H.R. 2533 — EASE Act of 2025

This section requires the Center for Medicare and Medicaid Innovation (CMI) to test the Specialty Health Care Services Access Model (i.e., a new model under which the Secretary of Health and Human Services enters into agreements with one or more selected provider networks to furnish specified specialty health care services via digital modalities such as telehealth, in coordination with primary care providers, to eligible individuals in rural or underserved areas). (As background, the CMI tests innovative payment and service delivery models for Medicare (Title XVIII), Medicaid (Title XIX), and CHIP (Title XXI) to reduce program expenditures while preserving or enhancing quality of care; this provision mandates testing of the new model by adding it to the list of models in 42 U.S.C. 1315a(b)(2)(B) and requiring its inclusion.) Eligible individuals are Medicare beneficiaries (entitled to Part A benefits or enrolled in Part B) or individuals enrolled in Medicaid or CHIP who meet full eligibility criteria (including verification requirements) and reside in specified rural or underserved areas. Provider networks must (1) comprise at least 50 Federally qualified health centers, rural health clinics, critical access hospitals, or rural emergency hospitals (at least half in rural areas, as defined by the Health Resources and Services Administration); (2) be 501(c)(3) nonprofits; (3) have an established record supporting health care delivery in rural and underserved communities across multiple U.S. regions; and (4) demonstrate ability to collect, exchange, and evaluate model data. (Thus, the model targets improved specialty care access for rural Medicare, Medicaid, and CHIP beneficiaries via telehealth through qualified nonprofit networks.) Any amounts appropriated to implement these amendments are subject to requirements in Public Law 117-328 applicable to programs under sections 330 through 340 of the Public Health Service Act (i.e., community health centers, National Health Service Corps, and related initiatives).