Academy of International Mobile Healthcare Integration
Trade associationOppose
Gemt program funding
Medicaid reimbursement rates
Medicaid Program: Medicaid Managed Care State Directed Payments and Medicaid Fee-for-Service Targeted Medicaid Practitioner Payments
CMS-2026-1916-0001NPRM
Comments
960
Last activity Jul 24, 2026
Deadline
Closed on Jul 22, 2026
Closed Jul 22, 2026
Net supportiSupport minus oppose · campaigns included
-71%
-71% excluding campaigns
Document
Details
The document's own metadata, straight from the source system.
- Title
- Medicaid Program: Medicaid Managed Care State Directed Payments and Medicaid Fee-for-Service Targeted Medicaid Practitioner Payments
- Posted
- May 22, 2026
- Comment period
- May 22, 2026 – Jul 22, 2026
- FR Doc
- 2026-10292
- CFR
- 42 CFR Parts 438 and 447
- Topics
Analysis
Overview
What the public is saying — stance, who's commenting, and the issues they raise.
Include campaigns
Analyzed 859 of 960 comments
89%· analysis in progress
Stance breakdown
-71%
Net support
Support107Oppose717Other35Not yet analyzed101
Aggregates include form-letter campaigns. Excluding them, net support is -71% across organic comments.
Who commented
Breakdown by commenter type.
Union
7
Individual
110
Government
186
Trade association
149
Advocacy
93
Academic
24
Business
268
Other
22
Not yet analyzed
101
Comments over time
Weekly arrivals, stacked by stance.
Posted May 22, 2026Deadline Jul 22, 2026
May 18Jun 1Jun 15Jun 29Jul 13Jul 20
Support107Oppose717Other35
Support × commenter type
How each type splits across stance.
Support
Oppose
Other
Business
10%
89%
1%
Government
12%
88%
1%
Trade association
11%
88%
1%
Individual
20%
55%
25%
Advocacy
14%
86%
0%
Academic
8%
88%
4%
Other
23%
73%
5%
Union
0%
100%
0%
Issues raised
The docket's canonical issues. Select one to browse its comments.
Medicaid reimbursement rates667
Administrative burden and readiness383
Elimination of state plan directed payments381
Medicaid reimbursement rate reductions217
Gemt program funding121
Fire-based ems exemptions97
Safety-net hospital funding74
Funding for community mental health38
Impact on rural pediatric access9
State-provider communication transparency4
Position map
Who stands where on each issue?
Every non-silent position is backed by an excerpt from the comment.
Issues shown
Uncheck an issue to choose another.
| Organization | Gemt program funding | Fire-based ems exemptions | Medicaid reimbursement rates | Administrative burden and readiness | Medicaid reimbursement rate reductions |
|---|---|---|---|---|---|
Academy of International Mobile Healthcare Integration Trade associationOppose The Academy of International Mobile Healthcare Integration (AIMHI) opposes the proposed rule because it would cap supple | · | · | · | ||
Ada County Paramedics GovernmentOppose Ada County Paramedics, a county-based EMS taxing district, opposes the proposed rule that would limit Ground Emergency M | · | · | · | ||
Allen Parish Ambulance BusinessOppose Marna Istre, Executive Director of Allen Parish Ambulance, opposes the proposed rule because it sets a Medicaid payment | · | · | · | ||
Ambulance District Asso of Missouri, Missouri Ambulance Assco, Missouri EMS Asso and the Missouri Fire Chiefs Assoc Trade associationOppose A coalition of Missouri EMS and fire service associations opposes the proposed limitation on Ground Emergency Medical Tr | · | · | · | ||
Arbor Health BusinessOppose Arbor Health, a rural healthcare system, opposes the proposed rule's calculation of Medicare rates at the service and ho | · | · | · | · | · |
Aurora Fire Department GovernmentOppose Kevin Nickel, Interim Fire Chief of the Aurora Fire Department, opposes the proposed rule because it would limit Ground | · | · | |||
Beecher Fire Protection District GovernmentOppose The Beecher Fire Protection District, a fire-based EMS organization, opposes the proposed rule to limit Ground Emergency | · | · | |||
Bennington Rescue Squad AdvocacyOppose The Bennington Rescue Squad, an emergency medical services provider, opposes the proposed rule because it would cap Medi | · | · | · | · | |
Burney Fire Protection District GovernmentOppose The Burney Fire Protection District opposes the proposed rule capping Ground Emergency Medical Transportation (GEMT) sup | · | · | · | ||
California Fire Chief Associations Trade associationOppose The California Fire Chiefs Association opposes the proposed rule capping Ground Emergency Medical Transportation (GEMT) | · | · | · | ||
California Professional Firefighters UnionOppose The California Professional Firefighters (CPF), representing over 38,000 personnel, opposes the proposal to cap Ground E | · | · | |||
Cascade Rural Fire Protection District GovernmentOppose The Cascade Rural Fire Protection District, a governmental fire-based EMS service, opposes the proposed rule that would | · | · | · | ||
Cathedral City Fire & EMS GovernmentOppose Michael Contreras, Fire Chief of Cathedral City Fire & EMS, opposes the proposed rule because capping Ground Emergency M | · | · | · | ||
Cedarburg Fire Department GovernmentOppose The Cedarburg Fire Department opposes the proposed federal restrictions and payment caps on Ground Emergency Medical Tra | · | · | · | ||
CENCAL Fire & EMS Authority GovernmentOppose Lenard Gutierrez, Executive Director of CENCAL Fire & EMS Authority, opposes the proposed rule capping Ground Emergency | · | · | |||
City of Alameda Fire Department GovernmentOppose The City of Alameda Fire Department opposes the proposed rule capping Ground Emergency Medical Transportation (GEMT) sup | · | · | · | ||
City of Albany Fire Department GovernmentOppose Chris LaBelle, Fire Chief of the City of Albany Fire Department, opposes the proposed rule because it would limit State | · | · | · | · | · |
City of Berkeley Fire Department GovernmentOppose The City of Berkeley Fire Department opposes the proposed limitation on Ground Emergency Medical Transportation (GEMT) s | · | · | · | ||
City of Carlsbad GovernmentOppose Nate Pearson, representing the City of Carlsbad Fire Department, opposes the proposed rule capping Ground Emergency Medi | · | · | · | ||
City of Des Plaines Fire Department GovernmentOppose Matthew Matzl, Fire Chief of the City of Des Plaines Fire Department, opposes the proposed rule to cap Ground Emergency | · | · | |||
City of Dinuba Fire Department GovernmentOppose Greg Chastain, Fire Chief of the City of Dinuba Fire Department, opposes the proposed reimbursement caps for governmenta | · | · | · | ||
City of Fullerton - Fire Department GovernmentOppose The City of Fullerton Fire Department opposes the proposed application of Medicare-based payment limits to governmental | · | · | · | ||
City of Glendale Fire Department GovernmentOppose Jeff Brooks, Fire Chief of the City of Glendale Fire Department, opposes the proposed rule capping Ground Emergency Medi | · | · | · | ||
City of Gonzales Fire Department GovernmentOppose Chief Preston Landry of the City of Gonzales Fire Department opposes the proposed rule because it sets a Medicaid paymen | · | · | |||
City of Indian Wells GovernmentOppose The City of Indian Wells opposes the proposed rule because it would cap Ground Emergency Medical Transportation (GEMT) p | · | · | · | ||
City of Naperville GovernmentOppose The Mayor of Naperville, Illinois, is requesting that CMS withdraw or revise the proposed limitation on Ground Emergency | · | · | · | ||
City of Petaluma Fire Department GovernmentOppose Jeff Schach, Fire Chief of the City of Petaluma Fire Department, opposes the proposed rule because it would cap Ground E | · | · | |||
City of San José GovernmentOppose The City of San José opposes the proposed rule because it would cap supplemental payments for ground emergency medical t | · | · | |||
City of South Pasadena Fire Department GovernmentOppose The City of South Pasadena Fire Department opposes the proposed rule capping Ground Emergency Medical Transportation sup | · | · | · | ||
City of Sterling Heights Fire Department GovernmentOppose The City of Sterling Heights Fire Department opposes the proposed limitation on Ground Emergency Medical Transportation | · | · | · | ||
Colorado Springs Fire Department GovernmentSupport Randy Royal, Fire Chief of the Colorado Springs Fire Department, urges CMS to protect the Ground Emergency Medical Trans | · | · | · | ||
Community Behavioral Health Association of Maryland AdvocacyOppose The Community Behavioral Health Association of Maryland (CBH) opposes the proposed rule because it extends Medicare-base | · | · | · | · | · |
Coulee Medical Center BusinessOppose Coulee Medical Center, a rural Critical Access Hospital, opposes the proposed rule because it threatens the financial vi | · | · | · | · | · |
Crested Butte Fire Protection District GovernmentSupport Sean Caffrey, representing the Crested Butte Fire Protection District, urges CMS to exempt governmental, volunteer, and | · | · | |||
East Baton Rouge Parish Department of Emergency Medical Services (EBREMS) GovernmentOppose The East Baton Rouge Parish Department of Emergency Medical Services (EBREMS) opposes the proposed rule because it sets | · | · | · | · | |
Emergency Medical Services Association of Colorado Trade associationSupport The Emergency Medical Services Association of Colorado (EMSAC) supports the proposed rule's intent to preserve cost-reco | · | · | · | ||
Essentia Health BusinessOppose Essentia Health, a healthcare organization with 15,000 employees, opposes the proposed rule because it exceeds the statu | · | · | · | ||
Falcon Fire Protection District GovernmentSupport The Falcon Fire Protection District, a governmental fire-based EMS agency, argues that the proposed rule could negativel | · | · | |||
Fayette County Ambulance BusinessOppose Fayette County Ambulance opposes the proposed rule, arguing that it would weaken Alabama's successful ambulance suppleme | · | · | · | ||
Fire Districts Association of California Trade associationOppose The Fire Districts Association of California opposes the proposed rule capping Ground Emergency Medical Transportation ( | · | · | |||
fire-based EMS organization GovernmentOppose The commenter, an Assistant Fire Chief of a fire-based EMS organization, opposes the proposed rule because it may restri | · | · | · | ||
Florida Behavioral Health Association AdvocacyOppose The Florida Behavioral Health Association (FBHA) opposes the proposed rule because it would impose payment caps on menta | · | · | · | · | · |
Foothill Fire Chiefs Association Trade associationOppose The Foothill Fire Chiefs Association opposes the proposed cap on Ground Emergency Medical Transportation (GEMT) suppleme | · | · | · | ||
Fremont Fire Department GovernmentOppose Zoraida Diaz, Fire Chief of the Fremont Fire Department, opposes the proposed rule because capping Ground Emergency Medi | · | · | · | ||
Glen Ellyn Volunteer Fire Co. GovernmentOppose The Fire Chief of the Glen Ellyn Volunteer Fire Co. | · | · | |||
Glendale Firefighters Association Local 776 UnionOppose Ara Zakarian, President of the Glendale Firefighters Association Local 776, opposes the proposed rule because it would c | · | · | |||
IAFC (International Association of Fire Chiefs) Trade associationOppose The commenter, representing the International Association of Fire Chiefs (IAFC), opposes the proposed payment limits for | · | · | · | ||
Imagine Pediatrics AdvocacySupport Imagine Pediatrics supports CMS's efforts to strengthen oversight and transparency of State Directed Payments in Medicai | · | · | · | · | · |
Indiana Council of Community Mental Health Centers Trade associationOppose The Indiana Council of Community Mental Health Centers (ICCMHC) opposes the proposed rule because it would impose paymen | · | · | · | · | · |
Joliet Fire Department GovernmentOppose The City of Joliet Fire Department opposes the proposed rule to limit Ground Emergency Medical Transportation (GEMT) sup | · | · | · | ||
Kit Carson County Ambulance Service GovernmentOppose Shane Dixon, EMS Director for Kit Carson County Ambulance Service, opposes the proposed rule because it threatens supple | · | · | |||
La Grange Fire Department GovernmentOppose The La Grange Fire Department, a governmental EMS organization, opposes the proposed rule to limit Ground Emergency Medi | · | · | |||
Laguna Beach Fire Department GovernmentOppose Niko King, Fire Chief of the Laguna Beach Fire Department, opposes the proposed rule capping Medicaid supplemental payme | · | · | |||
Lansing Fire Department GovernmentOppose The Lansing Fire Department, a municipal EMS organization, opposes the proposed rule to limit Ground Emergency Medical T | · | · | · | ||
Lemont Fire Protection District GovernmentOppose The Lemont Fire Protection District, a governmental EMS organization, opposes the proposed rule to limit Ground Emergenc | · | · | · | ||
Lewiston Fire Department GovernmentOppose The Lewiston Fire Department, a municipal fire department providing EMS services in Idaho, opposes the proposed limitati | · | · | |||
Livermore-Pleasanton Fire Department GovernmentOppose Aaron Lacey, Fire Chief of the Livermore-Pleasanton Fire Department, opposes the proposed rule because it would cap Grou | · | · | |||
Lockport Township Fire Protection District GovernmentOppose John O'Connor, Fire Chief of the Lockport Township Fire Protection District, opposes the proposal to limit Ground Emerge | · | · | |||
Manhattan Fire Protection District GovernmentOppose The Manhattan Fire Protection District, a local government EMS organization, opposes the proposed rule to limit Ground E | · | · | · | ||
Marion County Ambulance BusinessOppose Fayette County Ambulance opposes the proposed rule, arguing that it would weaken Alabama's successful ambulance suppleme | · | · | · | ||
Maryland Behavioral Health Coalition AdvocacyOppose The Maryland Behavioral Health Coalition, a group of state and local organizations, opposes the proposed rule because it | · | · | · | · | · |
Massachusetts Call/Volunteer Firefighters Association, Inc. (MCVFA) AdvocacyOppose Joseph V. | · | · | · | · | |
Mehlville Fire Protection District GovernmentOppose The Mehlville Fire Protection District, a local government entity providing fire and EMS services, opposes the proposed | · | · | · | ||
Mendocino County Fire Chiefs Association Trade associationOppose The Mendocino County Fire Chiefs Association opposes the proposed rule because it would cap Ground Emergency Medical Tra | · | · | · | ||
Mid-Columbia Fire & Rescue GovernmentOppose David Jensen, Fire Chief of Mid-Columbia Fire & Rescue, opposes the proposed rule because it would limit supplemental Me | · | · | |||
Mid-County EMS BusinessOppose Kenan M. | · | · | · | ||
Minnesota Hospital Association Trade associationOppose The Minnesota Hospital Association opposes the proposed rule because it expands the scope of Medicare-based payment limi | · | · | · | · | · |
Mississippi Ambulance Alliance Trade associationSupport The Mississippi Ambulance Alliance supports CMS's efforts to strengthen transparency and accountability in Medicaid supp | · | · | · | · | |
Montgomery County Fire and Rescue Service GovernmentOppose The Montgomery County Fire and Rescue Service opposes the proposed targeted payment limits, arguing that fire-based EMS | · | · | · | ||
National City Fire Department GovernmentOppose Sergio Mora, Fire Chief of the National City Fire Department, opposes the proposed rule because it would limit reimburse | · | · | · | · | |
New Jersey Association of Mental Health and Addiction Agencies Trade associationOppose The New Jersey Association of Mental Health and Addiction Agencies, Inc. | · | · | · | · | · |
New Lenox Fire Protection District GovernmentOppose The New Lenox Fire Protection District, a fire-based EMS organization, opposes the proposed rule to limit Ground Emergen | · | · | |||
New York State Council for Community Behavioral Healthcare AdvocacyOppose The NYS Council for Community Behavioral Healthcare opposes the proposed rule because it extends payment caps to mental | · | · | · | · | · |
Newport Beach Fire Department GovernmentOppose Jeff Boyles, Fire Chief of the Newport Beach Fire Department, opposes the proposed rule capping Ground Emergency Medical | · | · | |||
North County Fire Protection District GovernmentOppose The North County Fire Protection District (NCFPD) opposes the proposed rule capping Ground Emergency Medical Transportat | · | · | · | ||
Oceanside Fire Department GovernmentOppose The Oceanside Fire Department opposes the proposed rule capping Ground Emergency Medical Transportation (GEMT) supplemen | · | · | · | ||
Onvida Health Yuma Medical Center BusinessSupport Onvida Health Yuma Medical Center, a large healthcare provider in Arizona, supports the proposed rule but urges CMS to p | · | · | · | · | · |
Orland Fire Protection District GovernmentOppose John Purtill, Fire Chief/Administrator of the Orland Fire Protection District, opposes the proposed rule to limit Ground | · | · | |||
Palatine Fire Department GovernmentOppose The Palatine Fire Department, a municipal EMS organization, opposes the proposed rule that would limit Ground Emergency | · | · | |||
Palos Heights Fire Protection District GovernmentOppose The Palos Heights Fire Protection District, a local fire and EMS department, opposes the proposed rule to limit Ground E | · | · | · | ||
Pasadena Fire Department GovernmentOppose Chad Augustin, Fire Chief of the Pasadena Fire Department, opposes the proposed rule capping Ground Emergency Medical Tr | · | · | · | ||
Paso Robles Professional Firefighters Local 4148 UnionOppose Noah Munds, President of Paso Robles Professional Firefighters Local 4148, opposes the proposed rule because it would ca | · | · | · | ||
Polson Ambulance Inc BusinessSupport Tim Brester, owner of Polson Ambulance Inc, argues that adequate Medicaid reimbursement is essential for the survival of | · | · | · | · | |
Prospect Heights Fire Protection District GovernmentOppose Jason Hardy, Battalion Chief of the Prospect Heights Fire Protection District, opposes the proposed reimbursement cap on | · | · | · | ||
PWW Advisory Group BusinessOppose PWW Advisory Group, a consulting firm for emergency medical services, opposes the proposed Medicare Fee Schedule (AFS) l | · | · | · | ||
Regional One Health BusinessOppose Regional One Health, a safety-net hospital, opposes several aspects of the proposed rule, arguing that it imposes unnece | · | · | · | · | · |
Richmond University Medical Center BusinessSupport Richmond University Medical Center, a nonprofit safety-net hospital, supports the proposed rule but requests a specific | · | · | · | · | · |
Richton Park Fire Department GovernmentOppose Mick Smith, Fire Chief of the Richton Park Fire Department, opposes the proposed rule because it would limit Ground Emer | · | · | · | ||
River Forest Fire Department GovernmentOppose The River Forest Fire Department, a local government fire/EMS organization, opposes the proposed rule to limit Ground Em | · | · | · | · | |
Riverside County Fire Dept. GovernmentOppose Robert Fish, Fire Chief of the Riverside County Fire Department, opposes the proposed rule capping Ground Emergency Medi | · | · | · | ||
San Diego Fire-Rescue Department GovernmentOppose Robert Logan, Fire Chief of the San Diego Fire-Rescue Department, opposes the proposed rule capping Ground Emergency Med | · | · | |||
San Marcos Fire Department GovernmentOppose Dan Barron, Fire Chief of the San Marcos Fire Department, opposes the proposed rule because capping Ground Emergency Med | · | · | · | ||
San Ramon Valley Fire Protection District GovernmentOppose The San Ramon Valley Fire Protection District opposes the proposed cap on supplemental Medicaid payments, arguing that i | · | · | · | ||
Santa Rosa Fire Department GovernmentSupport The Fire Chief of the Santa Rosa Fire Department supports the proposed rule, noting that the department provides critica | · | · | · | ||
Skokie Fire Department GovernmentOppose The Skokie Fire Department opposes the proposed rule to limit Ground Emergency Medical Transportation (GEMT) supplementa | · | · | · | ||
Sonoma Valley Fire District GovernmentOppose The Sonoma Valley Fire District opposes the proposed rule capping Ground Emergency Medical Transportation (GEMT) supplem | · | · | · | ||
South Coast Fire Protection District GovernmentOppose Jason Warner, Fire Chief of the South Coast Fire Protection District, opposes the proposed rule because it would cap Gro | · | · | |||
South Elgin and Countryside Fire Protection District GovernmentOppose William Luchsinger, Fire Chief of the South Elgin and Countryside Fire Protection District, opposes the proposed rule li | · | · | |||
Southern Paramedic Service, Inc. BusinessSupport Gary Padget, CEO of Southern Paramedic Service, Inc, supports the proposed action provided that CMS allows states the fl | · | · | · | · | |
Stryker BusinessOppose Stryker opposes the proposed cap on Medicaid Ground Emergency Medical Transportation (GEMT) supplemental payments, argui | · | · | · | · | |
Sycuan Fire Department GovernmentOppose The Sycuan Fire Department, a fire-based EMS agency, opposes the proposed rule capping Ground Emergency Medical Transpor | · | · | · | ||
Temple University Health System BusinessOppose Abhinav Rastogi, President and CEO of Temple University Health System, opposes the proposed rule because it extends Medi | · | · | · | · | · |
Tennessee Association of Mental Health Organizations Trade associationOppose The Tennessee Association of Mental Health Organizations (TAMHO) opposes the proposed rule because it extends Medicare-b | · | · | · | · | · |
Thompson Valley Emergency Medical Services GovernmentSupport James Robinson, representing Thompson Valley EMS (a Colorado Title 32 Special District), urges CMS to protect the Ground | · | · | · | ||
Truckee Meadows Fire Protection District GovernmentOppose Richard Edwards, Fire Chief of the Truckee Meadows Fire Protection District, opposes the proposed funding caps on Ground | · | · | |||
Ukiah Valley Fire Authority GovernmentOppose Susan Sher, Mayor of Ukiah, is writing on behalf of the Ukiah Valley Fire Authority to oppose the proposal to cap Ground | · | · | · | ||
Ute Pass Regional Health Service District GovernmentOppose The Ute Pass Regional Health Service District, a governmental health service district, opposes the proposed rule because | · | · | |||
Village of Bolingbrook GovernmentOppose The Village of Bolingbrook, representing a municipal fire department, opposes the proposed rule because it replaces cost | · | · | · | ||
Village of Downers Grove GovernmentOppose The Fire Chief of the Village of Downers Grove opposes the proposed rule because it would limit Ground Emergency Medical | · | · | |||
Village of Matteson Fire Department GovernmentOppose The Village of Matteson Fire Department opposes the proposed rule that would limit Ground Emergency Medical Transportati | · | · | · | ||
Village of Oak Park Fire Department GovernmentOppose The Village of Oak Park Fire Department opposes the proposed rule to cap Ground Emergency Medical Transportation (GEMT) | · | · | · | ||
Village of Villa Park Fire Department GovernmentOppose The Village of Villa Park Fire Department opposes the proposed rule to limit Ground Emergency Medical Transportation (GE | · | · | |||
Village of Western Springs GovernmentOppose The Village of Western Springs and its Department of Fire & EMS oppose the proposed rule because it would limit Ground E | · | · | · | ||
Vista Fire Rescue GovernmentOppose Gerard Washington, Fire Chief of Vista Fire Rescue, opposes the proposed rule because capping Ground Emergency Medical T | · | · | · | ||
Washington Council for Behavioral Health Trade associationOppose The Washington Council for Behavioral Health, representing over forty community behavioral health agencies, opposes the | · | · | · | · | · |
Wauconda Fire Protection District GovernmentOppose The Wauconda Fire Protection District, a local government fire/EMS organization, opposes the proposed rule to limit Grou | · | · | · | ||
West Metro Fire Protection District GovernmentSupport The West Metro Fire Protection District, a governmental fire district, urges CMS to protect the Ground Emergency Medical | · | · | · | ||
WestCare AdvocacyOppose WestCare, a national nonprofit behavioral health provider, opposes the proposed rule because it extends restrictive paym | · | · | · | · | · |
Win-Bur-Sew Fire Protection District GovernmentOppose Fire Chief Charles Cunningham of the Win-Bur-Sew Fire Protection District opposes the proposed rule limiting Ground Emer | · | · | |||
Woods System of Care BusinessSupport Woods System of Care, a population health management organization, supports the implementation of the proposed rule but | · | · | · | · | · |
Ada County Paramedics
GovernmentOppose
Gemt program funding
Medicaid reimbursement rates
Allen Parish Ambulance
BusinessOppose
Administrative burden and readiness
Medicaid reimbursement rate reductions
Ambulance District Asso of Missouri, Missouri Ambulance Assco, Missouri EMS Asso and the Missouri Fire Chiefs Assoc
Trade associationOppose
Gemt program funding
Medicaid reimbursement rates
Arbor Health
BusinessOppose
Aurora Fire Department
GovernmentOppose
Fire-based ems exemptions
Medicaid reimbursement rates
Administrative burden and readiness
Beecher Fire Protection District
GovernmentOppose
Medicaid reimbursement rates
Administrative burden and readiness
Medicaid reimbursement rate reductions
Bennington Rescue Squad
AdvocacyOppose
Medicaid reimbursement rates
Burney Fire Protection District
GovernmentOppose
Gemt program funding
Fire-based ems exemptions
California Fire Chief Associations
Trade associationOppose
Gemt program funding
Fire-based ems exemptions
California Professional Firefighters
UnionOppose
Fire-based ems exemptions
Medicaid reimbursement rates
Administrative burden and readiness
Cascade Rural Fire Protection District
GovernmentOppose
Gemt program funding
Medicaid reimbursement rates
Cathedral City Fire & EMS
GovernmentOppose
Gemt program funding
Fire-based ems exemptions
Cedarburg Fire Department
GovernmentOppose
Gemt program funding
Medicaid reimbursement rates
CENCAL Fire & EMS Authority
GovernmentOppose
Gemt program funding
Fire-based ems exemptions
Medicaid reimbursement rates
City of Alameda Fire Department
GovernmentOppose
Gemt program funding
Fire-based ems exemptions
City of Albany Fire Department
GovernmentOppose
City of Berkeley Fire Department
GovernmentOppose
Gemt program funding
Fire-based ems exemptions
City of Carlsbad
GovernmentOppose
Gemt program funding
Fire-based ems exemptions
City of Des Plaines Fire Department
GovernmentOppose
Gemt program funding
Fire-based ems exemptions
Medicaid reimbursement rates
City of Dinuba Fire Department
GovernmentOppose
Gemt program funding
Fire-based ems exemptions
City of Fullerton - Fire Department
GovernmentOppose
Gemt program funding
Fire-based ems exemptions
City of Glendale Fire Department
GovernmentOppose
Gemt program funding
Fire-based ems exemptions
City of Gonzales Fire Department
GovernmentOppose
Fire-based ems exemptions
Medicaid reimbursement rates
Administrative burden and readiness
City of Indian Wells
GovernmentOppose
Gemt program funding
Fire-based ems exemptions
City of Naperville
GovernmentOppose
Medicaid reimbursement rates
Administrative burden and readiness
City of Petaluma Fire Department
GovernmentOppose
Gemt program funding
Fire-based ems exemptions
Medicaid reimbursement rates
City of San José
GovernmentOppose
Gemt program funding
Fire-based ems exemptions
Medicaid reimbursement rates
City of South Pasadena Fire Department
GovernmentOppose
Gemt program funding
Fire-based ems exemptions
City of Sterling Heights Fire Department
GovernmentOppose
Gemt program funding
Medicaid reimbursement rates
Colorado Springs Fire Department
GovernmentSupport
Gemt program funding
Fire-based ems exemptions
Community Behavioral Health Association of Maryland
AdvocacyOppose
Coulee Medical Center
BusinessOppose
Crested Butte Fire Protection District
GovernmentSupport
Medicaid reimbursement rates
Administrative burden and readiness
Medicaid reimbursement rate reductions
East Baton Rouge Parish Department of Emergency Medical Services (EBREMS)
GovernmentOppose
Administrative burden and readiness
Emergency Medical Services Association of Colorado
Trade associationSupport
Gemt program funding
Fire-based ems exemptions
Essentia Health
BusinessOppose
Administrative burden and readiness
Medicaid reimbursement rate reductions
Falcon Fire Protection District
GovernmentSupport
Fire-based ems exemptions
Medicaid reimbursement rates
Administrative burden and readiness
Fayette County Ambulance
BusinessOppose
Administrative burden and readiness
Medicaid reimbursement rate reductions
Fire Districts Association of California
Trade associationOppose
Gemt program funding
Fire-based ems exemptions
Medicaid reimbursement rates
fire-based EMS organization
GovernmentOppose
Medicaid reimbursement rates
Administrative burden and readiness
Florida Behavioral Health Association
AdvocacyOppose
Foothill Fire Chiefs Association
Trade associationOppose
Gemt program funding
Fire-based ems exemptions
Fremont Fire Department
GovernmentOppose
Gemt program funding
Fire-based ems exemptions
Glen Ellyn Volunteer Fire Co.
GovernmentOppose
Gemt program funding
Medicaid reimbursement rates
Administrative burden and readiness
Glendale Firefighters Association Local 776
UnionOppose
Gemt program funding
Fire-based ems exemptions
Medicaid reimbursement rates
IAFC (International Association of Fire Chiefs)
Trade associationOppose
Gemt program funding
Fire-based ems exemptions
Imagine Pediatrics
AdvocacySupport
Indiana Council of Community Mental Health Centers
Trade associationOppose
Joliet Fire Department
GovernmentOppose
Medicaid reimbursement rates
Administrative burden and readiness
Kit Carson County Ambulance Service
GovernmentOppose
Fire-based ems exemptions
Medicaid reimbursement rates
Administrative burden and readiness
La Grange Fire Department
GovernmentOppose
Fire-based ems exemptions
Medicaid reimbursement rates
Administrative burden and readiness
Laguna Beach Fire Department
GovernmentOppose
Gemt program funding
Fire-based ems exemptions
Medicaid reimbursement rates
Lansing Fire Department
GovernmentOppose
Gemt program funding
Medicaid reimbursement rates
Lemont Fire Protection District
GovernmentOppose
Medicaid reimbursement rates
Administrative burden and readiness
Lewiston Fire Department
GovernmentOppose
Gemt program funding
Medicaid reimbursement rates
Administrative burden and readiness
Livermore-Pleasanton Fire Department
GovernmentOppose
Gemt program funding
Fire-based ems exemptions
Medicaid reimbursement rates
Lockport Township Fire Protection District
GovernmentOppose
Gemt program funding
Fire-based ems exemptions
Medicaid reimbursement rates
Manhattan Fire Protection District
GovernmentOppose
Medicaid reimbursement rates
Medicaid reimbursement rate reductions
Marion County Ambulance
BusinessOppose
Administrative burden and readiness
Medicaid reimbursement rate reductions
Maryland Behavioral Health Coalition
AdvocacyOppose
Massachusetts Call/Volunteer Firefighters Association, Inc. (MCVFA)
AdvocacyOppose
Fire-based ems exemptions
Mehlville Fire Protection District
GovernmentOppose
Medicaid reimbursement rates
Administrative burden and readiness
Mendocino County Fire Chiefs Association
Trade associationOppose
Gemt program funding
Fire-based ems exemptions
Mid-Columbia Fire & Rescue
GovernmentOppose
Fire-based ems exemptions
Medicaid reimbursement rates
Medicaid reimbursement rate reductions
Mid-County EMS
BusinessOppose
Gemt program funding
Medicaid reimbursement rates
Minnesota Hospital Association
Trade associationOppose
Mississippi Ambulance Alliance
Trade associationSupport
Administrative burden and readiness
Montgomery County Fire and Rescue Service
GovernmentOppose
Gemt program funding
Fire-based ems exemptions
National City Fire Department
GovernmentOppose
Gemt program funding
New Jersey Association of Mental Health and Addiction Agencies
Trade associationOppose
New Lenox Fire Protection District
GovernmentOppose
Gemt program funding
Medicaid reimbursement rates
Administrative burden and readiness
New York State Council for Community Behavioral Healthcare
AdvocacyOppose
Newport Beach Fire Department
GovernmentOppose
Gemt program funding
Fire-based ems exemptions
Medicaid reimbursement rates
North County Fire Protection District
GovernmentOppose
Gemt program funding
Fire-based ems exemptions
Oceanside Fire Department
GovernmentOppose
Gemt program funding
Fire-based ems exemptions
Onvida Health Yuma Medical Center
BusinessSupport
Orland Fire Protection District
GovernmentOppose
Gemt program funding
Fire-based ems exemptions
Medicaid reimbursement rates
Palatine Fire Department
GovernmentOppose
Gemt program funding
Fire-based ems exemptions
Medicaid reimbursement rates
Palos Heights Fire Protection District
GovernmentOppose
Medicaid reimbursement rates
Administrative burden and readiness
Pasadena Fire Department
GovernmentOppose
Gemt program funding
Fire-based ems exemptions
Paso Robles Professional Firefighters Local 4148
UnionOppose
Gemt program funding
Fire-based ems exemptions
Polson Ambulance Inc
BusinessSupport
Medicaid reimbursement rate reductions
Prospect Heights Fire Protection District
GovernmentOppose
Gemt program funding
Medicaid reimbursement rates
PWW Advisory Group
BusinessOppose
Gemt program funding
Medicaid reimbursement rates
Regional One Health
BusinessOppose
Richmond University Medical Center
BusinessSupport
Richton Park Fire Department
GovernmentOppose
Medicaid reimbursement rates
Administrative burden and readiness
River Forest Fire Department
GovernmentOppose
Administrative burden and readiness
Riverside County Fire Dept.
GovernmentOppose
Gemt program funding
Fire-based ems exemptions
San Diego Fire-Rescue Department
GovernmentOppose
Fire-based ems exemptions
Medicaid reimbursement rates
Administrative burden and readiness
San Marcos Fire Department
GovernmentOppose
Gemt program funding
Fire-based ems exemptions
San Ramon Valley Fire Protection District
GovernmentOppose
Gemt program funding
Fire-based ems exemptions
Santa Rosa Fire Department
GovernmentSupport
Gemt program funding
Fire-based ems exemptions
Skokie Fire Department
GovernmentOppose
Medicaid reimbursement rates
Administrative burden and readiness
Sonoma Valley Fire District
GovernmentOppose
Gemt program funding
Fire-based ems exemptions
South Coast Fire Protection District
GovernmentOppose
Fire-based ems exemptions
Medicaid reimbursement rates
Medicaid reimbursement rate reductions
South Elgin and Countryside Fire Protection District
GovernmentOppose
Gemt program funding
Fire-based ems exemptions
Medicaid reimbursement rates
Southern Paramedic Service, Inc.
BusinessSupport
Administrative burden and readiness
Stryker
BusinessOppose
Administrative burden and readiness
Sycuan Fire Department
GovernmentOppose
Gemt program funding
Fire-based ems exemptions
Temple University Health System
BusinessOppose
Tennessee Association of Mental Health Organizations
Trade associationOppose
Thompson Valley Emergency Medical Services
GovernmentSupport
Gemt program funding
Medicaid reimbursement rate reductions
Truckee Meadows Fire Protection District
GovernmentOppose
Gemt program funding
Fire-based ems exemptions
Medicaid reimbursement rates
Ukiah Valley Fire Authority
GovernmentOppose
Gemt program funding
Fire-based ems exemptions
Ute Pass Regional Health Service District
GovernmentOppose
Fire-based ems exemptions
Medicaid reimbursement rates
Medicaid reimbursement rate reductions
Village of Bolingbrook
GovernmentOppose
Gemt program funding
Medicaid reimbursement rates
Village of Downers Grove
GovernmentOppose
Gemt program funding
Medicaid reimbursement rates
Administrative burden and readiness
Village of Matteson Fire Department
GovernmentOppose
Medicaid reimbursement rates
Administrative burden and readiness
Village of Oak Park Fire Department
GovernmentOppose
Gemt program funding
Medicaid reimbursement rates
Village of Villa Park Fire Department
GovernmentOppose
Gemt program funding
Fire-based ems exemptions
Medicaid reimbursement rates
Village of Western Springs
GovernmentOppose
Medicaid reimbursement rates
Administrative burden and readiness
Vista Fire Rescue
GovernmentOppose
Gemt program funding
Fire-based ems exemptions
Washington Council for Behavioral Health
Trade associationOppose
Wauconda Fire Protection District
GovernmentOppose
Medicaid reimbursement rates
Administrative burden and readiness
West Metro Fire Protection District
GovernmentSupport
Gemt program funding
Fire-based ems exemptions
WestCare
AdvocacyOppose
Win-Bur-Sew Fire Protection District
GovernmentOppose
Gemt program funding
Medicaid reimbursement rates
Administrative burden and readiness
Woods System of Care
BusinessSupport
10 organization-typed comments could not be identified.
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- Jul 21, 2026Massachusetts Call/Volunteer Firefighters Association, Inc. (MCVFA)OpposeAdvocacy📎 Attachment
Joseph V. Maruca, representing the MCVFA, opposes the proposed rule because it would reduce payments to small, volunteer, and non-profit EMS agencies in rural areas. He argues that these organizations are already underfunded and that reducing reimbursements will exacerbate "Ambulance Deserts" and decrease the quality of patient care.
Read comment → - Jul 21, 2026Emergency Medical Services Association of ColoradoSupportTrade association📎 Attachment
The Emergency Medical Services Association of Colorado (EMSAC) supports the proposed rule's intent to preserve cost-reconciled payments but urges CMS to provide explicit language and guidance to protect governmental and volunteer EMS programs. They argue that these programs perform essential public-safety functions and require clear exemptions from targeted payment limits to ensure the stability of emergency medical services.
Read comment → - Jul 21, 2026Foothill Fire Chiefs AssociationOpposeTrade association📎 Attachment
The Foothill Fire Chiefs Association opposes the proposed cap on Ground Emergency Medical Transportation (GEMT) supplemental payments, arguing that a uniform national limit fails to account for the high costs of providing fire-based EMS in the Los Angeles region. They request that CMS exempt governmental, volunteer, and 501(c)(3) fire-based EMS agencies that operate under approved, cost-reconciled GEMT programs.
Read comment → - Jul 20, 2026Fire Districts Association of CaliforniaOpposeTrade association📎 Attachment
The Fire Districts Association of California opposes the proposed rule capping Ground Emergency Medical Transportation (GEMT) supplemental payments at Medicare Ambulance Fee Schedule rates. They argue that these caps threaten the financial sustainability of fire-based EMS agencies and request an exemption for governmental, volunteer, and 501(c)(3) fire-based EMS agencies.
Read comment → - Jul 17, 2026International Association of Fire FightersOpposeUnion📎 Attachment
The International Association of Fire Fighters (IAFF) opposes the proposed rule to limit supplemental, state-directed Medicaid payments for governmental fire departments and EMS agencies. They argue that these payments are critical for maintaining emergency response capabilities and urge CMS to exempt these agencies from the caps and instead reform the Ambulance Fee Schedules to reflect actual costs.
Read comment → - Jul 17, 2026Kit Carson County Ambulance ServiceOpposeGovernment📎 Attachment
Shane Dixon, EMS Director for Kit Carson County Ambulance Service, opposes the proposed rule because it threatens supplemental Medicaid funding for Ground Emergency Medical Transportation (GEMT) programs. He argues that these funds are essential for maintaining emergency response readiness in rural areas and requests a broad exemption for governmental, volunteer, and 501(c)(3) fire-based EMS agencies.
Read comment → - Jul 17, 2026California Fire Chief AssociationsOpposeTrade association📎 Attachment
The California Fire Chiefs Association opposes the proposed rule capping Ground Emergency Medical Transportation (GEMT) supplemental payments at Medicare Ambulance Fee Schedule rates. They argue that these caps threaten the financial sustainability of fire-based EMS agencies and request an exemption for governmental, volunteer, and 501(c)(3) fire-based EMS agencies.
Read comment → - Jul 15, 2026Lincolnshire-Riverwoods Fire Protection DistrictOpposeGovernment📎 Attachment
Tom Krueger, Fire Chief of the Lincolnshire-Riverwoods Fire Protection District, opposes the proposed rule to limit Ground Emergency Medical Transportation (GEMT) supplemental payments to the Medicare Ambulance Fee Schedule. He argues that the Medicare schedule does not reflect the actual costs of maintaining 24/7 emergency readiness and that reducing these payments would threaten the district's ability to provide essential services to Medicaid beneficiaries.
Read comment → - Jul 14, 2026Fremont Fire DepartmentOpposeGovernment
Zoraida Diaz, Fire Chief of the Fremont Fire Department, opposes the proposed rule because capping Ground Emergency Medical Transportation (GEMT) supplemental payments at Medicare Ambulance Fee Schedule rates would undermine the financial viability of fire-based EMS systems. The commenter argues that these caps would lead to reduced ambulance availability, delayed equipment replacement, and compromised patient outcomes in their community.
Read comment → - Jul 13, 2026Mendocino County Fire Chiefs AssociationOpposeTrade association📎 Attachment
The Mendocino County Fire Chiefs Association opposes the proposed rule because it would cap Ground Emergency Medical Transportation (GEMT) supplemental payments at Medicare Ambulance Fee Schedule rates. They argue that these payments are essential for maintaining rural EMS systems, which currently operate at a loss and rely on local tax subsidies.
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