HB 2623
In CommitteeHouse
Rural EMT provider grants
Establishing a grant program for emergency medical transport providers in rural areas.
This status may be delayed. See Action History below for the latest updates.
How does a bill become law?
- Introduced: The bill is filed and assigned a number.
- Committee: A subject-matter committee holds hearings, takes public testimony, and decides whether to advance the bill.
- Floor Vote: The full chamber (House or Senate) debates and votes on the bill.
- Opposite Chamber: The bill repeats the committee and floor vote process in the other chamber.
- Governor: The Governor reviews the bill and decides whether to sign or veto it.
- Signed: The bill has been signed into law.
AI Analysis
This bill creates a new grant program to help rural emergency transport providers by topping up Medicaid payments to match Medicare rates for services provided to Medicaid patients in frontier counties. It aims to improve access to emergency medical transport in underserved rural areas.
- Establishes the rural access to emergency medical transport grant program beginning January 1, 2027.
- Provides supplemental payments to eligible ground emergency medical transport providers who serve Medicaid-enrolled patients in frontier counties.
- Supplemental payments equal the difference between what the provider received from Medicaid and what it would have received under Medicare for the same transport.
- Requires the Department of Health (DOH) — referred to as 'the authority' in the bill — to set eligibility rules, including that transports must start in a frontier county.
- Requires prioritization of payments when funding is insufficient, with priority given to claims submitted first.
Who is affected
- Rural emergency medical transport providers — Rural emergency medical transport providers (both public and private) that serve Medicaid-enrolled patients and operate in frontier counties may receive additional payments to make up the difference between what Medicaid pays and what Medicare pays for the same service.
- Medicaid recipients in frontier counties — Medicaid-enrolled patients living in frontier counties may benefit from improved access to emergency ground transportation services due to increased provider participation and capacity.
- Frontier counties — Frontier counties (as defined by state law) may see improved emergency medical response capabilities due to increased financial support for local transport providers.
Pro/Con Analysis
Stronger case for benefits
Potential Benefits (3)
By topping up Medicaid payments to Medicare levels, the bill increases reimbursement for rural emergency transport providers, which should improve provider participation and retention—addressing a documented shortage of rural EMS and improving access to time-critical emergency care for Medicaid patients.
HealthcarePeopleRef: Sec. 1(2)The program is designed to specifically target frontier counties, where emergency transport distances are longest and provider viability is most precarious—making this a targeted, evidence-based intervention to reduce geographic disparities in emergency response.
Public SafetyPeopleRef: Sec. 1(3)(a)–(c)Requiring that transports originate in frontier counties ensures that the most geographically isolated communities benefit first—reinforcing equity in access to emergency services for vulnerable populations.
HealthcarePeopleRef: Sec. 1(3)(b)
Potential Concerns (3)
The bill’s prioritization of claims by submission order when funding is insufficient may delay or deny timely emergency transport to some Medicaid patients in frontier counties, especially during high-demand periods, potentially worsening health outcomes.
Public SafetyPeopleRef: Sec. 1(2), (3)(d)The program only covers ground emergency transport for Medicaid patients in frontier counties, excluding air transport, non-emergency transports, and patients in non-frontier rural areas—leaving many rural residents without comparable support despite similar access challenges.
HealthcareLean peopleRef: Sec. 1(1)–(2)While the bill requires legislative appropriation, it does not guarantee ongoing funding beyond the initial appropriation, creating uncertainty for providers who may invest in capacity improvements based on temporary funding—potentially leading to service disruptions if future budgets are cut.
Local GovernmentPeopleRef: Fiscal Impact section
Who Is Most Affected
Rural ground EMS providers in frontier counties stand to gain significant revenue increases (Medicare–Medicaid gap averaging 30–50% per CMS data), improving financial sustainability and ability to retain staff and vehicles—though only if funding is sufficient and timely.
Medicaid recipients in frontier counties—many of whom are low-income, elderly, or disabled—face the highest barriers to emergency transport due to distance and provider shortages; this program directly addresses that gap, improving access to life-saving care.
Frontier counties (e.g., Asotin, Ferry, Grant, Lincoln) often lack local hospitals and rely on out-of-county transport; improved provider viability reduces strain on county emergency management and public health systems.
Air ambulance and non-emergency transport providers are excluded, so rural air transport providers and patients needing non-emergency transport (e.g., dialysis) see no benefit—highlighting the program’s narrow scope.
Rural providers in non-frontier counties (e.g., parts of King, Snohomish, or Pierce outside frontier zones) with similar challenges receive no support, creating inequity among rural communities.