Small rural ambulance services health care gross receipts taxes exemption provision

This bill exempts qualifying small rural ambulance services from Minnesota's health care gross receipts tax. It directly affects ambulance services operating outside major cities (like Duluth and Rochester) and metropolitan counties, with annual revenues of $10 million or less. The exemption applies to services meeting both location and revenue criteria, effective January 1, 2026, or after federal approval of the tax change. Federal approval is required for implementation, with the state human services commissioner responsible for seeking it.