Zinke secures victory for veterans, VA scraps plan to gut air ambulance service in Montana

(WASHINGTON, DC) Ceding to Congressman Ryan Zinke’s relentless oversight and demands, the Department of Veterans Affairs (VA) has delayed implementation of their proposed rule that would essentially eliminate any availability for affordable air and ground ambulance services for veterans. In 2020 the VA proposed cutting the reimbursement rate for ground and air ambulance services by as much as 90%, using market data from 1998 for air ambulance services and 2002 for ground ambulance services. Had it gone into effect as proposed, the new rule would have caused drastic cuts and make it financially impossible for air ambulances to operate. In Montana, similar cuts have gone into effect in rural counties, causing Granite County to lose ambulance service altogether. 

Zinke has used his position on the MILCON-VA subcommittee on Appropriations to delay implementation of this rule for nearly two years. His efforts include leading multiple oversight letters to VA Secretary Denis McDonough seeking a delay in the effective date of the rule, introducing legislation to combat the rule, introducing an amendment to the FY24 Military Construction, Veterans Affairs, and Related Agencies appropriations bill and testifying before the Rules Committee to protect veterans’ access to life flights and a variety of ambulance services, all leading to the delay of the initial enactment originally meant to go into effect in February of 2024. 

The VA’s further delay until 2029 will allow a new appraisal of market data and will heavily mitigate the disastrous effects of the original rule. 

Even without this delay, Zinke-drafted language included in the House-passed FY25 Military Construction, Veterans Affairs, and Related Agencies appropriations bill would have defunded reimbursement changes set to take effect in 2025.

Zinke statement:

“In rural areas, healthcare is hard to access, we need to be expanding options for veterans, not limiting them.” Zinke said. “This delay in the enactment will allow the Centers for Medicare & Medicaid Services to update the outdated data and keep lifesaving air and ground ambulance services available for Montanans. I am glad the VA came to its senses on this one and stopped a rule that would have been disastrous for veterans.” 

Statements of Support:

“The Jewish War Veterans of the USA (JWV) applauds the Congressional efforts of Rep. Zinke, SVAC Chairman Tester, HVAC Chairman Bost, SVAC Ranking Member Moran, and others in delaying the effective day of the rule until February 2029,” Jewish War Veterans National Executive Director Ken Greenberg said. “JWV has led the fight in the VSO community on the VA’s proposed rule (RIN 2900-AP89, Change in Rates VA Pays for Special Modes of Transportation) that cuts the VA reimbursement rate for emergency air medical services to below the costs of the services themselves. For the last two years, JWV has been vocal that “as published, the rule would put more than 2.7 million rural veterans in our country who are enrolled in the VHA, and 4.8 million rural veterans overall, at risk of losing life-saving emergency air transportation.” 

“From the very start of the VA’s ill-fated effort to effectively deny rural American veterans timely access to air ambulance services – by imposing untenably low reimbursement rates on those air ambulance service providers – Rep. Zinke’s been at the forefront of protecting Montana’s and America’s veterans’ access to timely air ambulance services,” The National Defense Committee said. “This welcome announcement by the VA to delay implementation of this poorly designed regulation would not have happened but for the aggressive Congressional oversight by Rep. Zinke, Rep. Bost of Illinois, and others to force the VA to backdown.  National Defense Committee looks forward to working with Rep. Zinke to get the VA to refine this inherently faulty proposal, and we thank him for his steadfast commitment.”

 Background:

• On February 16, 2023, The Department of Veterans Affairs (VA) published in the Federal Register a final rule to amend its beneficiary travel regulations to establish a new payment methodology for special modes of transportation available through the VA beneficiary travel program. The preamble of that final rule stated the effective date was February 16, 2024. 

• While Rep. Zinke opposed the VA rule from its finalization in February, there was the promise of negotiated contracts with VA to exempt vendors from reimbursement on the CMS schedule.

• In a March 2023 budget hearing, VA Secretary Denis McDonough promised Rep. Zinke that he would work with him on ensuring fair, negotiated contracts. 

• In June of 2023, Rep. Zinke led a letter to Secretary McDonough, alongside 12 Members of Congress, asking basic questions about the rule and asking for a delay in the effective date. 

• The next month, it was discovered that non-VA directed 911 emergency air and ground ambulance transports would automatically be reimbursed on the CMS schedule because they are ineligible to be negotiated via contract due to lack of VA statutory authority.

• In response, Rep. Zinke introduced a bipartisan amendment to the Fiscal Year 2024 Military Construction, Veterans Affairs, and Related Agencies appropriations bill that would defund the rule change. While Rep. Zinke testified in support of the amendment, it was not ruled in order by the House Rules Committee.

• On July 28^th, Rep. Zinke led a bipartisan group of thirty Members of Congress in another letter to Secretary McDonough asking him to delay the effective date of the finalized VA rule until Congress passes legislation authorizing the VA to contract emergency ambulance services. That letter has also gone unanswered, despite multiple follow-ups by staff.

• VA published in the Federal Register on December 29, 2023, a final rule to delay the effective date for the rule from February 16, 2024, to February 16, 2025. 

• This rulemaking further delays the effective date of February 16, 2025, to February 16, 2029.

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