Sponsors (41)
The bill expands Medicare payment for on-scene non-transport emergency care to improve timely access and reimburse providers, trading potential improvements in care and reduced uncompensated services against higher Medicare costs, risks of overuse or variable care quality across regions, and short-term policy uncertainty.
Medicare beneficiaries can receive payment-covered on-scene emergency treatment without hospital transport, increasing access to timely care and reducing unnecessary transports.
Ambulance providers and health systems are reimbursed for non-transport on-scene care at rates generally similar to transport, reducing uncompensated care and creating financial incentives to provide appropriate on-scene treatment.
Patients and local EMS can use telehealth during on-scene care because the patient's location is treated as an originating site, enabling remote medical direction and specialist support.
Taxpayers and Medicare beneficiaries could face higher Medicare spending and increased pressure on the trust fund if utilization of paid non-transport responses rises.
Beneficiaries—particularly in rural areas—may experience uneven access or inconsistent quality of on-scene emergency care because state and local protocols could vary.
Providers may upcode or overuse dispatch-without-transport services to receive higher payments, creating unnecessary costs and potential inappropriate care.
Based on analysis of 2 sections of legislative text.
Requires CMMI to test a five-year Medicare Part B model paying ambulance providers for on-scene treatment when no transport occurs, with payments aligned to transport rates.
Creates a new five-year Medicare Part B demonstration that pays ground ambulance providers (or entities under arrangement) for treating patients on scene when an ambulance is dispatched but the patient is not transported to a hospital. The model must be launched within two years and sets payment rates generally aligned with what would have been paid if transport had occurred; telehealth rules treat the patient location as the telehealth originating site for related services. The Comptroller General must issue a report to congressional tax-writing committees within four years of model start covering access, outcomes, utilization, regional and demographic effects, best practices, challenges, and recommendations.
Introduced April 1, 2025 by Mike Carey · Last progress April 1, 2025