Moves to revamp how the U.S. government reimburses air ambulance operators for transporting and treating patients hinge on finalization of congressional cost estimates for the changes. Such "scoring" of estimates by the Congressional Budget Office are required to assess how proposed legislation would affect federal, state, local and private-industry spending. Common bills in the House of Representatives and the Senate (H.R. 822 and S.1149, respectively) argue that the federal Medicare insurance program's "air ambulance fee schedule has never reflected true costs." The bills propose to correct this. If enacted into law, they would require air ambulance providers to report on 15 categories of "basic operational costs," from aircraft operating expenses and communications to training and overhead support, to the U.S. Health and Human Services Department. That department, which oversees Medicare, and the Government Accountability Office would analyze that data and report to Congress on costs to use in Medicare rate adjustments. Once the bills are scored, proponents would have to come up with options for offsetting any increases to federal spending, since many members of Congress oppose such increases.