Voters should care about this bill because it aims to make emergency medical care more efficient and potentially more cost-effective for Medicare beneficiaries. Currently, ambulance services are typically only reimbursed by Medicare if they transport a patient to a hospital. This often means that even if a patient could be safely treated at home or linked with another form of care, they might still be transported to an emergency room because it's the only way for the ambulance service to get paid.
If this bill becomes law, it could reduce unnecessary emergency room visits, which are costly and can strain hospital resources. It allows for more flexible and appropriate emergency responses, potentially leading to better patient experiences and outcomes by avoiding unnecessary hospital stays. If it doesn't become law, the current system will continue, meaning many individuals in non-life-threatening emergencies might continue to be transported to hospitals even when on-site care would suffice.
KEY PROVISIONS
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PROVISION 01
Requires the Center for Medicare and Medicaid Innovation to establish and test the Comprehensive Alternative Response for Emergencies (CARE) Model.
This ensures that a new approach to emergency medical services, allowing for non-transport care, will be implemented and evaluated.
PROVISION 02
Allows Medicare to pay ground ambulance services for on-site treatment provided in response to an emergency medical call, even if the patient is not transported to a hospital.
This changes existing Medicare payment rules to cover a broader range of emergency care, potentially reducing unnecessary hospital visits.
PROVISION 03
Stipulates that payment rates for non-transport services under the CARE Model will generally match rates for services that *do* involve transport.
This ensures fair reimbursement for ambulance providers who offer on-site treatment without transport, encouraging participation.
PROVISION 04
Mandates a report by the Comptroller General within four years of the model's implementation to analyze its impact on beneficiary access, outcomes, and resource use.
This provision ensures that the effectiveness and consequences of the new model will be thoroughly reviewed to inform future policy decisions.
PROVISION 05
The CARE Model will be carried out for a period of 5 years.
This sets a clear timeframe for the pilot program, allowing for sufficient data collection and evaluation before permanent changes are considered.
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.
Voters should care about this bill because it aims to make emergency medical care more efficient and potentially more cost-effective for Medicare beneficiaries. Currently, ambulance services are typically only reimbursed by Medicare if they transport a patient to a hospital. This often means that even if a patient could be safely treated at home or linked with another form of care, they might still be transported to an emergency room because it's the only way for the ambulance service to get paid.
If this bill becomes law, it could reduce unnecessary emergency room visits, which are costly and can strain hospital resources. It allows for more flexible and appropriate emergency responses, potentially leading to better patient experiences and outcomes by avoiding unnecessary hospital stays. If it doesn't become law, the current system will continue, meaning many individuals in non-life-threatening emergencies might continue to be transported to hospitals even when on-site care would suffice.
KEY PROVISIONS
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high
Requires the Center for Medicare and Medicaid Innovation to establish and test the Comprehensive Alternative Response for Emergencies (CARE) Model.
This ensures that a new approach to emergency medical services, allowing for non-transport care, will be implemented and evaluated.
high
Allows Medicare to pay ground ambulance services for on-site treatment provided in response to an emergency medical call, even if the patient is not transported to a hospital.
This changes existing Medicare payment rules to cover a broader range of emergency care, potentially reducing unnecessary hospital visits.
med
Stipulates that payment rates for non-transport services under the CARE Model will generally match rates for services that *do* involve transport.
This ensures fair reimbursement for ambulance providers who offer on-site treatment without transport, encouraging participation.
med
Mandates a report by the Comptroller General within four years of the model's implementation to analyze its impact on beneficiary access, outcomes, and resource use.
This provision ensures that the effectiveness and consequences of the new model will be thoroughly reviewed to inform future policy decisions.
low
The CARE Model will be carried out for a period of 5 years.
This sets a clear timeframe for the pilot program, allowing for sufficient data collection and evaluation before permanent changes are considered.
not later than 2 years after the date of the enactment of the CARE Act of 2025
The Comprehensive Alternative Response for Emergencies Model must begin
not later than 4 years after the date on which the Comprehensive Alternative Response for Emergencies Model is implemented
The Comptroller General of the United States shall submit a report on the CARE Model
GLOSSARY
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Center for Medicare and Medicaid Innovation (CMMI)
A division within the Centers for Medicare & Medicaid Services that tests new payment and service delivery models to reduce program expenditures while preserving or enhancing the quality of care under Medicare and Medicaid.
Medicare Program
A federal health insurance program for people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease.
Social Security Act
The foundational law that established many of the country's social welfare programs, including Social Security, Medicare, and Medicaid.
Ground ambulance services
Emergency medical services provided by an ambulance vehicle that operates on land, including emergency medical technician (EMT) services.
Telehealth service
Healthcare services provided remotely through telecommunications technology, such as video calls or secure messaging, rather than in-person.
Originating site
The location of a Medicare patient at the time a telehealth service is furnished; certain originating sites are eligible for a facility fee payment.
Comptroller General of the United States
ACTION TIMELINE
2 EVENTS
APR 1, 25
Introduced in House
INTROREFERRAL
APR 1, 25
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.
The head of the Government Accountability Office (GAO), an independent, non-partisan agency that investigates how the federal government spends taxpayer dollars.
