WASHINGTON, D.C. – U.S. Senators Susan Collins (R-ME) and Peter Welch (D-VT) have introduced a bipartisan Comprehensive Alternative Response to Emergencies (CARE) Act. This bill would require the Centers for Medicare and Medicaid Services to test a five-year “treatment-in-place” model in which Medicare reimburses emergency medical service (EMS) providers when they treat a patient outside of the hospital, such as for minor medical incidents, rather than transporting them to a hospital for care.

“Having access to high-quality emergency medical services is essential for individuals in rural communities across Maine and the nation, yet in many areas these providers face serious staffing and financial challenges,” said Senator Collins, in a news release. “This bipartisan bill would expand the treatment-in-place model for EMS services, reducing unnecessary emergency room visits, lowering costs, and easing the strain on our state’s hospital and EMS workforces.”

“Vermont’s EMS providers are on the frontlines of medical emergencies. It’s only common sense that our government should pay EMS providers for their vital services, regardless of whether a person needs an ambulance to the hospital. But right now, EMS providers aren’t getting reimbursed for their lifesaving work—we need to fix that,” said Senator Welch. “I'm proud to work with Senator Collins on this bipartisan legislation to ensure that EMS providers can better help communities across rural America.” 

The CARE Act would build on the success of a temporary treatment-in-place model implemented during the COVID-19 pandemic, which demonstrated savings of more than $500 to Medicare per patient encounter. In Maine, about 35 percent of EMS calls conclude without transport to a hospital, leaving providers to absorb those costs. By reimbursing EMS for care delivered in place, this legislation would strengthen local emergency response and better ensure that more patients receive appropriate, timely care.

The bill is supported by the American Ambulance Association, the Maine Ambulance Association, North East Mobile Health Services, the National Association of Emergency Medical Technicians, the International Association of Fire Chiefs, the National Rural Healthcare Association, the National EMS Quality Alliance, and many local EMS organizations across the country. 

"We extend our heartfelt thanks to Senators Collins and Welch for their leadership in introducing the CARE Act,” said Jamie Pafford-Gresham, President of the American Ambulance Association. “By acknowledging that ambulance service organizations provide critical prehospital medical care, not just transportation, this legislation helps ensure that our nation’s EMTs and paramedics are properly recognized and services are reimbursed for this care delivered every single day in communities across America.”

“The CARE Act will help build upon projects underway in Maine in which our paramedics and EMTs are utilizing pre-hospital medical advancements to provide Mainers with high-quality health care without potentially having to go to the hospital,” said Dennis Brockway, CEO and President of North East Mobile Health Services. 

"The IAFC supports the bipartisan Comprehensive Alternative Response for Emergencies (CARE) Act," said Fire Chief Trisha L. Wolford, President and Board Chair of the International Association of Fire Chiefs. "Fire-based EMS agencies across the nation are on the front lines of our healthcare system, providing critical care every day while facing the challenges of overburdened emergency departments and increasing demand on EMS. The CARE Act represents a significant step toward recognizing and supporting fire and EMS departments in their lifesaving work, while enhancing patient outcomes and alleviating the burden on overcrowded emergency departments. We commend Senator Collins and Senator Welch for their leadership in advancing this initiative with a common-sense approach to modernizing emergency medical care."

The complete text of the bill can be read here.