Major Milestone: Congressional Letter Sent to CMS on Prescriptive PCS

By: Alexandra Hembrough, Esq., General Counsel, SGS

We are so excited and proud to announce a significant win for the EMS and ground ambulance industry. Over the past six months, Solutions Group, alongside multiple industry partners in an initiative we named the EMS Sustainability Initiative, has been working to build congressional support for a change that would strengthen Medicare’s Physician Certification Statement (PCS) requirement for Non-Emergency Ambulance Transportation (NEAT). On September 18, 2026, that effort culminated in a formal letter to CMS Administrator, Dr. Mehmet Oz, authored by Senator Joni Ernst (IA) and co-signed by Senator Jim Banks (IN), urging CMS to consider requiring the PCS to be a prescribed order – signed by a physician, nurse practitioner, or physician assistant – rather than an informal certification. The letter points to states like Louisiana and Illinois who have already adopted similar prescriptive PCS requirements for their Medicaid programs, offering CMS a proven model to consider at the federal level. 

This milestone represents real momentum for the EMS industry: a prescriptive PCS would not only increase compliance and program integrity, but also support CMS’s broader fight against fraud, waste, and abuse by ensuring Medicare beneficiaries are matched with the appropriate, medically necessary level of transportation. None of this would have been possible without the dedication of our initiative partners and the tireless work of our lobbying team at Ballard Partners who helped carry this effort from concept to congressional action. We are grateful for their partnership and enthusiastic to see how CMS responds in the months ahead.