Healthcare (Medicare · Public Safety)

This bill creates a new Medicare payment model (the "Comprehensive Alternative Response for Emergencies Model") that allows Medicare Part B to cover ground ambulance services provided in response to emergency medical calls *without* a full transport. It directly affects Medicare beneficiaries receiving emergency ambulance care and ambulance providers, ensuring they are paid for services like dispatch and initial response that don't include transport. The model requires payment rates to align with standard transport payments, mandates compliance with state protocols, and operates for a 5-year test period. A report by the Comptroller General will evaluate the model's impact on beneficiary access, outcomes, and regional differences after 4 years.

HR 3443 creates a new Medicare payment model to provide supplemental funding for ground and air ambulance services that administer specific life-saving medications (like epinephrine, lidocaine, and blood products) during emergencies. It directly affects EMS agencies serving Medicare beneficiaries by requiring them to apply for participation, meet data reporting standards (including patient outcomes and service metrics), and receive monthly or quarterly supplemental payments based on costs for maintaining medication supplies and data systems. The model runs for at least 5 years, with a requirement for a congressional report analyzing whether the payments improve medication access, patient outcomes, and care quality - especially for rural and underserved communities. The bill also mandates a MedPAC report on EMS payment structures and EMTALA guidance to reduce "wall time" delays in hospital handoffs.

S 3145, the CARE Act of 2025, creates a new Medicare payment model for ground ambulance services provided during emergencies without patient transport. It directly affects Medicare beneficiaries who receive emergency medical dispatch services (like on-site care) and ambulance providers who serve them. The bill requires Medicare to pay for these non-transport services at rates aligned with traditional transport payments, while allowing telehealth services provided alongside them to count as originating sites. The model will operate for five years, with a mandatory report after four years evaluating its impact on beneficiary access, outcomes, and regional variations in emergency services.

Senate Bill 3221, the Expanding Health Care Options for First Responders Act, creates a Medicare buy-in program for retired or disabled first responders aged 50 to 64. Eligible individuals - including law enforcement officers, certain public safety employees, and federal firefighters - can enroll in Medicare Parts A, B, and D at a premium calculated based on average Medicare costs for this group. The coverage counts as "minimum essential coverage" under the Affordable Care Act, making enrollees eligible for premium tax credits and cost-sharing subsidies. The bill also establishes an oversight board and provides federal grants (2027-2029) to support outreach and enrollment for this specific population.