IMPROVED ACCESS TO AMBULANCE SERVICES.

SEC. 146. IMPROVED ACCESS TO AMBULANCE SERVICES.(a) Extension of Increased Medicare Payments for Ground Ambulance Services.—Section 1834(l)(13) of the Social Security Act (42 U.S.C. 1395m(l)(13)) is amended—(1) in subparagraph (A)—(A) in the matter preceding clause (i), by inserting “and for such services furnished on or after July 1, 2008, and before January 1, 2010” after “2007,”;(B) in clause (i), by inserting “(or 3 percent if such service is furnished on or after July 1, 2008, and before January 1, 2010)” after “2 percent”; and(C) in clause (ii), by inserting “(or 2 percent if such service is furnished on or after July 1, 2008, and before January 1, 2010)” after “1 percent”; and(2) in subparagraph (B)—(A) in the heading, by striking “2006” and inserting “applicable period”; and(B) by inserting “applicable” before “period”.(b) Air Ambulance Payment Improvements.—(1) Treatment of certain areas for payment for air ambulance services under the ambulance fee schedule.—Notwithstanding any other provision of law, for purposes of making payments under section 1834(l) of the Social Security Act (42 U.S.C. 1395m(l)) for air ambulance services furnished during the period beginning on July 1, 2008, and ending on December 31, 2009, any area that was designated as a rural area for purposes of making payments under such section for air ambulance services furnished on December 31, 2006, shall be treated as a rural area for purposes of making payments under such section for air ambulance services furnished during such period.(2) Clarification regarding satisfaction of requirement of medically necessary.—(A) In general.—Section 1834(l)(14)(B)(i) of the Social Security Act (42 U.S.C. 1395m(l)(14)(B)(i)) is amended by striking “reasonably determines or certifies” and inserting “certifies or reasonably determines”.(B) Effective date.—The amendment made by subparagraph (A) shall apply to services furnished on or after the date of the enactment of this Act.