HR2533-119

1. Short title This Act may be cited as the Ensuring Access to Specialty care Everywhere Act of 2025 or the EASE Act of 2025.

2. Requiring the Center for Medicare and Medicaid Innovation to test a model to improve access to specialty health services for certain Medicare and Medicaid beneficiaries Section 1115A of the Social Security Act (42 U.S.C. 1315a) is amended— in subsection (b)(2)— in subparagraph (A), in the third sentence, by inserting , and shall include the model described in subparagraph (B)(xxviii) before the period at the end; and in subparagraph (B), by adding at the end the following new clause: The Specialty Health Care Services Access Model described in subsection (h). by adding at the end the following new subsection: For purposes of subsection (b)(2)(B)(xxviii), the Specialty Health Care Services Access Model described in this subsection is a model under which the Secretary enters into an agreement with one or more provider networks selected in accordance with paragraph (2) for purposes of furnishing specialty health care services (as specified by the Secretary) to eligible individuals through the use of digital modalities (such as telehealth and other remote technologies) in coordination with such individuals’ primary care providers. The Secretary shall select one or more networks of providers for purposes of furnishing services under the model described in paragraph (1). Any such network so selected shall— be comprised of at least 50 Federally qualified health centers, rural health clinics, critical access hospitals, or rural emergency hospitals, at least half of which are located in rural areas (as defined by the Administrator of the Health Resources and Services Administration); be a nonprofit entity under section 501(c)(3) of the Internal Revenue Code of 1986; have an established record of supporting the delivery of health care in rural and underserved communities in multiple regions throughout the country; and have the ability to collect, exchange, and evaluate data for purposes of the model described in paragraph (1). For purposes of this subsection, the term eligible individual means an individual— who— is entitled to benefits under part A of title XVIII or enrolled under part B of such title; or is enrolled under the Medicaid program under title XIX or the Children's Health Insurance Program under title XXI and meets all components for eligibility for medical assistance, child health assistance, or pregnancy-related assistance (as applicable), including those described in sections 1902(a)(46)(B) and 1137(d); and who is located in a rural or underserved area (as specified by the Secretary). Any amounts appropriated or allocated to carry out the amendments made by this section shall be subject to the requirements contained in Public Law 117–328 for funds for programs authorized under sections 330 through 340 of the Public Health Service Act (42 U.S.C. 254b through 256). (xxviii)The Specialty Health Care Services Access Model described in subsection (h). ; and (h)Specialty Health Care Services Access Model (1)In generalFor purposes of subsection (b)(2)(B)(xxviii), the Specialty Health Care Services Access Model described in this subsection is a model under which the Secretary enters into an agreement with one or more provider networks selected in accordance with paragraph (2) for purposes of furnishing specialty health care services (as specified by the Secretary) to eligible individuals through the use of digital modalities (such as telehealth and other remote technologies) in coordination with such individuals’ primary care providers. (2)Selection of provider networksThe Secretary shall select one or more networks of providers for purposes of furnishing services under the model described in paragraph (1). Any such network so selected shall— (A)be comprised of at least 50 Federally qualified health centers, rural health clinics, critical access hospitals, or rural emergency hospitals, at least half of which are located in rural areas (as defined by the Administrator of the Health Resources and Services Administration); (B)be a nonprofit entity under section 501(c)(3) of the Internal Revenue Code of 1986; (C)have an established record of supporting the delivery of health care in rural and underserved communities in multiple regions throughout the country; and (D)have the ability to collect, exchange, and evaluate data for purposes of the model described in paragraph (1). (3)Eligible individual definedFor purposes of this subsection, the term eligible individual means an individual— (A)who— (i)is entitled to benefits under part A of title XVIII or enrolled under part B of such title; or (ii)is enrolled under the Medicaid program under title XIX or the Children's Health Insurance Program under title XXI and meets all components for eligibility for medical assistance, child health assistance, or pregnancy-related assistance (as applicable), including those described in sections 1902(a)(46)(B) and 1137(d); and (B)who is located in a rural or underserved area (as specified by the Secretary)..