Medicare tests ambulance dispatch without transport—outcomes unclear
S. 3145 — CARE Act of 2025 · Filed by Susan Collins (R-ME) · 9 cosponsors · Introduced Nov 6, 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 aligned to what transport would have cost. The model runs for 5 years, and Congress will receive a report on outcomes and access impacts.
Why we flagged it
The bill establishes a 5-year pilot program testing alternative emergency medical response models under Medicare, specifically allowing ground ambulance dispatch and treatment without transport. It is fundamentally a payment and service-delivery innovation test, not a broad policy overhaul.
What the text implies
- The bill allows payment for ambulance dispatch and treatment without transport, which could shift financial incentives away from hospital transport. If payment rates are set too high relative to traditional transport, ambulance providers may be incentivized to avoid transporting patients who need hospital care, potentially delaying critical treatment.
- The model permits 'online medical direction through audiovisual telecommunications technology' but does not specify minimum standards for remote physician oversight, training, or liability. This could create a two-tiered emergency response system where rural or underserved areas receive lower-intensity remote care.
The full analysis lists 4 implications of this text.
Who stands to gain
ground ambulance service providers; ambulance companies; telehealth technology vendors