This legislation seeks to amend the Social Security Act to ensure more appropriate Medicare payments for ambulance services. It mandates a shift to a new regulatory framework for determining ambulance service payment amounts, beginning in 2027, moving away from previous methodologies. A key provision requires the Secretary of Health and Human Services to conduct an initial comprehensive review and adjustment of the fee schedule for both ground and air ambulance services for 2028. This review will consider relative value units, conversion factors, base rates, and mileage rates to reflect actual costs, including labor and uncompensated care. Following this, the Secretary will implement triennial reviews and adjustments , starting in 2031, to account for changes in medical practice, technology, and new cost data. For years between these triennial adjustments, payment amounts for ambulance services will be updated annually based on the consumer price index for all urban consumers . The bill also expands existing data submission requirements and potential payment reductions for non-compliance to include air ambulance services , ensuring comprehensive data collection for both ground and air providers. This data, including information from the No Surprises Act, will inform the fee schedule adjustments. Finally, the legislation mandates that by December 31, 2028, the Secretary convene experts and stakeholders to assess the adequacy of the ambulance fee schedule. These groups are tasked with submitting recommendations by July 1, 2029, for further modifications to improve the valuation of both ground and air ambulance services under Medicare.