I 118th CONGRESS 1st Session H. R. 3691 IN THE HOUSE OF REPRESENTATIVES May 25, 2023 Mr. Estes (for himself and Ms. DelBene ) introduced the following bill; which was referred to the Committee on Energy and Commerce , and in addition to the Committee on Ways and Means , for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned A BILL To amend title XVIII of the Social Security Act to revise payment for air ambulance services under the Medicare program.

1. Short title This Act may be cited as the Protecting Air Ambulance Services for Americans Act of 2023 . 2. Improvements to Medicare payment system for air ambulance services Section 1834(l) of the Social Security Act ( 42 U.S.C. 1395m(l) ) is amended by adding at the end the following new paragraph: (18) Improvements to Medicare payment system for air ambulance services (A) In general The Secretary may revise the fee schedule otherwise established under this subsection for air ambulance services based on data described in subparagraph (B) and data collected under subparagraph (C). (B) Data described For purposes of subparagraph (A), the data described in this subparagraph is data collected pursuant to the provisions of, and amendments made by, section 106 of division BB of the Consolidated Appropriations Act, 2021 ( Public Law 116–260 ). (C) Additional data collection The Secretary shall require, once every 3 years, providers of services and suppliers furnishing air ambulance services to submit to the Secretary— (i) data relating to the fixed and operating costs per air ambulance base attributable to furnishing air ambulance services to individuals enrolled under this part and data relating to the utilization of such services by such individuals; (ii) data relating to the revenue obtained by such providers and suppliers under this part attributable to the furnishing of such services; and (iii) any other information determined appropriate by the Secretary. (D) Consultation In the case that the Secretary elects to revise the fee schedule for air ambulance services under subparagraph (A), the Secretary shall consider stakeholder input in a process that is transparent and appropriately considers data described in subparagraph (B) and data collected under subparagraph (C). . 3. GAO study on emergency air ambulance costs Not later than 1 year after the date on which data begins to be collected pursuant to the provisions of, and amendments made by, section 106 of division BB of the Consolidated Appropriations Act, 2021 ( Public Law 116–260 ), the Comptroller General of the United States shall submit to the Committee on Finance of the Senate and the Committee on Ways and Means and the Committee on Energy and Commerce of the House of Representatives, a report detailing— (1) the average annual operating costs per air ambulance base; (2) the average cost per transport by air ambulance; (3) the payor mix for air ambulance services; (4) the adequacy of Medicare payments for such services; (5) geographic variations in the cost of furnishing such services; and (6) recommendations on improving the fee schedule under section 1834(l) of the Social Security Act ( 42 U.S.C. 1395m(l) ) for air ambulance services.