II 

118TH CONGRESS 

2D SESSION S. 5400 

To amend title XI of the Social Security Act to require the Center for 

Medicare and Medicaid Innovation to test an emergency medical services 

treatment-in-place model under the Medicare program. 

IN THE SENATE OF THE UNITED STATES 

NOVEMBER 21, 2024 

Mr. MANCHIN (for himself and Ms. COLLINS) 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 

an emergency medical services treatment-in-place model 

under the Medicare program. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Improving Access to 

5 Emergency Medical Services Act’’. 


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1 SEC. 2. REQUIRING THE CENTER FOR MEDICARE AND MED2 ICAID INNOVATION TO TEST AN EMERGENCY 

3 MEDICAL SERVICES TREATMENT-IN-PLACE 

4 MODEL UNDER THE MEDICARE PROGRAM. 

5 (a) IN GENERAL.—Section 1115A of the Social Secu6 rity Act (42 U.S.C. 1315a) is amended— 

7 (1) in subsection (b)(2)— 

8 (A) in subparagraph (A), in the third sen9 tence, by inserting ‘‘, and shall include the 

10 model described in subparagraph (B)(xxviii)’’ 

11 before the period at the end; and 

12 (B) in subparagraph (B), by adding at the 

13 end the following new clause: 

14 ‘‘(xxviii) The Emergency Medical 

15 Services Treatment-in-Place Model de16 scribed in subsection (h).’’; and 

17 (2) by adding at the end the following new sub18 section: 

19 ‘‘(h) EMERGENCY MEDICAL SERVICES TREATMENT20 IN-PLACE MODEL.— 

21 ‘‘(1) IN GENERAL.—For purposes of subsection 

22 (b)(2)(B)(xxviii), the Emergency Medical Services 

23 Treatment-in-Place Model described in this sub24 section is a model under which payment is made 

25 under part B of title XVIII for treatment services 

26 furnished to an individual enrolled under such part 


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1 by a provider or supplier of ground ambulance serv2 ices (as described in section 1834(l)) when such 

3 services— 

4 ‘‘(A) are not associated with a cor5 responding transport payable under such sec6 tion; 

7 ‘‘(B) are so furnished in response to an 

8 emergency medical call (as specified by the Sec9 retary) made with respect to such individual; 

10 and 

11 ‘‘(C) are so furnished in accordance with 

12 State and local protocols (which may include 

13 online medical direction). 

14 ‘‘(2) PAYMENT.—The Secretary shall set pay15 ment rates for services furnished under the model 

16 described in paragraph (1) in a manner that aligns 

17 such payments with the payments that would have 

18 been made for such services had such services re19 sulted in a transport payable under section 1834(l). 

20 ‘‘(3) DURATION.—The model described in para21 graph (1) shall be carried out for a period of 5 

22 years.’’. 

23 (b) REPORT.—Not later than 4 years after the date 

24 on which the Emergency Medical Services Treatment-in25 Place Model (as described in section 1115A(h) of the SoVerDate Sep 11 2014 01:32 Dec 06, 2024 Jkt 059200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S5400.IS S5400

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1 cial Security Act, as added by subsection (a)) is imple2 mented, the Comptroller General of the United States 

3 shall submit to the Committee on Ways and Means of the 

4 House of Representatives and the Committee on Finance 

5 of the Senate a report that, taking into account stake6 holder input— 

7 (1) analyzes various aspects of Medicare bene8 ficiaries’ access to emergency medical services, in9 cluding an evaluation of the impact of such model on 

10 beneficiary outcomes, resource utilization, and over11 all health care system efficiency; 

12 (2) compares beneficiary outcomes under such 

13 model with beneficiary outcomes using traditional 

14 emergency transportation; 

15 (3) assesses the impact of regional variations 

16 and demographics on beneficiary access to emer17 gency medical services; 

18 (4) identifies best practices and potential chal19 lenges in implementing such model; and 

20 (5) includes recommendations for improving 

21 emergency medical services. 

Æ 


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