Today, Representatives Mike Carey (OH-15), Lloyd Doggett (TX-35), Carol Miller (WV-01), Pat Ryan (NY-18) and Debbie Dingell (MI-12) introduced the bipartisan Improving Access to Emergency Medical Services for Seniors Act. The bill would allow seniors on Medicare to receive at-home emergency medical services to treat minor medical incidents.
“Not every patient is best served by an emergency room visit,” said Congressman Carey. “In fact, for many seniors, a trip to the hospital can mean long wait times, increased costs and potentially life-threatening complications. We’re proud to lead this bill to give our seniors access to the highest caliber of care.”
Treatment-in-place options for emergency medical reduces costs, increases convenience and protects seniors from potentially life-threatening infections.
Adults aged 65 and older account for nearly 20 percent of all ER visits. This population contributes to the backlog in waiting rooms, even when they might not have an issue requiring inpatient treatment. In a 2021 study, patients who received at-home care had a lower risk for readmission by 26 percent and a lower risk for long-term care admission as compared to patients who received in-hospital treatment.
“Treating patients immediately at home and preventing an emergency room trip is sometimes both the best way to help the patient and the taxpayer. Our legislation to establish a Medicare pilot program is designed to show the effectiveness of fair pay to first responders for such services. Thereby we hope to encourage a permanent payment system for treatment in place,” said Rep. Doggett.
Emergency Medical Services (EMS) providers are at the frontline of delivering care and transportation in rural America. In West Virginia, many patients live hours from a hospital and must consistently rely on EMS for treatment. Our EMS personnel are equipped to provide care to patients that may not be in a dire medical situation, rather than spend precious time and resources on transporting non-emergency patients to a hospital emergency department. This commonsense legislation builds upon the Treatment-in-Place Model to provide timely care to our rural patients and empower EMS providers, and I will continue to work to improve access to quality health care for patients in West Virginia and across the U.S.” said Congresswoman Miller.
“Our grandparents, neighbors, and friends are safer and healthier because of the dedicated care paramedics and EMTs provide to our community,” said Congressman Pat Ryan. “They deserve to be compensated – no matter where they administer care. That’s why I’m proud to co-lead the Improving Access to Emergency Medical Services Act to ensure that our highly trained first responders are fully supported in continuing to save lives and serve our seniors. I will keep fighting for the resources that our first responders need and deserve.”
Rep Dingell said, “We should be making it easier for seniors to live and receive the care they need at home and in their communities. The Improving Access to Emergency Ambulance Services Act will allow seniors to receive this care that can easily be provided at home by EMT professionals rather than paying for a hospital visit. Allowing EMTs to be reimbursed for this care and preventing unnecessary hospital visits would be an immense cost-saver for Medicare, free up emergency room space for those who really need critical care, and improve quality of life for our seniors.”
The bill has received support from the National Rural Health Association, International Association of Fire Chiefs, International Association of Firefighters, American Ambulance Association, Congressional Fire Service Institute, National Association of Towns and Townships and the National Association of Emergency Medical Technicians.
Randy Strozyk, President of the American Ambulance Association said, "We greatly appreciate the leadership of Representatives Mike Carey, Lloyd Doggett, Carol Miller, Debbie Dingell and Pat Ryan in laying the foundation for future Medicare reimbursement of vital ambulance services provided at the scene of a patient in need of medical care but doesn't require a transport to a health care facility. The Improving Access to Emergency Ambulance Services Act will establish a pilot project that will demonstrate the financial and medical benefits to the Medicare program of reimbursing for treatment in place of patients by paramedics and emergency medical technicians."
Susan Bailey, MSEM, NRP, President of NAEMT, remarked: "EMS is an integral part of our nation’s healthcare system and has been proven effective in the health continuum. EMS Practitioners are now providing medical care in a variety of settings. Our role has become much broader than ambulance transport. NAEMT has long advocated for providing EMS agencies the flexibility to navigate patients to the right care in the right setting through federal and state reimbursement of Treatment in Place (TIP). We applaud Rep. Mike Carey, Rep. Lloyd Doggett, Rep. Carol Miller, Rep. Pat Ryan and Rep. Debbie Dingell for their leadership and introduction of the Improving Access to Emergency Medical Services Act of 2024. Reimbursing EMS agencies for TIP will save Medicare billions of dollars on unnecessary emergency department visits, enhance patient experience, shorten task times for EMS agencies struggling with workforce shortages, help decompress overcrowded hospitals and emergency departments, and meet patients’ needs without long waits at the hospital.”
“EMS is a fundamental, core service that fire departments provide in their communities. Fire fighters are among the most skilled and experienced pre-hospital emergency care providers in the nation, and it is long past time that we reimburse them for the full range of care that they give to ill and injured patients. Updating Medicare’s reimbursement policies is a common-sense way to drive EMS innovation and improve the patients’ experiences during medical emergencies. The IAFF applauds Reps. Carey, Doggett, Miller, Ryan, and Dingell for their bipartisan leadership in developing this bill, and we urge Congress to answer our call to bring EMS into the 21st century,” said IAFF General President Edward A. Kelly
“I thank Representatives Carey, Doggett, Miller, Ryan, and Dingell for introducing this legislation to reimburse fire and EMS departments for treating Medicare patients in places like their homes,” said Fire Chief John S. Butler, Fairfax County, VA and International Association of Fire Chiefs President and Board Chair. “This legislation will allow some of our nation’s most vulnerable citizens to receive necessary care without the trauma and expense of being transported to the hospital. It also ensures that fire and EMS departments only must transport patients if it is medically necessary, which frees up vital EMS and hospital resources. This program will be a win-win for both Medicare patients and emergency response agencies.”
Full text of the bill is available here.