,,ii  #aaith ,,congress  #ast ,session  
,s4 #cade  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,november #f1  
#bjbe ,ms4 ,collins 7for herself and    
,mr4 ,welch7 introduced the following   
bill2 which was read twice and referred 
to the ,committee on ,finance  ,a ,,bill
  ,to amend title ,,xi of the ,social   
,security ,act to require the ,center   
for ,medicare and ,medicaid ,innovation 
to test a comprehensive alternative     
response for emergencies model under the
 ,medicare program4  #a4  ,short title  
,this ,act may be cited as the          
,comprehensive ,alternative ,response   
for ,emergencies ,act of #bjbe or the   
,,care ,act of #bjbe4  #b4  ,requiring  
the ,center for ,medicare and ,medicaid 
,innovation to test a comprehensive     
alternative response for emergencies    
model under the ,medicare program  7a7  
,in general  ,section #aaae;,a of the   
,social ,security ,act 7#db ,u4,s4,c4   
#acae;a7 is amended--  7#a7 in          
subsection 7b7-- 7,a7 in paragraph      

7#b77;,a71 in the third sentence1 by    
inserting 1 and1 beginning not later    
than the date that is #b years after the
 date of the enactment of the ,,care    
,act of #bjbe1 shall include the        
,comprehensive ,alternative ,response   
for ,emergencies ,model described in    
subsection 7h7 before the period at the 
end2 and  7,b7 in paragraph 7#c77;,b71  
by striking ,the ,secretary and         
inserting ,except in the case of the    
model described in subsection 7h71 the  
,secretary2 and  7#b7 by adding at the  
end the following new subsection3  7h7  
,comprehensive alternative response for 
emergencies model  7#a7 ,in general ,for
 purposes of subsection 7b77#b77;,a71   
the ,comprehensive ,alternative         
,response for ,emergencies ,model       
described in this subsection is a model 
under which payment is made under part  
,b of title ,,xviii for treatment of    
services furnished to an individual     
enrolled under such part by a provider  
or supplier of ground ambulance services

 7as described in section #ahcd7l771 or 
by an entity under arrangement with such
 a provider1 when such services--  7,a7 
include the dispatch of a ground        
ambulance vehicle but do not include a  
corresponding transport payable under   
such section2  7,b7 are so furnished in 
response to an emergency medical call   
7as specified by the ,secretary7 made   
with respect to such individual2 and    
7,c7 are so furnished in accordance with
 ,state and local licensure requirements
 and protocols 7which may include online
 medical direction through the use of   
audiovisual telecommunications          
technology74  7#b7  ,payment  7,a7  ,in 
general  ,the ,secretary shall set      
payment rates for services furnished    
under the model described in paragraph  
7#a7 in a manner that generally aligns  
such payments with the payments that    
would have been made for such services  
had such services resulted in a         
transport payable under section         
#ahcd7l74  7,b7  ,originating site fee  

,in the case of a telehealth service    
payable under section #ahcd7m7 that is  
furnished in conjunction with treatment 
services furnished under the model      
described in paragraph 7#a71 the site   
where the individual receiving such     
telehealth service is located shall be  
treated as an originating site that is  
described in paragraph 7#d77;,c77ii77,v7
 of such section for purposes of        
applying paragraph 7#b77;,b7 of such    
section4  7#c7  ,duration  ,the model   
described in paragraph 7#a7 shall be    
carried out for a period of #e years4  4
  7b7  ,report  ,not later than #d years
 after the date on which the            
,comprehensive ,alternative ,response   
for ,emergencies ,model 7as described in
 section #aaae;,a7h7 of the ,social     
,security ,act1 as added by subsection  
7a77 is implemented1 the ,comptroller   
,general of the ,united ,states shall   
submit to the ,committee on ,ways and   
,means of the ,house of ,representatives
 and the ,committee on ,finance of the  

,senate a report that1 taking into      
account stakeholder input and to the    
extent data is available--  7#a7        
analyzes various aspects of ,medicare   
beneficiaries' access to emergency      
medical services1 including an          
evaluation of the impact of such model  
on beneficiary outcomes and resource    
utilization2  7#b7 compares beneficiary 
outcomes under such model with          
beneficiary outcomes using traditional  
emergency transportation2  7#c7 assesses
 the impact of regional variations and  
demographics on the availability of     
emergency medical services2  7#d7       
identifies best practices and potential 
challenges in implementing such model2  
and  7#e7 includes recommendations for  
improving emergency medical services4