II 118th CONGRESS 2d Session S. 5400 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. Short title This Act may be cited as the Improving Access to Emergency Medical Services Act . 2. Requiring the Center for Medicare and Medicaid Innovation to test an emergency medical services treatment-in-place 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)(2)— (A) in subparagraph (A), in the third sentence, by inserting , and shall include the model described in subparagraph (B)(xxviii) before the period at the end; and (B) in subparagraph (B), by adding at the end the following new clause: (xxviii) The Emergency Medical Services Treatment-in-Place Model described in subsection (h). ; and (2) by adding at the end the following new subsection: (h) Emergency Medical Services Treatment-in-Place Model (1) In general For purposes of subsection (b)(2)(B)(xxviii), the Emergency Medical Services Treatment-in-Place Model described in this subsection is a model under which payment is made under part B of title XVIII for treatment services furnished to an individual enrolled under such part by a provider or supplier of ground ambulance services (as described in section 1834(l)) when such services— (A) are not associated with 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 protocols (which may include online medical direction). (2) Payment The Secretary shall set payment rates for services furnished under the model described in paragraph (1) in a manner that 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). (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 Emergency Medical Services Treatment-in-Place 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— (1) analyzes various aspects of Medicare beneficiaries’ access to emergency medical services, including an evaluation of the impact of such model on beneficiary outcomes, resource utilization, and overall health care system efficiency; (2) compares beneficiary outcomes under such model with beneficiary outcomes using traditional emergency transportation; (3) assesses the impact of regional variations and demographics on beneficiary access to emergency medical services; (4) identifies best practices and potential challenges in implementing such model; and (5) includes recommendations for improving emergency medical services.