H.R.2538 - Comprehensive Alternative Response for Emergencies Act of 2025; CARE Act of 2025 (119th Congress)
Summary
H.R.2538, the Comprehensive Alternative Response for Emergencies Act of 2025 (CARE Act of 2025), aims to amend Title XI of the Social Security Act. It mandates the Center for Medicare and Medicaid Innovation (CMMI) to test a new payment model under Medicare. This model focuses on comprehensive alternative responses for emergencies, specifically concerning ground ambulance services.
Expected Effects
The bill will likely lead to changes in how Medicare reimburses for emergency medical services. It will allow for payments for ground ambulance services even when transport to a hospital does not occur. The goal is to explore alternative emergency response models and their impact on patient outcomes and resource utilization.
Potential Benefits
- Could improve access to appropriate emergency medical care by allowing payment for on-scene treatment.
- May reduce unnecessary transports to hospitals, freeing up ambulance resources.
- Could lead to more efficient use of Medicare funds by paying for the most appropriate level of care.
- The required report will provide valuable data on the effectiveness of the new model.
- Telehealth services furnished in conjunction with treatment services will have the originating site fee covered.
Most Benefited Areas:
Potential Disadvantages
- The payment model might incentivize unnecessary ambulance dispatches.
- There could be challenges in setting appropriate payment rates for services that do not result in transport.
- The model's implementation may create administrative burdens for providers and the CMMI.
- Regional variations in emergency medical services could affect the model's success.
- The 5-year duration may not be sufficient to fully assess long-term impacts.
Constitutional Alignment
The bill appears to align with the Constitution's general welfare clause (Preamble). Congress has the power to legislate on matters related to healthcare and Medicare under this clause. The bill does not appear to infringe on any specific constitutional rights or limitations.
Impact Assessment: Things You Care About ⓘ
This action has been evaluated across 19 key areas that matter to you. Scores range from 1 (highly disadvantageous) to 5 (highly beneficial).