EMS Agencies Asked to Engage Texas Medicaid

The Texas Health and Human Services Commission (HHSC) will hold a stakeholder meeting on Tuesday, August 8 at 1:30 p.m. in Austin to discuss proposed Medicaid cuts for ground ambulance service in Texas.  Both ALS and BLS services would be cut by approximately 35 percent under the biennial review proposal for Medicaid.

TEMSA is working with lawmakers and other stakeholders to fight the proposed cuts.

What EMS Agencies Need to Do
Every EMS agency is strongly encouraged to send its own letter regarding the proposed cuts to HHSC.

General instructions for sending a letter to HHSC:

  • Place the letter on your letterhead and have it signed by an agency leader.
  • More about the template and suggestions for the text of your letter can be found below.
  • The stakeholder meeting will be held on Tuesday, August 8 at 1:30 p.m..  (If you are able to attend the hearing to speak, that would be helpful. Click here for meeting details.)
  • Since the stakeholder letter is on August 8, you are strongly encouraged to deliver your letter to HHSC by Friday, August 4.

E-mail is the most effective delivery option.  If you e-mail it (the e-mail address is below), please ask for confirmation that they received it:


U.S. Mail:
Texas Health and Human Services Commission
Attention: Rate Analysis, Mail Code H-400
P.O. Box 149030
Austin, Texas 78714-9030

Overnight mail, special delivery mail or hand delivery:
Texas Health and Human Services Commission
Attention: Rate Analysis, Mail Code H-400
Brown-Heatly Building
4900 North Lamar Boulevard
Austin, Texas 78751

Phone number for package delivery512.730.7401

Fax: Attention: Rate Analysis at 512.730.7475

Letter Text and Template
The following template is recommended:

August 4, 2017

Charles Smith
Executive Commissioner
Texas Health and Human Services Commission
4900 N. Lamar Blvd.
Austin, TX 78751-2316

Re: Biennial Review of Ambulance Services (Proposed to Be Effective October 1, 2017)

Dear Commissioner Smith:

I am writing on behalf of XX EMS Agency to express my strong concerns regarding the proposed ground ambulance rate cutes for Medicaid. Add your text here. Focus on how the proposal will hurt your community.

Your name and contact information

Talking Points and Background 
You are encouraged to write the letter in your own words (it does not have to be long).  In addition, it would be useful to include an analysis of the proposed rate cut and include the figures in your letter.

Click here to view a link to the spreadsheet of proposed rates (the link can be found within the web page). The proposal would cut both ALS and BLS service.

You may find the following talking points to be useful for writing your letter:

  • Ambulance providers will have no choice but to make reductions in the number of ambulances that they equip and staff, which will impact response times for all Texas residents. Some communities will be forced to abandon the provision of 9-1-1 services altogether, or in order to continue to provide services, local jurisdictions will be forced to raise taxes to subsidize ambulance services.


  • Ambulances provide vital 9-1-1 services to our communities.  For many rural areas, ground ambulances are the community’s health safety net and the only access to emergency medical care.


  • Medicaid is a large payer for many ambulance services in Texas.  Medicaid makes up approximately 20 percent of the payer mix in most urban communities, and 30 percent or more in rural communities.  The current Medicaid payment rates for ground ambulances, which are already well below Medicare payment rates (Texas Medicaid pays 67 percent of Medicare ground ambulance rates), do not even cover the cost to transport a Medicaid patient.