A bill to amend title XI of the Social Security Act to provide Secretarial authority to temporarily waive or modify application of certain Medicare requirements with respect to ambulance services furnished during certain emergency periods.
Bill: S.149 | Sponsor: Sen. Cortez Masto, Catherine (D-NV)
Policy area: Health

Summary:
This bill allows for Medicare payment of ground ambulance services that did not result in the actual transport of an individual to a permitted facility, if the lack of transport was due to community-wide COVID-19 (i.e., coronavirus disease 2019) protocols for emergency medical services during the public health emergency.

To amend title XI of the Social Security Act to provide Secretarial 
    authority to temporarily waive or modify application of certain 
  Medicare requirements with respect to ambulance services furnished 
                   during certain emergency periods.

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

SECTION 1. SECRETARIAL AUTHORITY TO TEMPORARILY WAIVE OR MODIFY 
              APPLICATION OF CERTAIN MEDICARE REQUIREMENTS WITH RESPECT 
              TO AMBULANCE SERVICES FURNISHED DURING CERTAIN EMERGENCY 
              PERIODS.

    (a) Waiver Authority.--Section 1135(b) of the Social Security Act 
(42 U.S.C. 1320b-5(b)) is amended--
            (1) in the first sentence--
                    (A) in paragraph (7), by striking ``and'' at the 
                end;
                    (B) in paragraph (8), by striking the period at the 
                end and inserting ``; and''; and
                    (C) by inserting after paragraph (8) the following 
                new paragraph:
            ``(9) any requirement under section 1861(s)(7) or section 
        1834(l) that an ambulance service include the transport of an 
        individual to the extent necessary to allow payment for ground 
        ambulance services furnished in response to a 911 call (or the 
        equivalent in areas without a 911 call system) in cases in 
        which an individual would have been transported to a 
        destination permitted under Medicare regulations (as described 
        in section 410.40 to title 42, Code of Federal Regulations (or 
        successor regulations)) but such transport did not occur as a 
        result of community-wide emergency medical service (EMS) 
        protocols due to the public health emergency described in 
        subsection (g)(1)(B).''; and
            (2) in the flush matter at the end, by adding at the end 
        the following: ``Ground ambulance services for which payment is 
        made pursuant to paragraph (9) shall be paid at the base rate 
        that would have been paid under the fee schedule established 
        under 1834(l) (excluding any mileage payment) if the individual 
        had been so transported and, with respect to ambulance services 
        furnished by a critical access hospital or an entity described 
        in paragraph (8) of such section, at the amount that otherwise 
        would be paid under such paragraph.''.
    (b) Emergency Period Exception.--Section 1135(g)(1)(B) of the 
Social Security Act (42 U.S.C. 1320b-5(g)(1)(B)) is amended, in the 
matter preceding clause (i), by striking ``subsection (b)(8)'' and 
inserting ``paragraphs (8) and (9) of subsection (b)''.
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