Got to love the Feds, always a day late and a dollar short; most large 135 EMS operators mandated their own restrictive measures years ago.
Air Methods itself imposed a no-fly ruke at night if Rad Alt not operational in the wake of the DC accident.
Mr.Lappos, your conclusions are partially incorrect regarding the WAAS approach, it's not too much work, it's too expensive and unless rendered mandatory there are only so many programs willing to front that expense.
Like I said before I believe EMS ought to be IFR period.