Summary#
This bill requires the Center for Medicare and Medicaid Innovation (CMMI) to test a “Comprehensive Alternative Response for Emergencies” model under Medicare. Under the model, Medicare Part B would pay for treatment services when a ground ambulance is dispatched but the patient is not transported. The Secretary must set payment rates that generally align with payments that would have been made if the patient had been transported. Telehealth services given together with the on-scene treatment would treat the patient’s location as an originating site for the telehealth site fee. The model must be carried out for five years. The bill also changes a technical provision so that one standard requirement for models does not apply to this model. The Comptroller General must report to Congress no later than four years after the model starts, analyzing access, beneficiary outcomes, regional differences, implementation challenges, best practices, and recommendations.
What it means for you#
- If you are a Medicare Part B beneficiary, you could receive treatment from a ground ambulance crew without being taken to a hospital and Medicare may pay for that on-scene care when the model is used.
- Telehealth used with that on-scene care would be treated so the patient’s location qualifies for a telehealth originating-site fee.
- Services must follow state and local licensure and protocols.
- The model will only apply where and when it is tested; the bill does not list which areas or providers will participate.
Expenses#
- The bill directs Medicare Part B to pay for these non-transport treatment services, with payment rates generally aligned with what would be paid for a transport.
- It treats the patient’s location as an originating site for telehealth fee purposes when telehealth is furnished with the on-scene treatment.
- The model runs for five years and requires a Comptroller General report four years after implementation.
- No publicly available information on total federal costs, budget estimates, or specific payment amounts.
Proponents' View#
No publicly available information.
Opponents' View#
No publicly available information.