VILONIA, Ark. — As the U.S. government shutdown enters its 22nd day, Arkansas first responders are evaluating potential impacts on 911 response.
Ken Kelley, president and CEO of ProMed Ambulance and government affairs chair for the Arkansas Ambulance Association, said most Arkansas ambulance services rely on Medicare for 50–60% of their revenue, THV11 reported.
During the shutdown, the Centers for Medicare & Medicaid Services (CMS) temporarily held claims processing for ground ambulance transports and other services.
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On Oct. 21, CMS announced it had instructed Medicare Administrative Contractors to lift that hold and begin processing claims dated Oct. 1 and later for services paid under the Medicare Physician Fee Schedule, including ground ambulance transport claims. However, ambulance leaders say the delay has already created cash flow challenges.
“Providers are now receiving reduced payments. We’re actually receiving no payments currently,” Kelley said. “This could mean the possibility that units aren’t staffed because they can’t pay their employees. The units may not be able to be staffed because the service can’t afford to do critical maintenance to keep them road worthy to respond in their communities.”
Rural and super-rural areas are hit hardest: Medicare add-on payments that offset low call volumes expired Sept. 30, 2025, contributing to longer response times, fewer available ambulances and added strain on first responders. The ripple effects reach hospitals, slowing transfers from rural facilities to specialty centers. Many ambulance services are tapping cash reserves just to stay open.
“Like any other business, if they don’t have the cash to operate, they close their doors. That leaves that community with a gap,” Kelley said. “I would just encourage every citizen to be engaged with what’s going on in your ambulance service. Talk to your ambulance provider, talk to your health leaders in your community, and most importantly, talk to your elected representatives and let them know that EMS is an essential, vital service needs to be properly funded because we are there for the community.”
