H.R. 8218 – Rural Ambulance Reimbursement Fairness Act

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Updated April 14, 2026 at 2:47 PM UTC

The Rural Ambulance Reimbursement Fairness Act changes Medicare rules so that ambulance providers in rural areas can receive higher payments. It expands the distance criteria used to determine eligibility for increased reimbursement, especially in mountainous regions or places with only secondary roads. The change takes effect for services provided on or after January 1 2021 and affects rural ambulance companies that bill Medicare.

Key Provisions

Amends the Medicare payment rule to count a 15‑mile drive as qualifying for higher reimbursement in mountainous terrain or where only secondary roads are available, in addition to the existing 35‑mile drive rule.
Sets the amendment’s effective date as January 1 2021 for any ambulance services rendered after that date.

Legislative Activity

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HouseIntro Referral Latest Action

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.

Energy and Commerce Committee

September 11, 2020

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HouseIntro Referral

Introduced in House

September 11, 2020

HouseIntro Referral

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.

Energy and Commerce Committee

September 11, 2020

Bill Text

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Introduced in HouseIssued September 11, 2020

I

116th CONGRESS

2d Session

H. R. 8218

IN THE HOUSE OF REPRESENTATIVES

September 11, 2020

Mr. Gianforte 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 provide for increased Medicare payment for certain rural providers of ambulance services.

1.

Short title

This Act may be cited as the Rural Ambulance Reimbursement Fairness Act.

2.

Medicare payment for certain rural providers of ambulance services

(a)

In general

Paragraph (8) of section 1834(l) of the Social Security Act (42 U.S.C. 1395m(l)) is amended in the matter following subparagraph (B), by inserting (or, in the case of mountainous terrain or in areas with only secondary roads available, a 15-mile drive) after within a 35-mile drive.

(b)

Effective date

The amendment made by subsection (a) shall apply with respect to ambulance services furnished on or after January 1, 2021.