Medicare tests ambulance-only emergency response—without safeguards for patient care
H.R. 2538 — CARE Act of 2025 · Filed by Mike Carey (R-OH) · 47 cosponsors · Introduced Apr 1, 2025 · Referred to committee
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What it does
This bill directs Medicare to test a new emergency response model where ground ambulances can be dispatched and provide treatment without necessarily transporting the patient to a hospital, with payment rates aligned to traditional transport rates. The model runs for 5 years, and Congress will receive a report comparing outcomes to traditional emergency services.
Why we flagged it
The bill's core function is to authorize a 5-year pilot program testing alternative emergency response models within Medicare, specifically allowing ground ambulance dispatch and treatment without transport. This is a regulatory innovation test, not a broad policy overhaul.
What the text implies
- The bill does not specify what happens if a patient treated under the model later requires transport or hospitalization—liability, payment responsibility, and continuity of care are undefined.
- Payment rates are set to 'generally align' with transport rates, but the bill contains no mechanism to prevent ambulance providers from using this model to reduce costs while maintaining revenue, potentially incentivizing dispatch-only responses even when transport is medically appropriate.
The full analysis lists 5 implications of this text.
Who stands to gain
ground ambulance service providers; ambulance companies; telehealth technology vendors