CARE Act of 2025

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[S. 3145 Introduced in Senate (IS)]

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119th CONGRESS
  1st Session
                                S. 3145

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 SENATE OF THE UNITED STATES

                            November 6, 2025

Ms. Collins (for herself and Mr. Welch) introduced the following bill; 
     which was read twice and referred to the Committee on Finance

_______________________________________________________________________

                                 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 paragraph (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 of 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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