EMS One-Stop

• EMS shutdown survival: What leaders need to know now

  From Medicare cuts to billing delays, Asbel Montes joins Rob Lawrence to share practical strategies EMS agencies can use to weather the reimbursement storm In this episode of the EMS One-Stop podcast, we tackle the fast-moving realities of a federal shutdown and what it means for EMS finance, reimbursement and day-to-day operations. Rob Lawrence sits down with Solutions Group’s Asbel Montes — a veteran of EMS reimbursement and policy expertise — to decode where Congress is (and isn’t), what CMS’s temporary claims hold really means, and how ambulance services can protect cash flow while preparing for potential reprocessing chaos if extenders aren’t promptly restored. Beyond the headlines, Montes lays out a pragmatic playbook: build a Plan B for cash continuity, align with your billing team on reprocessing workflows, and model exposure across payers tied to the Medicare fee schedule. The conversation then widens to balance billing — why federal change is unlikely soon and why state-level action is delivering practical protections — before closing with leadership lessons on adaptation, data and telling EMS’s story as a guide, not the hero. Memorable quotes from Asbel Montes “Our extender expired — that’s that additional payment that we get from Medicare of that 2%, 3%, 22.6% — it expired September the 30th, and it was tied to the House-approved CR that went over to the Senate.” “We’re solutions givers, as we say here at Solutions Group, not crisis managers. And if you have a plan, I can at least execute a plan.” “What turned out to be a smaller amount, now the cost associated with it, you started to really understand the complexities that really happened in people’s AR.” “If this lasts longer than 15 days … then I would basically have a plan in place. So I would be trying to find out from my billing team … what is your contingency plan to ensure I don’t see a hiccup in cash moving forward?” “The only way government can really invoke change is to make it hit where it hurts. And that’s what’s going on right now. They’re hitting the pocketbook and our industry is grappling with it right now.” Additional resources Asbel Montes: The government shutdown’s ripple effect on healthcare The Leadership Lab with Asbel Montes Episode timeline & key moments 00:21 – Why the shutdown matters to EMS reimbursement and operations 01:21 – Montes’s 101: role at Solutions Group; 28 years in EMS finance and policy 02:40 – Historical context: number and length of shutdowns; current Hill outlook 03:48 – The ambulance extenders expired (2% urban, 3% rural, 22.6% super-rural); CMS claims hold window 05:03 – Planning posture: realistic timelines; “we’re solutions givers, not crisis managers” 06:12 – Back-of-the-napkin math: short-term dollars vs. long-term reprocessing burden 07:43 – 2015–2016 déjà vu: retroactive fixes and the heavy lift for back-office AR 10:26 – Secondary impacts: VA eligibility, appeals, enrollments during a prolonged shutdown 11:11 – The “three-legged stool” for leaders: (1) have a plan with billing; (2) reconcile accounts & patient balances; (3) prevent cash-flow lag if more than15 days 14:06 – Framing the moment: “hurricane shutdown” response and recovery mindset 15:43 – Balance billing at the federal level: committee work, political pain and why movement is unlikely soon 18:19 – State action wins: consumer protections and access; examples of Medicare-indexed approaches 20:24 – Why ground ambulance stayed out of federal NSA; local regulation and state primacy 22:42 – “All politics are local”: using EMS’s public visibility to advocate for patients and providers 23:09 – Adaptation over preservation: seize the 6-18 month window; let data and clinicians lead reform 27:13 – Lawrence’s “Darwinism” takeaway: adaptation as survival 28:31 – The Leadership Lab podcast: purpose, cadence and upcoming guests; Montes’s leadership journey Rate and review the EMS One-Stop podcast Enjoying the show? Please take a moment to rate and review us on Apple Podcasts. Contact the EMS One-Stop team at [email protected] to share ideas, suggestions and feedback. Listen on Apple Podcasts, Amazon Music, Spotify and RSS feed.

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• Rainn Wilson on ‘Code 3’ and the brutal beauty of EMS life

  In this episode of the EMS One-Stop podcast, our host, Rob Lawrence, sits down with Hollywood actor Rainn Wilson, who stars as Randy in “Code 3.” Known worldwide for his role as Dwight Schrute in The Office, Wilson has stepped into the world of EMS, portraying the life of a burned-out paramedic with both grit and humor. In the conversation, Wilson reflects on the process of bringing this story to life, his ride-along experiences in Los Angeles, and the powerful realities he uncovered about our profession. More than just a performance, Rainn has become an unexpected advocate for EMS. He speaks candidly about the underfunding of frontline providers, the emotional toll of the work and the sheer humanity that comes with being welcomed into people’s lives during their most vulnerable moments. Alongside the serious themes, he reminds us that Code 3 is also a comedy — one that captures the gallows humor, camaraderie and resilience medics carry with them on every shift. | MORE: Why ‘Code 3’ might be the most honest EMS film yet. From a ticking salary counter to fourth-wall confessions, this EMS road movie isn’t just another Hollywood take. It’s a love letter, a warning and a mirror. Memorable quotes from Rainn Wilson “Most of all, I just fell in love with the character of Randy.” “Bottom line, the fact that first responders are getting basically what people that work at Starbucks are getting paid really blew my mind.” “Well, one thing I never thought of, maybe stupidly so, is how vulnerable everything is because you're going into people's homes and they're in crisis.” “I think Rob, no one should be allowed to graduate from high school without their kind of basic CPR training.” “Everything about EMS — the tone, the vibe, the gallows humor, certainly all the technical medical elements, the burnout, the camaraderie, the idea that there's a mission here — they do it because they love it.” “Well, it was an honor to learn about this world and to make a movie that these workers are excited about and proud of.” “I want to say from the bottom of my heart, you know, ‘thank you. Thank you for your work. And, you know, I think it's grossly underappreciated, but, you know, America needs you.’” Episode timeline 00:26 – Rainn Wilson on the vulnerability of entering people’s homes in crisis 00:57 – “All we want to do is save your life. Some of you don’t make it easy.” 02:53 – Rainn’s first impressions of the “Code 3” script 03:38 – Falling in love with the character of Randy 04:22 – Discovering the realities of EMS work and shocking pay disparities 06:09 – Lessons from Wilson’s Los Angeles ride-along 10:12 – Wilson on CPR training and why everyone should learn it 12:29 – “We’re essentially a tube and a pump.” 13:11 – Rehearsals and the importance of portraying EMS medicine accurately 15:09 – On burnout, PTSD and the need to support medics’ mental health 18:08 – Using “Code 3” salary comparison as an advocacy tool 19:07 – Wilson praises Rob Riggle’s ED doctor role and its realism 20:41 – Cherishing the chance to shed light on EMS 21:10 – Reminder that the film is also a comedy — “a good old time with a bucket of popcorn” 22:25 – Final message: “America needs you. Keep saving lives.” Rate and review the EMS One-Stop podcast Enjoying the show? Please take a moment to rate and review us on Apple Podcasts. Contact the EMS One-Stop team at [email protected] to share ideas, suggestions and feedback. Listen on Apple Podcasts, Amazon Music, Spotify and RSS feed.

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• Burnout, bravery and gratitude: The story behind ‘Code 3’

  In this episode of the EMS One-Stop podcast, host Rob Lawrence sits down with Patrick Pianezza, co-writer of the new EMS film “Code 3”, a deeply honest and compelling portrayal of life on the ambulance. The film stars Rainn Wilson (“The Office”), Lil Rel Howery (“Free Guy”) and Aimee Carrero (“Elena of Avalor”), delivering a powerful performance that captures both the pressures and the humanity of EMS work. Using real-world experiences and stories from the field, “Code 3” highlights the passion, dedication and emotional toll experienced by EMS professionals every day. From burnout, to systemic challenges, the movie invites the public into the high-stakes world of emergency medical services, showing both the challenges and the heart behind the uniform. Patrick and Rob discuss not only the storytelling process, but also the personal experiences that informed the movie. Pianezza candidly shares the emotional toll of EMS work, the reality of burnout and the importance of mental health support for first responders. This episode is both a celebration of the dedication of those who serve in 911 and a call for awareness and gratitude for the vital work they perform. “Code 3” opens in selected cinemas on Sept. 12, 2025. Memorable quotes “I remember going to one of my old bosses and saying, ‘I think I'm burning out.’ The reaction I got was this dark chuckle … ‘We're all burnt out. Get back on the truck.’ That kind of festering mentality is not healthy.” — Patrick Pianezza “Six out of six people that I have worked with have unfortunately [died by] suicide, and the suicide rates for first responders is double that of the regular population … which is a statistic we need to fix.” — Patrick Pianezza “And it is … a good representation of life on the truck, on the street, with a guy who’s clearly burned out; but a person that cares, that has passion, commitment and will always do the right thing.” — Patrick Pianezza “There was no way to confront the story without talking about salaries, without talking about reimbursements … No one's gonna see a movie about Medicare, Medicaid, but we are as honest as we can be.” — Patrick Pianezza “This movie is nothing more than a gratitude tour for everyone who works in 911 … I’ll be a broken record here: thank you for what it is that you do because it matters. I’ve been in those boots and I’m here to tell you thank you.” — Patrick Pianezza “And as I say in my review, those who know me know my ability to take tactical naps during movies. Well, this one got two eyes open and absolutely five stars.” — Rob Lawrence Episode timeline 00:00 – Introduction: Rob Lawrence introduces Patrick Pianezza and the film “Code 3” starring Rainn Wilson 02:31 – Origins of “Code 3:” How the project started and the vision behind telling an authentic EMS story 05:01 – Creative team & casting: working with actors, crew and Rainn Wilson 08:01 – On-the-Street authenticity: translating real EMS experiences into the film 12:01 – Depicting burnout: emotional and mental challenges in EMS work 16:01 – Mental health & seeking help: Autobiographical elements and confronting burnout 20:01 – Systemic issues: salaries, Medicare, and Medicaid reimbursement challenges 24:01 – Impact on families & relationships: emotional toll beyond the job 27:01 – Personal reflection: Patrick’s journey, struggles and growth in EMS 29:01 – Gratitude tour: purpose of the film and acknowledging EMS professionals 32:01 – Closing thoughts: film release details, upcoming trailer and final messages of appreciation Enjoying the show? Send an email to [email protected] to share feedback or suggest guests for upcoming episodes. 

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• NEMSAC dismantled: Inside the fallout shaking federal EMS policy

  This breaking-news edition of EMS One-Stop dives straight into the announcement that the National EMS Advisory Council (NEMSAC) has been dissolved. Host Rob Lawrence is joined by Dr. Brandon Morshedi (NEMSAC chair-elect) and Brenden Hayden (immediate past chair), who explain what NEMSAC is, what it achieved and why its sudden dismissal has left the EMS community frustrated, concerned and searching for answers. Together, they outline the role of NEMSAC as the sole statutory advisory body connecting EMS to the federal executive branch, describe the hundreds of volunteer hours that went into shaping advisories, and discuss what happens now that years of hard work and documents have been pulled from EMS.gov. This episode sets the record straight, provides a clear explainer of the process, and captures the disappointment — yet determination — of leaders committed to moving EMS forward despite this setback. Additional resources: How NEMSAC is composed — who sits on the council and what types of expertise are represented The NEMSAC’s statutory role advice/briefings at the federal level NEMSAC’s key accomplishments Episode timeline 01:08 – Rob introduces the breaking news: NEMSAC dissolved 02:22 – What is NEMSAC? Brenden explains its statutory role 04:52 – How does NEMSAC differ from associations? Direct advisory to the executive branch 06:42 – Appointments, terms and how continuity usually worked 08:44 – The depth of work: meetings, subcommittees, advisories, letters 11:23 – Examples of major advisories and public comment process 14:27 – Shock: key advisories removed from EMS.gov 19:13 – Explainer: FICEMS and how advisories flow through federal government 26:25 – How members felt when dismissal was announced 30:18 – What happens to unfinished advisories and research 34:20 – Associations’ role in keeping the work alive 35:50 – The advisory each guest is most proud of 39:41 – Lessons learned: influence, unified voice, process 43:25 – Final reflections: leadership, advocacy, and what comes next Enjoying the show? Email [email protected] to share feedback or suggest guests for a future episode. 

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• CAAS GVS 4.0: Building safer, smarter and theft-proof ambulances

  In this episode of the EMS One-Stop podcast, host Rob Lawrence climbs back onto his soapbox to discuss two topics that directly impact on every EMS agency in America — the CAAS Ground Vehicle Standards (GVS) 4.0 and the simple, inexpensive steps we can take to stop ambulance theft. Joining Rob is longtime EMS leader and current CAAS GVS Administrator Mark Postma, who walks us through the origins of the standards, their national adoption and what’s new in the latest update. From ambulance remounting, to structural safety testing, Mark explains how GVS 4.0 has evolved to keep pace with manufacturing realities, supply chain delays and operational needs. The conversation then shifts to a shared passion for protecting fleet assets. Rob and Mark dissect the shockingly frequent problem of ambulance theft and how a $200 automatic immobilization device can prevent a $250,000 vehicle from disappearing — without relying on crews to remember to lock it. Additional resources: CAAS GVS V4.0 – Ground Vehicle Standard Commission on Accreditation of Ambulance Services (CAAS) – The New Standard in Mobile Healthcare Ambulance thefts in the U.S. surge: Over 40 stolen rigs in 18 months 6 ways to safety-proof your EMS fleet Memorable quotes "It’s no good going to City Council or to your board of directors on day 365 and saying, ‘I need a new truck for New Year day one’ — that’s not going to happen." — Rob Lawrence "The ground vehicle standard has become the standard that most vehicles are being built to and that state EMS officials are using." — Mark Postma "We spend a lot of time thinking about where things go in the box … add one more thing to your checklist: can the vehicle indeed be immobilized?" — Rob Lawrence "There’s just no reason why ambulances are being stolen with the current technology that’s out there." — Mark Postma Episode timeline 00:45 – Rob introduces the topic: GVS 4.0 and ambulance theft concerns 01:34 – Mark introduction and CAAS GVS role 04:11 – How the CAAS standards were developed and adopted by 35-plus states 06:09 – Comparing CAAS GVS to NFPA ambulance standards 06:48 – The rise of remounting, especially during COVID supply shortages 10:26 – Discussion of ongoing vehicle delivery delays and need for replacement planning 15:04 – What’s new in GVS 4.0 — major changes and safety structure updates 19:38 – Ambulance theft statistics and the GVS anti-theft requirement 22:28 – Automatic immobilization and why manual systems fail 23:57 – Mark shares success story: zero thefts since installing devices 26:17 – Exceptions in standards and why state inspectors must enforce anti-theft 27:42 – Final thoughts on making anti-theft part of fleet planning Enjoying the show? Email [email protected] to share feedback and suggest future guests. 

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