transport to destinations other than a hospital 
emergency department. 
(C) Necessary protections to ensure that 
patients receive timely and appropriate care in 
the appropriate setting. 
(D) Whether there are any barriers to pro-
viding alternate dispositions to patients who are 
not in need of care in hospital emergency de-
partments. 
(E) Other issues determined by the Direc-
tor, including, when possible, issues rec-
ommended by FICEMS or NEMSAC for eval-
uation under this subsection. 
(b) DEMONSTRATION PROJECTS.— 
(1) IN GENERAL.—Beginning not later than 1 
year after the date of the enactment of this Act, the 
Director shall conduct or support at least 10 dem-
onstration projects to— 
(A) evaluate the implementation and reim-
bursement of alternative dispositions of field 
EMS patients, including— 
(i) transporting patients by ambulance 
to alternate destinations when medically 
appropriate and in the patients’ best inter-
ests; and 
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(ii) when medically necessary, evalu-
ating, treating, or referring patients to 
other medically appropriate providers; 
(B) evaluate the implementation of reim-
bursement models based on readiness rather 
than transport or shared savings; and 
(C) determine whether such alternative dis-
positions and reimbursement models— 
(i) improve the safety, effectiveness, 
timeliness, and efficiency of EMS; and 
(ii) reduce overall utilization and ex-
penditures under the Medicare program 
under title XVIII of the Social Security 
Act. 
(2) EVIDENCE-BASED PROTOCOLS.—The Direc-
tor shall ensure that at least one demonstration 
project under paragraph (1) evaluates evidence- 
based protocols that give guidance on selection of 
the destination to which patients are transported. 
(3) DURATION.—The period of a demonstration 
project under paragraph (1) shall not exceed 36 
months. 
(4) RESEARCH.—If the Director determines 
that further research is necessary prior to or in con-
junction with the demonstration projects under this 
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subsection in order to evaluation the implementation 
of alternative dispositions of field EMS patients, the 
Director shall conduct or support such research. 
(5) AUTHORIZATION OF APPROPRIATIONS.—Of 
the amount made available to carry out section 
1115A of the Social Security Act (42 U.S.C. 1315a) 
for a fiscal year, there are authorized to be appro-
priated such sums as may be necessary to carry out 
this subsection. 
(c) REPORT TO CONGRESS.—Not later than 1 year 
after the completion of all demonstration projects under 
subsection (b), the Director shall submit to the Congress 
a report on the results of activities under this section, in-
cluding recommendations on the efficacy of alternative dis-
positions of field EMS patients. 
SEC. 10. ENHANCING RESEARCH IN FIELD EMS. 
(a) MODELS TO BE TESTED BY CENTER FOR MEDI-
CARE
AND
MEDICAID
INNOVATION.—Section 
1115A(b)(2)(B) of title XI of the Social Security Act (42 
U.S.C. 1315a(b)(2)(B)) is amended by adding at the end 
the following: 
‘‘(xxi) Enhancing health outcomes for 
patients receiving field emergency medical 
services and improving timely and efficient 
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delivery of high-quality field emergency 
medical services, such as through— 
‘‘(I) regionalization of emergency 
care; 
‘‘(II) medical transport to alter-
nate destinations; or 
‘‘(III) when medically necessary, 
the evaluation, treatment, or referral 
of patients to other medically appro-
priate health providers.’’. 
(b) EMERGENCY
MEDICAL
RESEARCH.—Section 
498D of the Public Health Service Act (42 U.S.C. 289g– 
4) is amended— 
(1) by redesignating subsections (c) and (d) as 
subsections (d) and (e), respectively; and 
(2) by inserting after subsection (b) the fol-
lowing: 
‘‘(c) FIELD
EMS EMERGENCY
MEDICAL
RE-
SEARCH.—The Secretary shall conduct research and eval-
uation relating to field EMS through the Agency for 
Healthcare Research and Quality and the Center for Medi-
care and Medicaid Innovation.’’. 
(c) FIELD EMS PRACTICE CENTER.—Subpart II of 
part D of title IX of the Public Health Service Act (42 
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U.S.C. 299b–33 et seq.) is amended by adding at the end 
the following: 
‘‘SEC. 938. FIELD EMS PRACTICE CENTER. 
‘‘(a) ESTABLISHMENT.—For the purpose described 
in subsection (b), the Director shall establish within the 
Office of Research and Evaluation a Field EMS Evidence- 
Based Practice Center. 
‘‘(b) PURPOSE.—The purpose of the Center is to con-
duct or support research to promote the highest quality 
of emergency medical care in field EMS and the most ef-
fective delivery system for the provision of such care. Re-
search conducted or supported pursuant to the preceding 
sentence shall include— 
‘‘(1) comparative safety and effectiveness re-
search; 
‘‘(2) other appropriate clinical or systems re-
search; and 
‘‘(3) research addressing— 
‘‘(A) critical care transport; 
‘‘(B) off-shore operations; 
‘‘(C) tactical emergency medical services; 
‘‘(D) air medical services; and 
‘‘(E) the application of lessons learned in 
military field medicine in the delivery of emer-
gency medical care in field EMS. 
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