Medicare tests ambulance dispatch without transport—outcomes unclear

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 bill ties telehealth originating-site fees to the model, potentially expanding telehealth billing in emergency contexts without clear safeguards on when remote-only assessment is appropriate versus when in-person transport is medically necessary.
• The 4-year reporting requirement is retrospective; by the time Congress receives outcome data, the model may already be entrenched in Medicare payment policy, limiting opportunity for course correction.

Who it affects

The bill may improve emergency response flexibility and reduce unnecessary transports, potentially lowering costs and improving outcomes for some Medicare beneficiaries. However, the mechanism could also incentivize dispatch-without-transport in ways that delay necessary hospital care, and the vague payment structure creates uncertainty about whether beneficiaries will face gaps in coverage or quality.

Who stands to gain

• ground ambulance service providers
• ambulance companies
• telehealth technology vendors
• private ambulance operators

Named in the bill

Centers for Medicare & Medicaid Services (CMS), Center for Medicare and Medicaid Innovation (CMMI), Medicare Part B, Comptroller General, Senate Committee on Finance, House Committee on Ways and Means, UHS (Universal Health Services), ground ambulance providers

Where it stands

9 cosponsors: 5 Democrats, 4 Republicans.

• Nov 6, 2025 — Introduced · Congress.gov: “Introduced in Senate”
• Nov 6, 2025 — Referred to Senate Committee on Finance · Congress.gov: “Read twice and referred to the Committee on Finance. (Sponsor introductory remarks on measure: CR S7964)”

Dates and quoted wording are Congress.gov's action record; the timeline shows status changes, not every procedural step.

Money around this bill

6 lobbying clients named this bill on 9 disclosure filings across 2 quarters, Dec 2025 to Jun 2026. Those filings disclosed $1,096,000 in lobbying spend. A filing names 20 bills on average, so that figure is what each filing reported, not a share belonging to this bill.

More lobbying clients named this bill than 82% of bills with at least one filing.

Susan Collins, the sponsor, reported $2,459,513 in PAC receipts in the 2026 cycle.

• American Ambulance Association — $650,000 on 2 filings
• International Association of Fire Fighters — $196,000 on 1 filing
• American Ambulance Association — $140,000 on 2 filings
• International Association of Fire Chiefs — $70,000 on 2 filings
• Sarnova, LLC — $30,000 on 1 filing

Lobbying Disclosure Act filings through Jul 22, 2026. A filing shows who paid to lobby on a bill it names, not what changed.