When Minutes Count for Emergency Medical Patients Act

Bill Number

H.R. 3443

Origin Chamber

House

Congress

119th Congress, Session 1

Policy Area

Health

Status

Introduced

Latest Action

2025-05-15: Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.

Last Updated

2026-06-10T08:08:14Z

AI-Generated Summary

Purpose

The "When Minutes Count for Emergency Medical Patients Act" (H.R. 3443) aims to enhance Medicare payments for emergency medical services (EMS) by creating a new payment model to support the supply and use of critical life-saving medications and blood products during emergencies. It also directs studies and reports to evaluate and improve EMS payment structures, address workforce shortages, and ensure quality care for Medicare beneficiaries, particularly in underserved areas.

Key Provisions

• EMS Payment Model (Section 2): Establishes the "When Minutes Count for EMS Patients Model" under the Center for Medicare & Medicaid Innovation (CMMI). This voluntary model provides supplemental payments to selected EMS agencies for ground and air ambulance services involving specified life-saving medications (e.g., epinephrine, albuterol, fentanyl) and blood products administered to patients with emergency medical conditions.
• Eligible EMS agencies must apply and demonstrate ability to provide data on care quality, patient outcomes, and specific metrics (e.g., ICD-10 codes and National EMS Information System elements).
• The Secretary of Health and Human Services (HHS) must select at least one agency per HHS region and across agency types (e.g., fire-based, hospital-based), ensuring coverage in rural, urban, suburban, and frontier areas.
• Payments are calculated based on costs like acquiring and maintaining double the average supply of medications to avoid shortages, blood product handling (including storage and wastage), and data reporting software. Payments are issued as monthly or quarterly lump sums, in addition to standard Medicare ambulance reimbursements.
• The model lasts at least 5 years, after which HHS must report to Congress on its effects, including utilization of supplies, patient outcomes (e.g., morbidity and mortality), and benefits for underserved and rural populations.
• MedPAC Report (Section 3(a)): Requires the Medicare Payment Advisory Commission (MedPAC) to submit a report to Congress within 2 years of enactment analyzing Medicare EMS payments. Key elements include:
• Evaluation of EMS medical directors' roles (e.g., oversight, protocol updates) and whether current payments suffice for their compensation, including recommendations for separate payments (online vs. offline direction).
• Assessment of EMS professional shortages since 2020, their impact on Medicare access, and suggestions to improve recruitment and staffing, especially with evolving EMS practices like "treat-in-place" care.
• Recommendations for quality assurance mechanisms, such as performance measures or participation requirements tailored to EMS uniqueness.
• Analysis of adding a statutory definition of "emergency medical services" to the Social Security Act and including EMS agencies as "providers of services" for potential payment and benefit changes.
• EMTALA Guidance and Report (Section 3(b)): Directs HHS to issue guidance within 1 year to hospitals on reducing "wall time" (delays over 30 minutes in handing off patients from EMS to hospital staff under the Emergency Medical Treatment and Labor Act, or EMTALA). HHS must then report to Congress within another year on the guidance's effectiveness in reducing delays and recommend any needed laws.

Significant Changes to Existing Law

• Amends Section 1115A of the Social Security Act to add the new EMS payment model to CMMI's list of initiatives, introducing supplemental funding not tied to actual Medicare patient usage but to maintaining broader community supplies.
• No direct alterations to baseline Medicare ambulance payments (under Section 1834), but the model layers on top, potentially influencing future reimbursements based on MedPAC's findings.
• Introduces requirements for EMS data reporting and regional selection criteria, expanding CMMI's scope to EMS-specific shortages and innovations like non-hospital transports.
• Prompts potential future amendments via MedPAC recommendations, such as defining EMS in statute or reclassifying agencies as providers, which could integrate EMS more fully into Medicare's framework.

Potential Impacts

• Government Agencies: Increases administrative burden on HHS and CMMI for model implementation, participant selection, and reporting; elevates MedPAC's role in EMS policy. Could raise Medicare expenditures through supplemental payments but generate data to inform cost-saving reforms.
• Citizens: Improves EMS readiness by addressing medication shortages, potentially leading to faster, higher-quality emergency care and better outcomes for Medicare beneficiaries (e.g., reduced mortality in rural or underserved areas). May enhance access for all patients via community-wide supply maintenance, though benefits extend beyond Medicare.
• International Relations: No direct impacts, as the bill focuses on domestic U.S. healthcare policy.

Main Stakeholders Affected

• EMS Agencies and Professionals: Primary beneficiaries of supplemental payments and MedPAC recommendations; addresses shortages and oversight needs to improve recruitment and operations.
• Medicare Beneficiaries: Gain from potentially better-equipped EMS responses, especially those in rural or emergency-prone areas.
• Hospitals and Emergency Departments: Affected by EMTALA guidance to reduce handoff delays, which could streamline workflows but require operational changes.
• HHS and MedPAC: Responsible for implementation, guidance, and analysis, influencing broader healthcare policy.
• Pharmaceutical and Blood Supply Providers: Indirectly impacted through increased demand for specified medications and products.

Notable Legal, Constitutional, or Political Implications

• Legal: Strengthens EMTALA enforcement by targeting "wall time" delays, potentially reducing liability for hospitals while clarifying obligations. MedPAC's analysis could lead to statutory expansions of Medicare coverage, affecting reimbursement disputes and EMS accreditation standards under the Controlled Substances Act.
• Constitutional: No apparent challenges; aligns with Congress's authority over interstate commerce and spending for public health.
• Political: Bipartisan sponsorship highlights consensus on EMS vulnerabilities post-2020 shortages; emphasizes equity for rural and underserved groups, which could influence future healthcare funding debates without overt partisanship.

This summary was generated by AI and may contain inaccuracies. Refer to the official source document for the authoritative text.

Sponsor

Rep. Hudson, Richard [R-NC-9]

Cosponsors (8)

Rep. Dingell, Debbie [D-MI-6], Rep. Tenney, Claudia [R-NY-24], Rep. Gottheimer, Josh [D-NJ-5], Del. Norton, Eleanor Holmes [D-DC-At Large], Rep. Mackenzie, Ryan [R-PA-7], Rep. Thompson, Glenn [R-PA-15], Rep. Bilirakis, Gus M. [R-FL-12], Rep. Kiggans, Jennifer A. [R-VA-2]

Recent Actions

• 2025-05-15: Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
• 2025-05-15: Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
• 2025-05-15: Introduced in House
• 2025-05-15: Introduced in House

Bill Versions

• When Minutes Count for Emergency Medical Patients Act — issued 2025-05-15 — PDF (18 pages)