Summary

Requires the Medicare innovation center (CMMI) to create and test a five-year model that pays Medicare Part B for emergency treatment provided on scene by ground ambulance providers even when the patient is not transported. Payments must generally align with what Medicare would pay for a transport; telehealth provided as part of that treatment treats the patient site as an originating site for telehealth fees. The model must be launched within two years of enactment and the Comptroller General must report to Congress on access, outcomes, utilization, equity, and lessons learned within four years of model start.

Key Points

• CMMI must launch a CARE Model within two years to test Medicare payment for on-scene ambulance treatment without transport.
• Medicare Part B may pay ground ambulance providers for treatment-only emergency responses when no transport occurs, if state/local rules are followed.
• Payment rates must generally align with what Medicare would pay for an ambulance transport under current rules.
• Telehealth used during on-scene treatment is treated as if the patient site is an originating site for telehealth fees.
• The model test runs for five years after implementation.
• GAO must report to key congressional committees within four years on access, outcomes, utilization, equity, and recommendations.
• The change aims to support alternatives to automatic ED transport and encourage on-scene care when clinically appropriate.
• Implementation relies on existing CMMI authority and Medicare Part B payment rules; no separate appropriation is specified.

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