NIOSH Update
On May 14, Robert F. Kennedy, Jr., the U.S. Secretary of Health and Human Services (HHS) testified before the House Appropriations Committee. On May 13, the staff of the Federal Fire Fatality Investigation and Prevention Program (FFFIPP) were informed that they were not going to be part of the June 2 reduction in force. At this time, it looks like the FFFIPP staff have been fully restored to their employment with HHS.
In addition, the National Firefighter Registry for Cancer (NFR) was back online. Nearly 24,000 firefighters have enrolled in the national registry. However, it is important to enroll more firefighters into the registry to demonstrate its importance to America’s fire and emergency service. If you have not enrolled in the system, please take approximately 30 minutes and enroll now!
Fire and EMS Provisions in the Pending Trump Tax Legislation
The U.S. House of Representatives continues to work on a reconciliation bill to extend President Trumps’s 2017 tax cuts and increase funding for operations to protect the U.S. border. This week, the House Energy and Commerce Committee marked up legislation to pay for the tax cuts, while the House Ways and Means Committee marked up its tax cut bill.
Summary
The House Energy and Commerce Committee
The House Energy and Commerce Committee’s legislation covered energy, environment, communications, and health issues. The legislation would give the Federal Communications Commission (FCC) authority to auction off radio spectrum. The FCC has been without this authority since 2023. The goal for the committee is to raise $88 billion dollars over the next nine years, with that money being used to help pay for border security and the Trump 2017 tax cuts. The federal FirstNet Authority’s system would not be affected.
The legislation also focused heavily on Medicaid eligibility determinations, fraud prevention, beneficiary verification, enrollment processes, provider screening, and pharmacy reimbursement reforms. It does not modify Medicaid supplemental payment structures or reference cost-reimbursement programs for EMS like Ground Emergency Medical Transport (GEMT) programs.
The text does include aspects that may affect fire-based EMS through a reduction of those on Medicaid:
- Stricter Medicaid Eligibility Rules: The bill would increase verification requirements for Medicaid recipients, including monthly cross-state enrollment checks, work requirements, address verification, and quarterly screenings for deceased enrollees. Complications/hiccups in this process could lead to a decrease in Medicaid-covered patients transported by EMS.
- More Frequent Redeterminations: States would be required to redetermine eligibility for expansion of adults under the ACA every 6 months, starting in 2027. This may increase uninsured transports and present billing challenges for fire-based EMS agencies.
- New Screening Requirements for Providers: Medicaid providers must undergo more frequent exclusion screenings, including checks against federal death records and provider termination lists. This does not directly impact fire departments, but third-party billing vendors that are used by fire-based EMS may be affected.
- Limits on Retroactive Medicaid Coverage: Coverage for services prior to Medicaid application would be shortened from 3 months to 1 month. EMS transports provided before a patient’s application may not be reimbursed depending on how long before their application they received care.
- Moratorium on Long-Term Care Staffing Rule: The text would force the Centers for Medicare and Medicaid Services (CMS) to put a pause on implementing their proposed rule aimed at increasing staffing levels at nursing homes and other long-term care facilities. While not directly aimed at EMS, fire-based EMS systems will bear the brunt of having to care for and transport patients from these facilities to the hospital when their condition deteriorates.
- PBM Reform: The bill would target Pharmacy Benefit Managers (PBM) and bring increased oversight on drug pricing. This may be helpful in lowering the costs of some drugs carried by ALS providers.
The House Ways and Means Committee
The House Committee on Ways and Means also marked up the tax legislation to be included in the reconciliation bill. The text would renew the 2017 Tax Cuts and Jobs Act (P.L. 115-97) and would include several of President Trump’s campaign priorities. One provision would eliminate federal income tax on overtime through 2028. This exception will not apply to those who qualify as “highly compensated employees” by the IRS. In the tax year 2025, it is estimated that “highly compensated employees” are those who earn over $150,000.
The next step for the House reconciliation bill is for the House Budget Committee to vote to consolidate all the other House committees’ inputs into one bill for consideration by the full House. Please ask your Members of Congress to add the High Rise Sprinkler Incentive Act (H.R. 173/S. 504) to this reconciliation bill.
U.S. Senate Advances Bill expanding Public Safety Officer Benefits for Cancer
On May 15, the Senate Judiciary Committee marked up and advanced the Honoring Our Fallen Heroes Act (S. 237). The bill would expand the Public Safety Officers’ Benefits program to provide benefits for the families of fire and EMS personnel that die (or become disabled) from cancer caused by job-related exposures. The bill next must be passed by the full Senate. The House has yet to act on its companion bill (H.R. 1269). The IAFC will continue to ask Congress to pass this legislation.
Fire Service Testifies on Wildland Fire Issues
On May 15, the House Natural Resource Committee’s Subcommittee on Oversight and Investigations held a hearing titled “Fix Our Forests: How Improved Land Management Can Protect Communities in the Wildland-Urban Interface.” Oversight Hearing | Oversight and Investigations Subcommittee | House Committee on Natural Resources. Chief Dan Munsey of the San Bernardino County (CA) Fire Protection District and Wildland Fire Captain Neil Chapman of the Flagstaff (AZ) Fire Department testified about the importance of coordinated efforts to treat public lands in preventing wildland fires. The House passed the Fix Our Forests Act (H.R. 471) on January 23. The IAFC endorsed the Senate companion bill (S. 1462), which was referred to the Senate Agriculture, Nutrition, and Forestry Committee.
The IAFC Government Relations & Policy Department produces The Washington Update on a weekly basis.