The United New York Ambulance Network (UNYAN) urges the New York State
Legislature to take bold action in 2026 to modernize the laws governing Emergency
Medical Services (EMS) to ensure financial sustainability, strengthen oversight, and
define EMS as a core healthcare and public safety function.
- Sustainable Reimbursement Reform
EMS agencies cannot survive without stable funding. Medicaid rates cover only a
fraction of operating costs and force agencies to subsidize services. Private insurance
payments are inconsistent and inadequate. UNYAN calls for:
- Increased Medicaid reimbursement to meet the actual cost of service delivery.
- Legislation reform requiring fair and sustainable reimbursement from
commercial insurers. - Access to federal and state transformation funds (OBBA/HR1) to support
rural EMS workforce, infrastructure, and innovation.
- Definition of EMS in Article 30
The law must reflect the full scope of EMS as it is provided today. UNYAN supports
amending Article 30 to read:
“Emergency medical service means a coordinated system of
interoperable healthcare response, assessment, treatment,
transportation, emergency medical dispatch, medical direction, and
practitioner education that provides emergency and non-emergency
care and transportation for the ill and injured and enhances
preparedness and mitigates risks to the public.”
That definition appropriately and accurately describes EMS as healthcare,
transportation, and public safety combined, guiding future policy and investment. - Regulation of Public Safety Answering Points (PSAPs)
911 dispatch centers are the first link in the chain of care. Operations vary widely,
resulting in delays and inconsistent care throughout New York State. UNYAN calls
for legislation to:
- Require PSAPs to utilize emergency medical dispatch (EMD) and priority
dispatch protocols statewide. - Require PSAPs to record and report all calls received, units dispatched, and
units that responded. - Follow established performance benchmarks to improve response and patient
outcomes.
- Regulation of BLS First Response Agencies
Basic Life Support (BLS) first response agencies increasingly provide advanced
optional interventions without consistent oversight. To ensure patient safety and
appropriate system integration, UNYAN calls for legislation to:
- Regulate BLS agencies that perform optional interventions (e.g., CPAP,
supraglottic airway). - Require electronic patient care reporting (ePCR) and participation in state
data systems. - Include tiered response and appropriate resource allocation to match system
needs.
Conclusion
New York’s EMS system is at a breaking point. Sustainable funding, clear
definitions, and smart regulation will ensure EMS remains reliable and responsive
to every community. These reforms are not optional; they are essential to protect
public health and safety.