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H.R. 3443 establishes a new Medicare payment model and comprehensive review of emergency medical services (EMS) funding. The bill creates a five-year pilot program that provides supplemental payments to ambulance services for life-saving medications—including epinephrine, fentanyl, and blood products—needed by paramedics during emergencies, with the goal of ensuring these critical supplies are always available without medication shortages forcing protocol changes. The pilot will include at least one EMS agency in each of the 10 federal health regions and will gather data on whether these supplemental payments improve patient outcomes, especially for rural and underserved communities. Additionally, the bill requires the Medicare Payment Advisory Commission to submit a report within two years analyzing whether current Medicare payments to EMS providers adequately compensate paramedics and medical directors, and whether EMS agencies should be formally recognized as Medicare providers. The bill also directs the Department of Health and Human Services to issue guidance on reducing "wall time"—delays exceeding 30 minutes when EMS personnel hand off patients to hospital staff—and report back to Congress on whether the guidance decreases these dangerous delays.

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