Healthcare (Hospitals · Public Safety)

The Emergency Responders Mental Health Training Act directs the Secretary of Health and Human Services to create a pilot fellowship program that funds postbaccalaureate training for mental health and substance use disorder professionals. This initiative aims to increase the number of culturally competent practitioners who understand the unique stressors, duties, and confidentiality requirements faced by emergency response providers such as police, firefighters, and EMTs. The bill authorizes $10 million in annual appropriations for fiscal years 2028 through 2033 to support these fellowships across fields including psychiatry, nursing, social work, and psychology. Additionally, the Secretary must submit reports to Congress two and five years after the program's establishment to evaluate its efficiency, impact on patient outcomes, and overall effectiveness.

This bill creates a new Medicare payment model (the "Comprehensive Alternative Response for Emergencies Model") that allows Medicare Part B to cover ground ambulance services provided in response to emergency medical calls *without* a full transport. It directly affects Medicare beneficiaries receiving emergency ambulance care and ambulance providers, ensuring they are paid for services like dispatch and initial response that don't include transport. The model requires payment rates to align with standard transport payments, mandates compliance with state protocols, and operates for a 5-year test period. A report by the Comptroller General will evaluate the model's impact on beneficiary access, outcomes, and regional differences after 4 years.

HR 3443 creates a new Medicare payment model to provide supplemental funding for ground and air ambulance services that administer specific life-saving medications (like epinephrine, lidocaine, and blood products) during emergencies. It directly affects EMS agencies serving Medicare beneficiaries by requiring them to apply for participation, meet data reporting standards (including patient outcomes and service metrics), and receive monthly or quarterly supplemental payments based on costs for maintaining medication supplies and data systems. The model runs for at least 5 years, with a requirement for a congressional report analyzing whether the payments improve medication access, patient outcomes, and care quality - especially for rural and underserved communities. The bill also mandates a MedPAC report on EMS payment structures and EMTALA guidance to reduce "wall time" delays in hospital handoffs.

S 3145, the CARE Act of 2025, creates a new Medicare payment model for ground ambulance services provided during emergencies without patient transport. It directly affects Medicare beneficiaries who receive emergency medical dispatch services (like on-site care) and ambulance providers who serve them. The bill requires Medicare to pay for these non-transport services at rates aligned with traditional transport payments, while allowing telehealth services provided alongside them to count as originating sites. The model will operate for five years, with a mandatory report after four years evaluating its impact on beneficiary access, outcomes, and regional variations in emergency services.