Sponsors (49)
Requires CMI to test a five-year Medicare model paying ambulances for on-scene treatment when no transport occurs, with rates generally aligned to transport payments.
Official title: To amend title XI of the Social Security Act to require the Center for Medicare and Medicaid Innovation to test a comprehensive alternative response for emergencies model under the Medicare program.
Introduced April 1, 2025 by Mike Carey · Last progress April 1, 2025
The bill expands access to telehealth‑enabled, on‑scene emergency care for Medicare beneficiaries and makes it financially viable for providers, but increases Medicare spending and raises risks of variable quality, overuse, and short‑term uncertainty for longer‑term system investments.
Medicare beneficiaries can receive and be billed for on‑scene emergency treatment without transport, increasing access to timely care at home or wherever the emergency occurs.
Ground ambulance providers and telehealth clinicians receive Part B payments aligned with transport rates for nontransport care, reducing uncompensated care and making alternative on‑scene treatment financially viable for providers.
Patients and emergency responders gain better telehealth-enabled care because the patient site is treated as an authorized originating site, allowing audiovisual medical direction and remote clinical support during responses.
Taxpayers and the Medicare program will face higher Part B spending due to payments for nontransport on‑scene care, increasing pressure on the trust fund and federal budgets.
Medicare beneficiaries and taxpayers could see increased utilization and costs if aligning payments with transport rates incentivizes overuse of billable on‑scene services without strong utilization guardrails.
Medicare beneficiaries — especially in rural or state‑varied areas — may experience inconsistent access or variable quality of on‑scene nontransport emergency care if local protocols differ across regions.
Based on analysis of 2 sections of legislative text.
Creates a five-year Medicare test called the Comprehensive Alternative Response for Emergencies (CARE) Model to pay for treatment services provided by ground ambulance crews when an ambulance responds to an emergency call but the patient is not transported. The model must be added by the Center for Medicare and Medicaid Innovation within two years and sets payment rates generally aligned with what would have been paid for transport while allowing originating-site telehealth fees. Requires the HHS Secretary to ensure state and local licensure and protocols are followed, and directs a Comptroller General report within four years of model start analyzing access, outcomes, regional differences, best practices, challenges, and recommendations for future policy.