Legislative Progress
Introduced
November 6, 2025
Latest Action
November 6, 2025
Primary Sponsor
Susan M. CollinsRepublican(ME)
Momentum (last 30 days)
0
score
0 actions · 0 new cosponsors · 0 votes
Speed vs cohort
0pct
0d open
vs 5,674 other S bills in the 119th — cohort avg 32d
Comprehensive Alternative Response for Emergencies Act of 2025 or the CARE Act of 2025 This bill requires the Center for Medicare and Medicaid Innovation (CMMI) to test a five-year model that provides for Medicare payment for ground ambulance services that do not result in the transport of the patient. Under the model, Medicare payment may be furnished for ground ambulance services when an ambulance is dispatched in response to an emergency medical call but the ambulance does not end up transporting the patient. Payment rates under the model must generally align with the payment rates that apply when there is an actual transport. The Government Accountability Office must report on the general access of Medicare beneficiaries to emergency medical services, including the impact of the model on beneficiary access and outcomes.
These links require the bill number to appear in the filing's source-reported specific issue text. Client expenses and lobbying-firm income are separate disclosure fields.
Filing registrants (6)
2026 · third_quarter · Medicare/Medicaid
Read twice and referred to the Committee on Finance. (Sponsor introductory remarks on measure: CR S7964)
Introduced in Senate
Bills with similar content found using semantic analysis.
Sources: Congress.gov
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 changes in geographical designation of zip codes under the Medicare ambulance fee schedule following the 2020 Census and the need for a zip code designation appeals process. 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). Engaged in support of the draft RESCUE Blood Act to provide additional Medicare reimbursement for prehospital blood. 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
2026 · third_quarter · Health Issues
H.R. 1610, FIRE Cancer Act of 2025 H.R. 1902, Helping Emergency Responders Overcome (HERO) Act H.R. 2538/S. 3145, CARE Act of 2025 H.R. 2921/S. 2745, Federal Firefighter Cancer Detection and Prevention Act of 2025 H.R. 3791, EMS Counts Act H.R. 4453/S. 4658, Parkinson's Protection for Firefighters Act H.R. 5575, FASTER Act H.R. 6147/S. 3221, Expanding Health Care Options for First Responders Act H.R. 10492/S. 5433, Wildland Firefighter Health and Safety Act S. 4819, Lifeline for First Responders Act Issues related to NIOSH programs supporting fire fighters Issues related to cancer screenings for federal fire fighters Issues related to fertility following PFAS exposures Issues related to CMS payments for ambulance service Issues related to CMS payments for pre-hospital blood transfusions Issues related to the WTC Health Program Issues related to the Rural EMS Training and Equipment Assistance Program
Client expense: $204,309 · Firm income: Not reported
Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Occupational Safety & Health Administration (OSHA), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)
2026 · third_quarter · Health Issues
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
2026 · third_quarter · Medicare/Medicaid
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
2026 · third_quarter · Health Issues
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)
2026 · third_quarter · Health Issues
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
2026 · third_quarter · Medicare/Medicaid
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
2026 · third_quarter · Health Issues
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.
2026 · second_quarter · Health Issues
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
2026 · second_quarter · Medicare/Medicaid
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
2026 · second_quarter · Health Issues
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
2026 · second_quarter · Health Issues
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
2026 · second_quarter · Health Issues
H.R. 1610, FIRE Cancer Act of 2025 H.R. 1902, Helping Emergency Responders Overcome (HERO) Act H.R. 2538/S. 3145, CARE Act of 2025 H.R. 2921/S. 2745, Federal Firefighter Cancer Detection and Prevention Act of 2025 H.R. 3791, EMS Counts Act H.R. 4453/S. 4658, Parkinson's Protection for Firefighters Act H.R. 5575, FASTER Act H.R. 6147/S. 3221, Expanding Health Care Options for First Responders Act S. 4819, Lifeline for First Responders Act Issues related to NIOSH programs supporting fire fighters Issues related to cancer screenings for federal fire fighters Issues related to fertility following PFAS exposures Issues related to CMS payments for ambulance service Issues related to CMS payments for pre-hospital blood transfusions
Client expense: $196,000 · Firm income: Not reported
Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Occupational Safety & Health Administration (OSHA), SENATE
2026 · second_quarter · Health Issues
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.
2026 · second_quarter · Medicare/Medicaid
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
2026 · second_quarter · Medicare/Medicaid
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
2026 · first_quarter · Health Issues
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
2026 · first_quarter · Medicare/Medicaid
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
2026 · first_quarter · Health Issues
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
2026 · first_quarter · Health Issues
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
2026 · first_quarter · Health Issues
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.
2026 · first_quarter · Medicare/Medicaid
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
2026 · first_quarter · Medicare/Medicaid
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
2025 · fourth_quarter · Health Issues
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 staffing reductions at the National Firefighter Registry for Cancer, Fire Fighter Fatality Investigation, WTC Health, and Prevention Program and National Personal Protective Technology Laboratory. 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 firfighter status being added to the U.S. Standard Certificate of Death Issues related to the preservation of staff and funding at National HighwayTraffic 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)
2025 · fourth_quarter · Medicare/Medicaid
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
2025 · fourth_quarter · Health Issues
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).
Client expense: Not reported · Firm income: $70,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2025 · fourth_quarter · Medicare/Medicaid
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 FY2026 Continuing Appropriations, Agriculture, Leg. Branch & Extensions Act (H.R. 5371) to extend and increase the Medicare payments and to eliminate the potential PAYGO cut to Medicare providers and suppliers. Lobbied on the implementation of provisions of the One Big Beautiful Bill Act (H.R. 1) including on the Rural Health Transformation Program and ensure that ground ambulance service providers and emergency medical services are eligible and covered for funding through inclusion in State plan program applications. 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 draft Emergency Medical Services Reimbursement for On-Scene Care and Support Act. 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: $300,000 · Firm income: Not reported
2025 · fourth_quarter · Medicare/Medicaid
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. The FY 2026 Continuing Appropriations, Agriculture, Legislative Branch, Military Construction and Veterans Affairs, and Extensions Act (P.L. 119-37), 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: $40,000 · Firm income: Not reported
2025 · fourth_quarter · Health Issues
The FY 2026 Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act (H.R. 5304/S. 2587), 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. The FY 2026 Continuing Appropriations, Agriculture, Legislative Branch, Military Construction and Veterans Affairs, and Extensions Act (P.L. 119-37), 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.
| Democratic |
| DE |
| Cindy Hyde-Smith | Republican | MS |
| James C. Justice | Republican | WV |
| Peter Welch | Democratic | VT |
| Sheldon Whitehouse | Democratic | RI |
| Shelley Moore Capito | Republican | WV |
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE
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
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)
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
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office
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)
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
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE
Client expense: $40,000 · 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