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ET3 Model Timeline Delay and Important Updates

Apr 08, 2020

ET3 Model Stakeholders,

Thank you for your engagement to date related to the ET3 Model. The Centers for Medicare & Medicaid Services (CMS) is seeking to support the community of organizations that are responding to the public health emergency stemming from the Novel Coronavirus Disease (COVID-19). As CMS and ET3 Model selected applicants work to respond to needs due to COVID-19, CMS has decided to delay the start of the ET3 Model from May 1, 2020 until Fall 2020.

CMS appreciates your continued support and enthusiasm for the innovations available under the ET3 Model, and as such, we will continue to communicate information and updates about the Model through this listserv.

Important Updates Regarding CMS Flexibilities to Fight COVID-19

In addition, we want to inform ET3 Model stakeholders that CMS recently announced in a press release an Interim Final Rule with Comment Period (IFC) that provides temporary regulatory waivers and new rules to equip the American healthcare system with maximum flexibility to respond to the 2019 COVID-19 pandemic. The IFC and all of CMS’s Coronavirus Waivers & Flexibilities can be found here.

The flexibilities offered specifically to ambulances during the Public Health Emergency (PHE) for the COVID-19 pandemic can be found at this link: Ambulances (PDF). This includes temporarily expanding the list of allowable destinations for ground ambulance transports during the COVID-19 PHE to include any destination that is equipped to treat the condition of the patient in a manner consistent with state and local Emergency Medical Services (EMS) protocols in use where the services are being furnished. These destinations may include, but are not limited to: any location that is an alternative site determined to be part of a hospital, CAH or SNF, community mental health centers, federally qualified health centers (FQHCs), rural health clinics (RHCs), physician’s offices, urgent care facilities, ambulatory surgical centers (ASCs), any location furnishing dialysis services outside of the ESRD facility when an ESRD facility is not available, and the beneficiary’s home. Home may be an appropriate destination for a COVID-19 patient who is discharged from the hospital to home to be under quarantine. There must be a medically necessary ground ambulance transport of a patient in order for an ambulance service to be covered.

These actions, and earlier CMS actions in response to COVID-19, are part of the ongoing White House Coronavirus Task Force efforts. To keep up with the important work the Task Force is doing in response to COVID-19, visit For a complete and updated list of CMS actions, and other information specific to CMS, please visit the Current Emergencies website.

Thank you again for your interest in the Model and for your efforts to improve the quality of care in the EMS industry. 

If you have any questions about this update, please contact the ET3 Model team at