119-hr2538

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2538 Introduced in House

    (IH) ]

<DOC>

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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