I
119THCONGRESS
1
STSESSION 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
APRIL1, 2025
Mr. C
AREY(for himself, Mr. DOGGETT, Mrs. MILLERof West Virginia, and
Mr. R
YAN) introduced the following bill; which was referred to the Com-
mittee 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 Representa-1
tives of the United States of America in Congress assembled, 2
SECTION 1. SHORT TITLE. 3
This Act may be cited as the ‘‘Comprehensive Alter-4
native Response for Emergencies Act of 2025’’ or the 5
‘‘CARE Act of 2025’’. 6
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SEC. 2. REQUIRING THE CENTER FOR MEDICARE AND MED-1
ICAID INNOVATION TO TEST A COMPREHEN-2
SIVE ALTERNATIVE RESPONSE FOR EMER-3
GENCIES MODEL UNDER THE MEDICARE 4
PROGRAM. 5
(a) I
NGENERAL.—Section 1115A of the Social Secu-6
rity Act (42 U.S.C. 1315a) is amended— 7
(1) in subsection (b)— 8
(A) in paragraph (2)(A), in the third sen-9
tence, by inserting ‘‘, and, beginning not later 10
than the date that is 2 years after the date of 11
the enactment of the CARE Act of 2025, shall 12
include the Comprehensive Alternative Re-13
sponse for Emergencies Model described in sub-14
section (h)’’ before the period at the end; and 15
(B) in paragraphs (3)(B), by striking ‘‘The 16
Secretary’’ and inserting ‘‘Except in the case of 17
the model described in subsection (h), the Sec-18
retary’’; and 19
(2) by adding at the end the following new sub-20
section: 21
‘‘(h) C
OMPREHENSIVEALTERNATIVERESPONSE FOR 22
E
MERGENCIESMODEL.— 23
‘‘(1) I
N GENERAL.—For purposes of subsection 24
(b)(2)(A), the Comprehensive Alternative Response 25
for Emergencies Model described in this subsection 26
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is a model under which payment is made under part 1
B of title XVIII for treatment services furnished to 2
an individual enrolled under such part by a provider 3
or supplier of ground ambulance services (as de-4
scribed in section 1834(l)), or by an entity under ar-5
rangement with such a provider, when such serv-6
ices— 7
‘‘(A) include the dispatch of a ground am-8
bulance vehicle but do not include a cor-9
responding transport payable under such sec-10
tion; 11
‘‘(B) are so furnished in response to an 12
emergency medical call (as specified by the Sec-13
retary) made with respect to such individual; 14
and 15
‘‘(C) are so furnished in accordance with 16
State and local licensure requirements and pro-17
tocols (which may include online medical direc-18
tion through the use of audiovisual tele-19
communications technology). 20
‘‘(2) P
AYMENT.— 21
‘‘(A) I
N GENERAL.—The Secretary shall 22
set payment rates for services furnished under 23
the model described in paragraph (1) in a man-24
ner that generally aligns such payments with 25
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•HR 2538 IH
the payments that would have been made for 1
such services had such services resulted in a 2
transport payable under section 1834(l). 3
‘‘(B) O
RIGINATING SITE FEE.—In the case 4
of a telehealth service payable under section 5
1834(m) that is furnished in conjunction with 6
treatment services furnished under the model 7
described in paragraph (1), the site where the 8
individual receiving such telehealth service is lo-9
cated shall be treated as an originating site that 10
is described in paragraph (4)(C)(ii)(V) of such 11
section for purposes of applying paragraph 12
(2)(B) of such section. 13
‘‘(3) D
URATION.—The model described in para-14
graph (1) shall be carried out for a period of 5 15
years.’’. 16
(b) R
EPORT.—Not later than 4 years after the date 17
on which the Comprehensive Alternative Response for 18
Emergencies Model (as described in section 1115A(h) of 19
the Social Security Act, as added by subsection (a)) is im-20
plemented, the Comptroller General of the United States 21
shall submit to the Committee on Ways and Means of the 22
House of Representatives and the Committee on Finance 23
of the Senate a report that, taking into account stake-24
holder input and to the extent data is available— 25
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(1) analyzes various aspects of Medicare bene-1
ficiaries’ access to emergency medical services, in-2
cluding an evaluation of the impact of such model on 3
beneficiary outcomes and resource utilization; 4
(2) compares beneficiary outcomes under such 5
model with beneficiary outcomes using traditional 6
emergency transportation; 7
(3) assesses the impact of regional variations 8
and demographics on the availability of emergency 9
medical services; 10
(4) identifies best practices and potential chal-11
lenges in implementing such model; and 12
(5) includes recommendations for improving 13
emergency medical services. 14
Æ
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