115 of 120 Kentucky Counties Urge Lawmakers to Pass HB 447 to Protect Emergency Ambulance Access

FRANKFORT — In a powerful and unprecedented call to action, EMS leaders representing 115 of Kentucky’s 120 counties — more than 95% of the Commonwealth — have signed a joint letter urging the General Assembly to pass HB 447, legislation to modernize reimbursement for emergency ground ambulance services. The measure is also backed by 30 cosponsors from both parties, underscoring rare, broad-based agreement that stabilizing Kentucky’s EMS system is a public safety priority. The coordinated support from county leaders and a large number of bipartisan legislator’s marks one of the most significant unified calls for EMS reform in recent state history.

While Kentucky has 120 counties, only 118 currently operate or are served by a licensed ground ambulance service. Of those 118 counties, 115 have signed the letter in support of HB 447, meaning nearly every county with active ambulance service has joined the call for reform.

HB 447, sponsored by Rep. R. Raymer, would require health benefit plans to cover emergency ground ambulance services, establish a minimum reimbursement standard for out-of-network providers, prohibit balance billing and ensure timely payment to providers (effective January 1, 2027). Supporters say the urgency is clear: 91.7% of Kentucky counties have an “ambulance desert,” reimbursement rates have not been meaningfully updated in more than 20 years, and insurers often pay less than half of billed charges — in some counties, less than 10% — leaving local governments and taxpayers to subsidize 911 response. “Kentucky families deserve to know that when they call 911, help will come,” the letter states, framing the legislation as a commonsense, cross-party solution to protect patients and preserve access to lifesaving care statewide.

Ambulance service in Lawrence County is Patriot EMS (1675) with Director is Derek Manis; Johnson County is City of Paintsville Fire-Rescue EMS, with Director, Edgar Pack; Martin County is Patriot EMS with Director Derek Manis; Floyd County is Lifeguard Emergency Medical Services (1188) with Director Paul Phillips and Emergent Care EMS with Director William Lafferty; Magoffin County is currently without a dedicated ambulance service due to lack of reimbursements.