Sec. 9. Evaluating innovative models for access and delivery of field EMS for patients
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Not later than 1 year after the date of the enactment of this Act, the Director of the Office of EMS and Trauma, in consultation with the Administrator of the Centers for Medicare & Medicaid Services (in this section referred to as the Director ), and taking into consideration the recommendations of NEMSAC and FICEMS, shall complete an evaluation of— the provision of and reimbursement for alternative delivery models for medical care through field EMS; and the integration of field EMS patients with other medical providers and facilities as medically appropriate. The evaluation under paragraph
(1)shall consider each of the following: Alternative dispositions of patients, including— transporting patients by ambulance to destinations other than a hospital such as the office of the patient’s physician, an urgent care center, or the facilities of another health care provider; when medically necessary, the evaluation, treatment, or referral of patients to other medically appropriate health care providers; and the funding of the provision of medical care regardless of the decision to transport such as reimbursement models based on readiness rather than transport and shared savings. Issues related to medical liability and the requirements of section 1867 of the Social Security Act ( 42 U.S.C. 1395dd ; commonly referred to as EMTALA ) associated with transport to destinations other than a hospital emergency department. Necessary protections to ensure that patients receive timely and appropriate care in the appropriate setting. Whether there are any barriers to providing alternate dispositions to patients who are not in need of care in hospital emergency departments. Other issues determined by the Director, including, when possible, issues recommended by FICEMS or NEMSAC for evaluation under this subsection. Beginning not later than 1 year after the date of the enactment of this Act, the Director shall conduct or support at least 10 demonstration projects to— evaluate the implementation and reimbursement of alternative dispositions of field EMS patients, including— transporting patients by ambulance to alternate destinations when medically appropriate and in the patients’ best interests; and when medically necessary, evaluating, treating, or referring patients to other medically appropriate providers; evaluate the implementation of reimbursement models based on readiness rather than transport or shared savings; and determine whether such alternative dispositions and reimbursement models— improve the safety, effectiveness, timeliness, and efficiency of EMS; and reduce overall utilization and expenditures under the Medicare program under title XVIII of the Social Security Act. The Director shall ensure that at least one demonstration project under paragraph
(1)evaluates evidence-based protocols that give guidance on selection of the destination to which patients are transported. The period of a demonstration project under paragraph
(1)shall not exceed 36 months. If the Director determines that further research is necessary prior to or in conjunction with the demonstration projects under this subsection in order to evaluation the implementation of alternative dispositions of field EMS patients, the Director shall conduct or support such research. Of the amount made available to carry out section 1115A of the Social Security Act (42 U.S.C. 1315a) for a fiscal year, there are authorized to be appropriated such sums as may be necessary to carry out this subsection. Not later than 1 year after the completion of all demonstration projects under subsection (b), the Director shall submit to the Congress a report on the results of activities under this section, including recommendations on the efficacy of alternative dispositions of field EMS patients.
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Sec. 9
Evaluating innovative models for access and delivery of field EMS for patients
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