The Issues


Why Engage?

Laws and regulations affect every aspect of an EMS agency. As a result, TEMSA encourages Texas EMS agencies to engage in the public policy process to ensure that Texas communities have the best 911 service possible.

EMS Policy Overview

Click here to learn more about EMS in Texas and the public policy issues that affect EMS.


Medicaid represents one of the largest payers for most Texas EMS agencies.  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.

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Congress passed a spending bill in February 2018 that renewed the ambulance “Medicare extenders” for an additional five years. In addition, the bill directed the U.S. Department of Health and Human Services (HHS) to develop a cost reporting program for ambulances. The plan is due by December 31, 2019.

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EMS Professionals

EMS professionals are the foundation of Texas’ EMS agencies. TEMSA has worked on a number of policy-related issues that affect EMS professionals, including mental health, Workers’ Comp, guns, and more.

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Rural EMS Issuess

Texas EMS agencies play a critical role in our state’s health care delivery system. The fast response and high level of care delivered by our state’s EMS agencies have saved countless Texas lives. In many rural Texas communities, EMS agencies are taking on a new role as the community’s health care safety net due to rural hospital closures. And for those rural communities that lack a rural hospital but have a primary care clinic, the EMS agency serves as the only health care option outside of business hours.

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