[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2538 Introduced in House (IH)]
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119th CONGRESS
1st Session
H. R. 2538
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.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
April 1, 2025
Mr. Carey (for himself, Mr. Doggett, Mrs. Miller of West Virginia, and
Mr. Ryan) introduced the following bill; which was referred to the
Committee on Energy and Commerce, and in addition to the Committee on
Ways and Means, for a period to be subsequently determined by the
Speaker, in each case for consideration of such provisions as fall
within the jurisdiction of the committee concerned
_______________________________________________________________________
A BILL
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.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Comprehensive Alternative Response
for Emergencies Act of 2025'' or the ``CARE Act of 2025''.
SEC. 2. REQUIRING THE CENTER FOR MEDICARE AND MEDICAID INNOVATION TO
TEST A COMPREHENSIVE ALTERNATIVE RESPONSE FOR EMERGENCIES
MODEL UNDER THE MEDICARE PROGRAM.
(a) In General.--Section 1115A of the Social Security Act (42
U.S.C. 1315a) is amended--
(1) in subsection (b)--
(A) in paragraph (2)(A), in the third sentence, by
inserting ``, and, beginning not later than the date
that is 2 years after the date of the enactment of the
CARE Act of 2025, shall include the Comprehensive
Alternative Response for Emergencies Model described in
subsection (h)'' before the period at the end; and
(B) in paragraphs (3)(B), by striking ``The
Secretary'' and inserting ``Except in the case of the
model described in subsection (h), the Secretary''; and
(2) by adding at the end the following new subsection:
``(h) Comprehensive Alternative Response for Emergencies Model.--
``(1) In general.--For purposes of subsection (b)(2)(A),
the Comprehensive Alternative Response for Emergencies Model
described in this subsection is a model under which payment is
made under part B of title XVIII for treatment services
furnished to an individual enrolled under such part by a
provider or supplier of ground ambulance services (as described
in section 1834(l)), or by an entity under arrangement with
such a provider, when such services--
``(A) include the dispatch of a ground ambulance
vehicle but do not include a corresponding transport
payable under such section;
``(B) are so furnished in response to an emergency
medical call (as specified by the Secretary) made with
respect to such individual; and
``(C) are so furnished in accordance with State and
local licensure requirements and protocols (which may
include online medical direction through the use of
audiovisual telecommunications technology).
``(2) Payment.--
``(A) In general.--The Secretary shall set payment
rates for services furnished under the model described
in paragraph (1) in a manner that generally aligns such
payments with the payments that would have been made
for such services had such services resulted in a
transport payable under section 1834(l).
``(B) Originating site fee.--In the case of a
telehealth service payable under section 1834(m) that
is furnished in conjunction with treatment services
furnished under the model described in paragraph (1),
the site where the individual receiving such telehealth
service is located shall be treated as an originating
site that is described in paragraph (4)(C)(ii)(V) of
such section for purposes of applying paragraph (2)(B)
of such section.
``(3) Duration.--The model described in paragraph (1) shall
be carried out for a period of 5 years.''.
(b) Report.--Not later than 4 years after the date on which the
Comprehensive Alternative Response for Emergencies Model (as described
in section 1115A(h) of the Social Security Act, as added by subsection
(a)) is implemented, the Comptroller General of the United States shall
submit to the Committee on Ways and Means of the House of
Representatives and the Committee on Finance of the Senate a report
that, taking into account stakeholder input and to the extent data is
available--
(1) analyzes various aspects of Medicare beneficiaries'
access to emergency medical services, including an evaluation
of the impact of such model on beneficiary outcomes and
resource utilization;
(2) compares beneficiary outcomes under such model with
beneficiary outcomes using traditional emergency
transportation;
(3) assesses the impact of regional variations and
demographics on the availability of emergency medical services;
(4) identifies best practices and potential challenges in
implementing such model; and
(5) includes recommendations for improving emergency
medical services.
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