid policies relating to ground and air ambulance services, including workforce shortage issues, and supplemental relief for ambulance providers; H.R.2232/S.1643, Protecting Access to Ground Ambulance Medical Services Act of 2025; H.R.9970, RESCUE Act of 2026.

Client expense: Not reported · Firm income: $20,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 2232 and S. 1643 - Extension of the ground ambulance add-ons; Medicare update of the ambulance fee schedule definitions of urban, rural, and super-rural; treatment in place; MedPAC report on Ground Ambulance Data Collection System.

Client expense: Not reported · Firm income: $60,000

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Issues related to H.R. 2538 & S. 3145, the CARE Act of 2025. Issues related to H.R. 7277 & S. 3730, the Emergency Medical Services Reimbursement for On-Scene Care and Support Act. Issues related to H.R. 4011, the Community Paramedicine Act of 2025. Issues related to the Supporting Our First Responders Act. Issues related to H.R. 2220, the PARA-EMT Act of 2025. Issues related to H.R. 2232 & S. 1643, Protecting Access to Ground Ambulance Medical Services Act of 2025.

Client expense: Not reported · Firm income: $30,000

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

H.R. 2232/S. 1643, Protecting Access to Ground Ambulance Medical Services Act H.R. 2538/S. 3145, Comprehensive Alternative Response for Emergencies (CARE) Act Issues regarding the reimbursement of treatment in place care provided by EMS

Client expense: $10,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

H.R. 9260, Labor, Health and Human Services, and Education FY 2027 Appropriations relating to the National Institute for Occupational Safety and Health's (NIOSH) National Firefighter Registry for cancer, the Supporting and Improving Rural EMS Needs (SIREN) grant, NIOSH's Firefighter Fatality Investigation and Prevention Program (FFFIPP), NIOSH's National Personal Protective Technology Laboratory, and the World Trade Center Health Program. H.R. 1902, HERO Act H.R. 3791, EMS Counts Act Issues relating to the reversing staff reductions and the preservation of programs within the National Institute for Occupational Safety and Health, including the National Firefighter Registry for Cancer, Fire Fighter Fatality Investigation Prevention Program, WTC Health, National Personal Protective Technology Laboratory, the Respirator Approval Program, Emergency Response Support, and Health Hazard Evaluation Program. H.R. 2232/S. 1643, Protecting Access to Ground Ambulance Medical Services Act H.R. 2538/S. 3145, Comprehensive Alternative Response for Emergencies (CARE) Act Issues relating to volunteer firefighter status being added to the U.S. Standard Certificate of Death Issues related to the preservation of staff and funding at National Highway Traffic Safety Administrations (NHTSA) Office of Emergency Medical Services (EMS)

Client expense: $10,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Highway Traffic Safety Administration (NHTSA), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)

Medicare reimbursement policy for air and ground ambulance services; Intergovernmental Transfers (IGTs)/State Plan Amendments related to Medicaid reimbursement. H.R. 2232/S. 1643, Protecting Access to Ground Ambulance Medical Services Act of 2025; New York Medicaid State Plan Amendment on Treat in Place.

Client expense: $540,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Support Medicare Reimbursement for EMS Treatment in Place (TIP); Support S. 2196/H.R. 2538, the CARE Act; Support S. 3730/H.R. 7277, EMS ROCs Act; Support Mobile Integrated Healthcare (MIH) Community Paramedicine (CP) Programs; Support introduction of legislation to provide grants to communities to create and maintain/sustain MIH-CP programs;H.R. 4011. Support FY2027 Funding for SIREN Act Grants in FY27 Labor HHS Appropriations bill; Support the H.R. 3791, EMS Counts Act; Support H.R. 7386, FirstNet Reauthorization; Support H.R. 2196/S.2546, reauthorization of an extension of the Commemorative Works Act (CWA) to build an EMS Memorial in DC; Support H.R. 7623, the Freedom House Ambulance Services Congressional Gold Medal Act; Support H.R. 2220, the PARA-EMT Act; Support language in the FY27 NDAA on the transition of military medics; Support S. 1643/H.R. 2232, the Protecting Access to Ground Ambulance Medical Services Act; Support participation of the Congressional EMS Caucus; Support S.315/H.R. 979, the AM Radio for Every Vehicle; Support S. 4819, Lifeline for First Responders Act; Support H.R. 8789, Volunteer First Responder Housing Act; Oppose the Centers for Medicare & Medicaid Services (CMS) Proposed Rule CMS-2449-P, specifically the provisions that would limit Ground Emergency Medical Transportation (GEMT) supplemental payments; Oppose H.R.7739, Rural Emergency Response Support Act;

Client expense: Not reported · Firm income: $31,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislation and regulation impacting ground ambulance and emergency medical services including funding, reimbursement, training, workforce. Seek equitable coverage for all paramedics and emergency medical technicians on workforce issues. Legislation to amend title XVIII to protect patient access to ground ambulance services under part B of the Medicare program through stabilized and increased reimbursement (H.R.2232/S.1643). The Preserve Access to Rapid Ambulance Medical Treatment Act (H.R.2220) and the PARA-EMT Act; The Comprehensive Alternative Response for Emergencies (CARE) Act (H.R.2538/S.3145); Appropriations requests for grant funding under the ASPR; NDAA - military to civilian workforce transition; Relief for private ground ambulance providers from the federal fuel tax (TAX).

Client expense: Not reported · Firm income: $70,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislation and regulation impacting ground ambulance and emergency medical services including funding, reimbursement, training, workforce. Seek equitable coverage for all paramedics and emergency medical technicians on workforce issues. Legislation to amend title XVIII to protect patient access to ground ambulance services under part B of the Medicare program (H.R.2232/S.1643); Appropriations requests for grant funding under the ASPR; NDAA - military to civilian workforce transition; Relief for private ground ambulance providers from the federal fuel tax (TAX).

Client expense: Not reported · Firm income: $70,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 2220, PARA-EMT Act of 2025 H.R. 2232, Protecting Access to Ground Ambulance Medical Services Act of 2025 H.R. 2538, CARE Act of 2025 H.R. 3791, EMS Counts Act H.R. 4011, Community Paramedicine Act of 2025 Issues related to reimbursement of ground ambulance services Issues related to the Ground Emergency Medical Transportation program

Client expense: $196,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Medicare and Medicaid policies relating to ground and air ambulance services, including workforce shortage issues, and supplemental relief for ambulance providers; H.R.2232/S.1643, Protecting Access to Ground Ambulance Medical Services Act of 2025.

Client expense: Not reported · Firm income: $20,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare and Medicaid policies relating to ground and air ambulance services, including workforce shortage issues, and supplemental relief for ambulance providers; H.R.2232/S.1643, Protecting Access to Ground Ambulance Medical Services Act of 2025.

Client expense: Not reported · Firm income: $20,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

The FY 2027 Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act (H.R. 9260), provisions to fund the following programs at the U.S. Department of Health and Human Services: - National Institute for Occupational Safety and Health's National Firefighter Registry for Cancer. - National Institute for Occupational Safety and Health's Fire Fighter Fatality Investigation and Prevention Program. - National Institute for Occupational Safety and Health's National Personal Protective Technology Laboratory. - World Trade Center Health Program. - Funding for the SIREN grant program for rural EMS. Issues relating to the supply chain and delivery and cost of fire apparatus and equipment. Issues relating to the Ground Emergency Medical Transportation program. Fighting Post-Traumatic Stress Disorder Act (S. 825), provisions to provide behavioral health resources to first responders at the U.S. Department of Justice. Issues relating to fire safety in home oxygen systems and reimbursement for the installation of thermal fuses. The Protecting Access to Ground Ambulance Medical Services Act (H.R. 2232/S. 1643), provisions to extend the add-on payments for ambulance transport of Medicare patients. Issues relating to the staffing reductions at the National Firefighter Registry for Cancer, Fire Fighter Fatality Investigation, WTC Health, and Prevention Program and National Personal Protective Technology Laboratory. Issues relating to firefighter cancer. Issues relating to the acquisition of medications and medical equipment used by EMS. The Comprehensive Alternative Response for Emergencies Act (H.R. 2538/S. 3145), provisions to reimburse fire and EMS departments for treating Medicare patients in place. The Community Paramedicine Act (H.R. 4011), provisions to fund Community Paramedicine and Mobile Integrated Health (CP/MIH) programs. The EMS Counts Act (H.R. 3791), provisions to direct the Bureau of Labor Statistics to accurately count the number of EMS practitioners in the United States. Issues relating to the reimbursement of blood products by EMS providers.

Client expense: $30,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Highway Traffic Safety Administration (NHTSA), SENATE

Issues relating to billing for ground ambulance transport. Issues relating to reimbursement of fire and EMS departments for mobile integrated health programs; treatment of patients in place; the reimbursement of blood products by EMS providers; and transportation of patients to alternate destinations of care. Issues relating to fire safety of home oxygen systems and reimbursement for the installation of thermal fuses. The Comprehensive Alternative Response for Emergencies Act (H.R. 2538/S. 3145), provisions to relating to reimbursement of fire and EMS departments for treating Medicare patients in place. The Protecting Access to Ground Ambulance Medical Services Act (H.R. 2232/S. 1643), provisions to extend the add-on payments for ambulance transport of Medicare patients. Issues relating to state participation in the Ground Emergency Medical Transportation program.

Client expense: $30,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE

H.R.2232 and S.1643, Protecting Access to Ground Ambulance Medical Services Act of 2025, Medicare and Medicaid policies relating to ground and air ambulance services, including supplemental relief for ambulance providers.

Client expense: Not reported · Firm income: $20,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.2232 and S.1643, Protecting Access to Ground Ambulance Medical Services Act of 2025, Medicare and Medicaid policies relating to ground and air ambulance services, including supplemental relief for ambulance providers.

Client expense: Not reported · Firm income: $20,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Lobbied on the Protecting Access to Ground Ambulance Medical Services Act (H.R. 2232, S.1643) to raise the percentages of temporary increases in Medicare payments for ground ambulance services. Educated congressional offices and committees on mandatory past due changes in geographical designation of zip codes under the Medicare ambulance fee schedule following the 2020 Census. Provided context on the Ground Ambulance Chapter of the MedPAC Report of July 15 to highlight need for increased reimbursement for ground ambulance services and reform of the ambulance fee schedule. Lobbied on the Comprehensive Alternative Response for Emergencies Act of 2025 (H.R. 2538, S. 3145) to create a CMMI demonstration project on the reimbursement of ambulance response without transport, and the Emergency Medical Services Reimbursement for On-Scene Care and Support Act (H.R. 7277, S. 3730). Lobbied on the Community Paramedicine Act (H.R. 4011) to provide local governments and partners with funding to furnish mobile integrated healthcare. Engaged with congressional offices on the Preserving Emergency Access in Key Sites Act (PEAKS Act) (H.R. 3378, S.1960). Lobbied in support of reducing the amount of the copay for critical ambulance services for patients in Medicare Advantage plans.

Client expense: $350,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office

Support Medicare Reimbursement for EMS Treatment in Place (TIP); Support S. 2196/H.R. 2538, the CARE Act; Support Mobile Integrated Healthcare (MIH) Community Paramedicine (CP) Programs; Support introduction of legislation to provide grants to communities to create and maintain/sustain MIH-CP programs;H.R. 4011. Support FY2027 Funding for SIREN Act Grants in FY27 Labor HHS Appropriations bill; Support the H.R. 3791, EMS Counts Act; Support H.R. 2196/S.2546, creation of an EMS Memorial in DC; Support H.R. 7623, the Freedom House Ambulance Services Congressional Gold Medal Act; Support H.R. 2220, the PARA-EMT Act; Support S. 1643/H.R. 2232, the Protecting Access to Ground Ambulance Medical Services Act; Support participation of the Congressional EMS Caucus;

Client expense: Not reported · Firm income: $31,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to H.R. 2538 & S. 3145, the CARE Act of 2025. Issues related to H.R. 7277 & S. 3730, the Emergency Medical Services Reimbursement for On-Scene Care and Support Act. Issues related to H.R. 4011, the Community Paramedicine Act of 2025. Issues related to the Supporting Our First Responders Act. Issues related to H.R. 2220, the PARA-EMT Act of 2025. Issues related to H.R. 2232 & S. 1643, Protecting Access to Ground Ambulance Medical Services Act of 2025.

Client expense: Not reported · Firm income: $30,000

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

H.R. 2232/S. 1643, Protecting Access to Ground Ambulance Medical Services Act H.R. 2538/S. 3145, Comprehensive Alternative Response for Emergencies (CARE) Act

Client expense: $10,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

H.R. 5304/S. 2587, Labor, Health and Human Services, and Education FY 2026 Appropriations relating to the National Institute for Occupational Safety and Health's (NIOSH) National Firefighter Registry for cancer, the Supporting and Improving Rural EMS Needs (SIREN) grant, NIOSH's Firefighter Fatality Investigation and Prevention Program (FFFIPP), NIOSH's National Personal Protective Technology Laboratory, and the World Trade Center Health Program. H.R. 1902, HERO Act H.R.3791, EMS Counts Act Issues relating to the reversing staff reductions and the preservation of programs within the National Institute for Occupational Safety and Health, including the National Firefighter Registry for Cancer, Fire Fighter Fatality Investigation Prevention Program, WTC Health, National Personal Protective Technology Laboratory, the Respirator Approval Program, Emergency Response Support, and Health Hazard Evaluation Program. H.R. 2232/S. 1643, Protecting Access to Ground Ambulance Medical Services Act H.R. 2538/S. 3145, Comprehensive Alternative Response for Emergencies (CARE) Act Issues relating to volunteer firefighter status being added to the U.S. Standard Certificate of Death Issues related to the preservation of staff and funding at National Highway Traffic Safety Administrations (NHTSA) Office of Emergency Medical Services (EMS)

Client expense: $10,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Highway Traffic Safety Administration (NHTSA), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)

Medicare reimbursement policy for air and ground ambulance services; Intergovernmental Transfers (IGTs)/State Plan Amendments related to Medicaid reimbursement. H.R. 2232/S. 1643, Protecting Access to Ground Ambulance Medical Services Act of 2025; New York Medicaid State Plan Amendment on Treat in Place.

Client expense: $540,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislation and regulation impacting ground ambulance and emergency medical services including funding, reimbursement, training, workforce. Seek equitable coverage for all paramedics and emergency medical technicians on workforce issues. Legislation to amend title XVIII to protect patient access to ground ambulance services under part B of the Medicare program (H.R.2232/S.1643); Appropriations requests for grant funding under the ASPR; NDAA - military to civilian workforce transition; Relief for private ground ambulance providers from the federal fuel tax (TAX).

Client expense: Not reported · Firm income: $70,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislation and regulation impacting ground ambulance and emergency medical services including funding, reimbursement, training, workforce. Seek equitable coverage for all paramedics and emergency medical technicians on workforce issues. Legislation to amend title XVIII to protect patient access to ground ambulance services under part B of the Medicare program through stabilized and increased reimbursement (H.R.2232/S.1643). The Preserve Access to Rapid Ambulance Medical Treatment Act (H.R.2220) and the PARA-EMT Act; The Comprehensive Alternative Response for Emergencies (CARE) Act (H.R.2538/S.3145); Appropriations requests for grant funding under the ASPR; NDAA - military to civilian workforce transition; Relief for private ground ambulance providers from the federal fuel tax (TAX).

Client expense: Not reported · Firm income: $70,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 2232 and S. 1643 - Extension of the ground ambulance add-ons; Medicare update of the ambulance fee schedule definitions of urban, rural, and super-rural; treatment in place.

Client expense: Not reported · Firm income: $60,000

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

H.R. 2220, PARA-EMT Act of 2025 H.R. 2232, Protecting Access to Ground Ambulance Medical Services Act of 2025 H.R. 2538, CARE Act of 2025 H.R. 3791, EMS Counts Act H.R. 4011, Community Paramedicine Act of 2025 Issues related to reimbursement of ground ambulance services Issues related to grants for community paramedicine programs Issues related to the ET3 Program Issues related to the Ground Emergency Medical Transportation program Issues related to fall prevention programs for seniors

Client expense: $164,993 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

The FY 2026 Consolidated Appropriations Act (P.L. 119-75), provisions to fund the following programs at the U.S. Department of Health and Human Services: - National Institute for Occupational Safety and Health's National Firefighter Registry for Cancer. - National Institute for Occupational Safety and Health's Fire Fighter Fatality Investigation and Prevention Program. - National Institute for Occupational Safety and Health's National Personal Protective Technology Laboratory. - World Trade Center Health Program. - Funding for the SIREN grant program for rural EMS. Issues relating to the supply chain and delivery and cost of fire apparatus and equipment. Issues relating to the Ground Emergency Medical Transportation program. Fighting Post-Traumatic Stress Disorder Act (S. 825), provisions to provide behavioral health resources to first responders at the U.S. Department of Justice. Issues relating to fire safety in home oxygen systems and reimbursement for the installation of thermal fuses. The Protecting Access to Ground Ambulance Medical Services Act (H.R. 2232/S. 1643), provisions to extend the add-on payments for ambulance transport of Medicare patients. Issues relating to the staffing reductions at the National Firefighter Registry for Cancer, Fire Fighter Fatality Investigation, WTC Health, and Prevention Program and National Personal Protective Technology Laboratory. Issues relating to firefighter cancer. Issues relating to the acquisition of medications and medical equipment used by EMS. The Comprehensive Alternative Response for Emergencies Act (H.R. 2538/S. 3145), provisions to reimburse fire and EMS departments for treating Medicare patients in place. The Community Paramedicine Act (H.R. 4011), provisions to fund Community Paramedicine and Mobile Integrated Health (CP/MIH) programs. The EMS Counts Act (H.R. 3791), provisions to direct the Bureau of Labor Statistics to accurately count the number of EMS practitioners in the United States. Issues relating to the reimbursement of blood products by EMS providers.

Client expense: $60,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Highway Traffic Safety Administration (NHTSA), SENATE

Issues relating to billing for ground ambulance transport. Issues relating to reimbursement of fire and EMS departments for mobile integrated health programs; treatment of patients in place; the reimbursement of blood products by EMS providers; and transportation of patients to alternate destinations of care. Issues relating to fire safety of home oxygen systems and reimbursement for the installation of thermal fuses. The Comprehensive Alternative Response for Emergencies Act (H.R. 2538/S. 3145), provisions to relating to reimbursement of fire and EMS departments for treating Medicare patients in place. The Protecting Access to Ground Ambulance Medical Services Act (H.R. 2232/S. 1643), provisions to extend the add-on payments for ambulance transport of Medicare patients. Issues relating to state participation in the Ground Emergency Medical Transportation program.

Client expense: $60,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE

Medicare and Medicaid policies relating to ground and air ambulance services, including workforce shortage issues, and supplemental relief for ambulance providers; H.R.2232/S.1643, Protecting Access to Ground Ambulance Medical Services Act of 2025. Issues related to Medicaid, H.R.1, One Big Beautiful Bill Act (P.L.119-21) implementation.

Client expense: Not reported · Firm income: $20,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare and Medicaid policies relating to ground and air ambulance services, including workforce shortage issues, and supplemental relief for ambulance providers; H.R.2232/S.1643, Protecting Access to Ground Ambulance Medical Services Act of 2025. Issues related to Medicaid, H.R.1, One Big Beautiful Bill Act (P.L.119-21) implementation.

Client expense: Not reported · Firm income: $20,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.2232 and S.1643, Protecting Access to Ground Ambulance Medical Services Act of 2025, Medicare and Medicaid policies relating to ground and air ambulance services, including supplemental relief for ambulance providers.

Client expense: Not reported · Firm income: $20,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.2232 and S.1643, Protecting Access to Ground Ambulance Medical Services Act of 2025, Medicare and Medicaid policies relating to ground and air ambulance services, including supplemental relief for ambulance providers.

Client expense: Not reported · Firm income: $20,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Lobbied on the Protecting Access to Ground Ambulance Medical Services Act (H.R. 2232, S.1643) to extend and raise the percentages of temporary increases in Medicare payments for ground ambulance services. Educated congressional offices and committees on mandatory past due changes in geographical designation of zip codes under the Medicare ambulance fee schedule following the 2020 Census. Lobbied on the Consolidated Appropriations Act 2026 (H.R. 7148) to extend and increase the Medicare payments to ground ambulance services. Lobbied on the Comprehensive Alternative Response for Emergencies Act of 2025 (H.R. 2538, S. 3145) to create a CMMI demonstration project on the reimbursement of ambulance response without transport, and the Emergency Medical Services Reimbursement for On-Scene Care and Support Act (H.R. 7277, S. 3730). Lobbied on the Community Paramedicine Act (H.R. 4011) to provide local governments and partners with funding to furnish mobile integrated healthcare. Engaged with congressional offices on the Preserving Emergency Access in Key Sites Act (PEAKS Act) (H.R. 3378, S.1960). Lobbied in support of reducing the amount of the copay for critical ambulance services for patients in Medicare Advantage plans.

Client expense: $350,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office

Support Medicare Reimbursement for EMS Treatment in Place (TIP); Support S. 2196/H.R. 2538, the CARE Act; Support Mobile Integrated Healthcare (MIH) Community Paramedicine (CP) Programs; Support introduction of legislation to provide grants to communities to create and maintain/sustain MIH-CP programs;H.R. 4011. Support FY2026 Funding for SIREN Act Grants; Support the H.R. 3791, EMS Counts Act; Support S. 1643/H.R. 2232, the Protecting Access to Ground Ambulance Medical Services Act; Support participation of the Congressional EMS Caucus; Support S. 3730, the ROCs Act.

Client expense: Not reported · Firm income: $31,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 2232 and S. 1643 - Extension of the ground ambulance add-ons; Medicare update of the ambulance fee schedule definitions of urban, rural, and super-rural; treatment in place.

Client expense: Not reported · Firm income: $60,000

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE