H.R. 2538 — CARE Act of 2025

This section amends Section 1115A of the Social Security Act, which established the Center for Medicare and Medicaid Innovation (CMI) to test innovative Medicare and Medicaid payment and service delivery models to reduce expenditures while preserving or enhancing care quality, by (1) requiring CMI, beginning no later than two years after enactment of the CARE Act of 2025, to select and test the Comprehensive Alternative Response for Emergencies Model under Medicare Part B; and (2) exempting that model from CMI's criteria for expanding tested models nationwide. The new model pays ground ambulance providers or suppliers (or entities under arrangement with them) for Part B treatment services furnished in response to an emergency medical call—where a vehicle is dispatched but no transport occurs under Medicare ambulance payment rules (Section 1834(l))—if services comply with state and local licensure and protocols (potentially including online medical direction via telehealth); payments generally align with loaded transport rates, and qualifying telehealth furnished concurrently is eligible for an originating site fee. The model operates for five years. This section also requires the Comptroller General, four years after model implementation, to report to the House Ways and Means Committee and Senate Finance Committee on Medicare beneficiaries' emergency medical services access (including model impacts on outcomes and resource use versus traditional transport), regional/demographic variations, best practices, challenges, and improvement recommendations.