2022 -- S 2476 SUBSTITUTE A AS AMENDED | |
======== | |
LC004627/SUB A | |
======== | |
STATE OF RHODE ISLAND | |
IN GENERAL ASSEMBLY | |
JANUARY SESSION, A.D. 2022 | |
____________ | |
A N A C T | |
RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES | |
| |
Introduced By: Senators Miller, DiMario, Lawson, Valverde, and Cano | |
Date Introduced: March 01, 2022 | |
Referred To: Senate Health & Human Services | |
It is enacted by the General Assembly as follows: | |
1 | SECTION 1. Chapter 27-18 of the General Laws entitled "Accident and Sickness Insurance |
2 | Policies" is hereby amended by adding thereto the following sections: |
3 | 27-18-89. Emergency medical services transport to alternate facilities. |
4 | (a) As used in this section, the following terms shall have the following meanings: |
5 | (1) "Basic life support" or "BLS" means transportation by ground ambulance vehicle and |
6 | medically necessary supplies and services, plus the provision of BLS ambulance services. The |
7 | ambulance must be staffed by at least two (2) people who meet the requirements of state laws and |
8 | regulations where the services are being furnished. Also, at least one of the staff members must be |
9 | licensed, at a minimum, as an emergency medical technician by the state or local authority where |
10 | the services are furnished and be legally authorized to operate all lifesaving and life-sustaining |
11 | equipment on board the vehicle. |
12 | (2) "Emergency medical services" or "EMS" means the practitioners, ambulance vehicles, |
13 | and ambulance service entities licensed in accordance with chapter 4.1 of title 23 to provide |
14 | emergency medical care, transportation, and preventive care to mitigate loss of life or exacerbation |
15 | of illness or injury, including, but not limited to, EMS responding to the 911 system established |
16 | under chapter 21.1 of title 39. |
17 | (3) "Emergency medical services practitioner" means an individual who is licensed in |
18 | accordance with state laws and regulations to perform emergency medical care and preventive care |
19 | to mitigate loss of life or exacerbation of illness or injury, including emergency medical |
| |
1 | technicians, advanced emergency medical technicians, advanced emergency medical technicians- |
2 | cardiac, and paramedics. |
3 | (4) “Mobile integrated healthcare/community paramedicine” means the provision of |
4 | healthcare using patient-centered, mobile resources in the out-of-hospital environment with EMS |
5 | agency’s licensed paramedic and advanced emergency medical technician-cardiac practitioners |
6 | working in collaboration with physicians, nurses, mid-level practitioners, community health teams |
7 | and social, behavioral and substance use disorder specialists to address the unmet needs of |
8 | individuals experiencing intermittent health care issues. The mobile integrated |
9 | healthcare/community paramedicine program rules, regulations, standing orders, protocols, and |
10 | procedures shall be instituted by the department of health with the collaboration of the ambulance |
11 | service coordinating advisory board. |
12 | (b) This section authorizes emergency medical services in the state participating in a mobile |
13 | integrated healthcare/community paramedicine program to divert non-emergency basic life service |
14 | calls from emergency departments. Emergency medical services practitioners shall assess |
15 | individuals who are in need of emergency medical services and apply the correct level of care |
16 | thereafter, which may include transport to an alternative facility deemed appropriate by the |
17 | emergency medical services practitioner. An alternative facility shall include, but not be limited to: |
18 | (1) An individual’s primary care provider; |
19 | (2) A community health clinic; |
20 | (3) An urgent care facility; |
21 | (4) An emergency room diversion facility, as defined in § 23-17.26-2; and |
22 | (5) A community-based behavioral health facility designed to provide immediate |
23 | assistance to a person in crisis. |
24 | (c) Emergency medical services shall be permitted to transport to the following facilities |
25 | designated by the director of the department of health: |
26 | (1) Emergency room diversion facilities, as defined in § 23-17.26-2; and |
27 | (2) Community-based behavioral health facilities designed to provide immediate assistance |
28 | to a person in crisis. |
29 | (d) Commencing January 1, 2023, every individual or group health insurance contract, plan |
30 | or policy issued for delivery or renewed in this state that provides medical coverage that includes |
31 | coverage for emergency medical services shall provide coverage for transport to an alternative |
32 | location facility as identified in subsection (b) of this section and shall reimburse the EMS for such |
33 | services at the same rate as for a non-emergency basic life support transport to an emergency |
34 | department. |
| LC004627/SUB A - Page 2 of 14 |
1 | (e) If treatment at an alternative facility is deemed appropriate by the EMS practitioner, the |
2 | emergency medical service shall bill at the rate described in subsection (d) of this section, even if |
3 | an advanced life support assessment was provided. |
4 | (f) The office of the health insurance commissioner and/or the department of health may |
5 | promulgate such rules and regulations as are necessary and proper to effectuate the purpose and for |
6 | the efficient administration and enforcement of this section. |
7 | 27-18-90. Coverage of EMS mental health and substance use disorder treatment. |
8 | (a) As used in this section, "emergency medical services" or "EMS" means the |
9 | practitioners, ambulance vehicles, and ambulance service entities licensed in accordance with |
10 | chapter 4.1 of title 23 to provide emergency medical care, transportation, and preventive care to |
11 | mitigate loss of life or exacerbation of illness or injury, including, but not limited to, EMS |
12 | responding to the 911 system established under chapter 21.1 of title 39. |
13 | (b) Emergency medical services shall be permitted to allow licensed providers who treat |
14 | mental health disorders, including substance use disorders, to accompany EMS. Such providers |
15 | shall be permitted to treat EMS patients when medically necessary and appropriate. Such treatment |
16 | shall be permitted to occur in the community. |
17 | (c) Commencing January 1, 2023, every individual or group health insurance contract, plan |
18 | or policy issued for delivery or renewed in this state that provides medical coverage that includes |
19 | coverage for emergency medical services, shall provide coverage for transportation and treatment |
20 | described in subsection (b) of this section and shall reimburse such services at a rate not lower than |
21 | the same service would have been had that service been delivered in a traditional office setting. |
22 | (d) Treatment and coverage for mental health disorders, including substance use disorders, |
23 | as described in this section shall be provided in accordance with chapter 38.2 of title 27. |
24 | (e) The office of the health insurance commissioner and/or the department of health may |
25 | promulgate such rules and regulations as are necessary and proper to effectuate the purpose and for |
26 | the efficient administration and enforcement of this section. |
27 | SECTION 2. Chapter 27-19 of the General Laws entitled "Nonprofit Hospital Service |
28 | Corporations" is hereby amended by adding thereto the following sections: |
29 | 27-19-81. Emergency medical services transport to alternate facilities. |
30 | (a) As used in this section, the following terms shall have the following meaning: |
31 | (1) "Basic life support" or "BLS" means transportation by ground ambulance vehicle and |
32 | medically necessary supplies and services, plus the provision of BLS ambulance services. The |
33 | ambulance must be staffed by at least two (2) people who meet the requirements of state laws and |
34 | regulations where the services are being furnished. Also, at least one of the staff members must be |
| LC004627/SUB A - Page 3 of 14 |
1 | licensed, at a minimum, as an emergency medical technician by the state or local authority where |
2 | the services are furnished and be legally authorized to operate all lifesaving and life-sustaining |
3 | equipment on board the vehicle. |
4 | (2) "Emergency medical services" or "EMS" means the practitioners, ambulance vehicles, |
5 | and ambulance service entities licensed in accordance with chapter 4.1 of title 23 to provide |
6 | emergency medical care, transportation, and preventive care to mitigate loss of life or exacerbation |
7 | of illness or injury, including, but not limited to, EMS responding to the 911 system established |
8 | under chapter 21.1 of title 39. |
9 | (3) "Emergency medical services practitioner" means an individual who is licensed in |
10 | accordance with state laws and regulations to perform emergency medical care and preventive care |
11 | to mitigate loss of life or exacerbation of illness or injury, including emergency medical |
12 | technicians, advanced emergency medical technicians, advanced emergency medical technicians- |
13 | cardiac, and paramedics. |
14 | (4) “Mobile integrated healthcare/community paramedicine” means the provision of |
15 | healthcare using patient-centered, mobile resources in the out-of-hospital environment with EMS |
16 | agency’s licensed paramedic and advanced emergency medical technician-cardiac practitioners |
17 | working in collaboration with physicians, nurses, mid-level practitioners, community health teams |
18 | and social, behavioral and substance use disorder specialists to address the unmet needs of |
19 | individuals experiencing intermittent health care issues. The mobile integrated |
20 | healthcare/community paramedicine program rules, regulations, standing orders, protocols, and |
21 | procedures shall be instituted by the department of health with the collaboration of the ambulance |
22 | service coordinating advisory board. |
23 | (b) This section authorizes emergency medical services in the state participating in a mobile |
24 | integrated healthcare/community paramedicine program to divert non-emergency basic life service |
25 | calls from emergency departments. Emergency medical services practitioners shall assess |
26 | individuals who are in need of emergency medical services and apply the correct level of care |
27 | thereafter, which may include transport to an alternative facility deemed appropriate by the |
28 | emergency medical services practitioner. An alternative facility shall include, but not be limited to: |
29 | (1) An individual’s primary care provider; |
30 | (2) A community health clinic; |
31 | (3) An urgent care facility; |
32 | (4) An emergency room diversion facility, as defined in § 23-17.26-2; and |
33 | (5) A community-based behavioral health facility designed to provide immediate |
34 | assistance to a person in crisis. |
| LC004627/SUB A - Page 4 of 14 |
1 | (c) Emergency medical services shall be permitted to transport to the following facilities |
2 | designated by the director of RIDOH: |
3 | (i) emergency room diversion facilities, as defined in § 23-17.26-2; and |
4 | (ii) community-based behavioral health facilities designed to provide immediate assistance |
5 | to a person in crisis. |
6 | (d) Commencing January 1, 2023, every individual or group health insurance contract, plan |
7 | or policy issued for delivery or renewed in this state that provides medical coverage that includes |
8 | coverage for emergency medical services shall provide coverage for transport to an alternative |
9 | location facility as identified in subsection (b) of this section and shall reimburse the EMS for such |
10 | services at the same rate as for a non-emergency basic life support transport to an emergency |
11 | department. |
12 | (e) If treatment at an alternative facility is deemed appropriate by the EMS practitioner, the |
13 | emergency medical service shall bill at the rate described in subsection (d) of this section even if |
14 | an advanced life support assessment was provided. |
15 | (f) The office of the health insurance commissioner and/or Rhode Island department of |
16 | health may promulgate such rules and regulations as are necessary and proper to effectuate the |
17 | purpose and for the efficient administration and enforcement of this section. |
18 | 27-19-82. Coverage of EMS mental health and substance use disorder treatment. |
19 | (a) As used in this section, "emergency medical services" or "EMS" means the |
20 | practitioners, ambulance vehicles, and ambulance service entities licensed in accordance with |
21 | chapter 4.1 of title 23 to provide emergency medical care, transportation, and preventive care to |
22 | mitigate loss of life or exacerbation of illness or injury, including, but not limited to, EMS |
23 | responding to the 911 system established under chapter 21.1 of title 39. |
24 | (b) Emergency medical services shall be permitted to allow licensed providers who treat |
25 | mental health disorders, including substance use disorders, to accompany EMS. Such providers |
26 | shall be permitted to treat EMS patients when medically necessary and appropriate. Such treatment |
27 | shall be permitted to occur in the community. |
28 | (c) Commencing January 1, 2023, every individual or group health insurance contract, plan |
29 | or policy issued for delivery or renewed in this state that provides medical coverage that includes |
30 | coverage for emergency medical services, shall provide coverage for transportation and treatment |
31 | described in subsection (b) of this section and shall reimburse such services at a rate not lower than |
32 | the same service would have been had that service been delivered in a traditional office setting. |
33 | (d) Treatment and coverage for mental health disorders, including substance use disorders, |
34 | as described in this section shall be provided in accordance with chapter 38.2 of title 27. |
| LC004627/SUB A - Page 5 of 14 |
1 | (e) The office of the health insurance commissioner and/or Rhode Island department of |
2 | health may promulgate such rules and regulations as are necessary and proper to effectuate the |
3 | purpose and for the efficient administration and enforcement of this section. |
4 | SECTION 3. Chapter 27-20 of the General Laws entitled "Nonprofit Medical Service |
5 | Corporations" is hereby amended by adding thereto the following sections: |
6 | 27-20-77. Emergency medical services transport to alternate facilities. |
7 | (a) As used in this section, the following terms shall have the following meaning: |
8 | (1) "Basic life support" or "BLS" means transportation by ground ambulance vehicle and |
9 | medically necessary supplies and services, plus the provision of BLS ambulance services. The |
10 | ambulance must be staffed by at least two (2) people who meet the requirements of state laws and |
11 | regulations where the services are being furnished. Also, at least one of the staff members must be |
12 | licensed, at a minimum, as an emergency medical technician by the state or local authority where |
13 | the services are furnished and be legally authorized to operate all lifesaving and life-sustaining |
14 | equipment on board the vehicle. |
15 | (2) "Emergency medical services" or "EMS" means the practitioners, ambulance vehicles, |
16 | and ambulance service entities licensed in accordance with chapter 4.1 of title 23 to provide |
17 | emergency medical care, transportation, and preventive care to mitigate loss of life or exacerbation |
18 | of illness or injury including, but not limited to, EMS responding to the 911 system established |
19 | under chapter 21.1 of title 39. |
20 | (3) "Emergency medical services practitioner" means an individual who is licensed in |
21 | accordance with state laws and regulations to perform emergency medical care and preventive care |
22 | to mitigate loss of life or exacerbation of illness or injury, including emergency medical |
23 | technicians, advanced emergency medical technicians, advanced emergency medical technicians- |
24 | cardiac, and paramedics. |
25 | (4) “Mobile integrated healthcare/community paramedicine” means the provision of |
26 | healthcare using patient-centered, mobile resources in the out-of-hospital environment with EMS |
27 | agency’s licensed paramedic and advanced emergency medical technician-cardiac practitioners |
28 | working in collaboration with physicians, nurses, mid-level practitioners, community health teams |
29 | and social, behavioral and substance use disorder specialists to address the unmet needs of |
30 | individuals experiencing intermittent health care issues. The mobile integrated |
31 | healthcare/community paramedicine program rules, regulations, standing orders, protocols, and |
32 | procedures shall be instituted by the department of health with the collaboration of the ambulance |
33 | service coordinating advisory board. |
34 | (b) This section authorizes emergency medical services in the state participating in a mobile |
| LC004627/SUB A - Page 6 of 14 |
1 | integrated healthcare/community paramedicine program to divert non-emergency basic life service |
2 | calls from emergency departments. Emergency medical services practitioners shall assess |
3 | individuals who are in need of emergency medical services and apply the correct level of care |
4 | thereafter, which may include transport to an alternative facility deemed appropriate by the |
5 | emergency medical services practitioner. An alternative facility shall include, but not be limited to: |
6 | (1) An individual’s primary care provider; |
7 | (2) A community health clinic; |
8 | (3) An urgent care facility; |
9 | (4) An emergency room diversion facility, as defined in § 23-17.26-2; and |
10 | (5) A community-based behavioral health facility designed to provide immediate |
11 | assistance to a person in crisis. |
12 | (c) Emergency medical services shall be permitted to transport to the following facilities |
13 | designated by the director of RIDOH: |
14 | (i) emergency room diversion facilities, as defined in § 23-17.26-2; and |
15 | (ii) community-based behavioral health facilities designed to provide immediate assistance |
16 | to a person in crisis. |
17 | (d) Commencing January 1, 2023, every individual or group health insurance contract, plan |
18 | or policy issued for delivery or renewed in this state that provides medical coverage that includes |
19 | coverage for emergency medical services shall provide coverage for transport to an alternative |
20 | location facility as identified in subsection (b) of this section and shall reimburse the EMS for such |
21 | services at the same rate as for a non-emergency basic life support transport to an emergency |
22 | department. |
23 | (e) If treatment at an alternative facility is deemed appropriate by the EMS practitioner, the |
24 | emergency medical service shall bill at the rate described in subsection (c) of this section, even if |
25 | an advanced life support assessment was provided. |
26 | (f) The office of the health insurance commissioner and/or Rhode Island department of |
27 | health may promulgate such rules and regulations as are necessary and proper to effectuate the |
28 | purpose and for the efficient administration and enforcement of this section. |
29 | 27-20-78. Coverage of EMS mental health and substance use disorder treatment. |
30 | (a) As used in this section, "emergency medical services" or "EMS" means the |
31 | practitioners, ambulance vehicles, and ambulance service entities licensed in accordance with |
32 | chapter 4.1 of title 23 to provide emergency medical care, transportation, and preventive care to |
33 | mitigate loss of life or exacerbation of illness or injury, including, but not limited to, EMS |
34 | responding to the 911 system established under chapter 21.1 of title 39. |
| LC004627/SUB A - Page 7 of 14 |
1 | (b) Emergency medical services shall be permitted to allow licensed providers who treat |
2 | mental health disorders, including substance use disorders, to accompany EMS. Such providers |
3 | shall be permitted to treat EMS patients when medically necessary and appropriate. Such treatment |
4 | shall be permitted to occur in the community. |
5 | (c) Commencing January 1, 2023, every individual or group health insurance contract, plan |
6 | or policy issued for delivery or renewed in this state that provides medical coverage that includes |
7 | coverage for emergency medical services, shall provide coverage for transportation and treatment |
8 | described in subsection (b) of this section and shall reimburse such services at a rate not lower than |
9 | the same service would have been had that service been delivered in a traditional office setting. |
10 | (d) Treatment and coverage for mental health disorders, including substance use disorders, |
11 | as described in this section shall be provided in accordance with chapter 38.2 of title 27. |
12 | (e) The office of the health insurance commissioner and/or Rhode Island department of |
13 | health may promulgate such rules and regulations as are necessary and proper to effectuate the |
14 | purpose and for the efficient administration and enforcement of this section. |
15 | SECTION 4. Chapter 27-41 of the General Laws entitled "Health Maintenance |
16 | Organizations" is hereby amended by adding thereto the following sections: |
17 | 27-41-94. Emergency medical services transport to alternate facilities. |
18 | (a) As used in this section, the following terms shall have the following meaning: |
19 | (1) "Basic life support" or "BLS" means transportation by ground ambulance vehicle and |
20 | medically necessary supplies and services, plus the provision of BLS ambulance services. The |
21 | ambulance must be staffed by at least two (2) people who meet the requirements of state laws and |
22 | regulations where the services are being furnished. Also, at least one of the staff members must be |
23 | licensed, at a minimum, as an emergency medical technician by the state or local authority where |
24 | the services are furnished and be legally authorized to operate all lifesaving and life-sustaining |
25 | equipment on board the vehicle. |
26 | (2) "Emergency medical services" or "EMS" means the practitioners, ambulance vehicles, |
27 | and ambulance service entities licensed in accordance with chapter 4.1 of title 23 to provide |
28 | emergency medical care, transportation, and preventive care to mitigate loss of life or exacerbation |
29 | of illness or injury, including, but not limited to, EMS responding to the 911 system established |
30 | under chapter 21.1 of title 39. |
31 | (3) "Emergency medical services practitioner" means an individual who is licensed in |
32 | accordance with state laws and regulations to perform emergency medical care and preventive care |
33 | to mitigate loss of life or exacerbation of illness or injury, including emergency medical |
34 | technicians, advanced emergency medical technicians, advanced emergency medical technicians- |
| LC004627/SUB A - Page 8 of 14 |
1 | cardiac, and paramedics. |
2 | (4) “Mobile integrated healthcare/community paramedicine” means the provision of |
3 | healthcare using patient-centered, mobile resources in the out-of-hospital environment with EMS |
4 | agency’s licensed paramedic and advanced emergency medical technician-cardiac practitioners |
5 | working in collaboration with physicians, nurses, mid-level practitioners, community health teams |
6 | and social, behavioral and substance use disorder specialists to address the unmet needs of |
7 | individuals experiencing intermittent health care issues. The mobile integrated |
8 | healthcare/community paramedicine program rules, regulations, standing orders, protocols, and |
9 | procedures shall be instituted by the department of health with the collaboration of the ambulance |
10 | service coordinating advisory board. |
11 | (b) This section authorizes emergency medical services in the state participating in a mobile |
12 | integrated healthcare/community paramedicine program to divert non-emergency basic life service |
13 | calls from emergency departments. Emergency medical services practitioners shall assess |
14 | individuals who are in need of emergency medical services and apply the correct level of care |
15 | thereafter, which may include transport to an alternative facility deemed appropriate by the |
16 | emergency medical services practitioner. An alternative facility shall include, but not be limited to: |
17 | (1) An individual’s primary care provider; |
18 | (2) A community health clinic; |
19 | (3) An urgent care facility; |
20 | (4) An emergency room diversion facility, as defined in § 23-17.26-2; and |
21 | (5) A community-based behavioral health facility designed to provide immediate |
22 | assistance to a person in crisis. |
23 | (c) Emergency medical services shall be permitted to transport to the following facilities |
24 | designated by the director of RIDOH: |
25 | (i) Emergency room diversion facilities, as defined in § 23-17.26-2; and |
26 | (ii) Community-based behavioral health facilities designed to provide immediate |
27 | assistance to a person in crisis. |
28 | (d) Commencing January 1, 2023, every individual or group health insurance contract, plan |
29 | or policy issued for delivery or renewed in this state that provides medical coverage that includes |
30 | coverage for emergency medical services shall provide coverage for transport to an alternative |
31 | location facility as identified in subsection (b) of this section and shall reimburse the EMS for such |
32 | services at the same rate as for a non-emergency basic life support transport to an emergency |
33 | department. |
34 | (e) If treatment at an alternative facility is deemed appropriate by the EMS practitioner, the |
| LC004627/SUB A - Page 9 of 14 |
1 | emergency medical service shall bill at the rate as described in subsection (d) of this section, even |
2 | if an advanced life support assessment was provided. |
3 | (f) The office of the health insurance commissioner and/or Rhode Island department of |
4 | health may promulgate such rules and regulations as are necessary and proper to effectuate the |
5 | purpose and for the efficient administration and enforcement of this section. |
6 | 27-41-95. Coverage of EMS mental health and substance use disorder treatment. |
7 | (a) As used in this section, "emergency medical services" or "EMS" means the |
8 | practitioners, ambulance vehicles, and ambulance service entities licensed in accordance with |
9 | chapter 4.1 of title 23 to provide emergency medical care, transportation, and preventive care to |
10 | mitigate loss of life or exacerbation of illness or injury, including, but not limited to, EMS |
11 | responding to the 911 system established under chapter 21.1 of title 39. |
12 | (b) Emergency medical services shall be permitted to allow licensed providers who treat |
13 | mental health disorders, including substance use disorders, to accompany EMS. Such providers |
14 | shall be permitted to treat EMS patients when medically necessary and appropriate. Such treatment |
15 | shall be permitted to occur in the community. |
16 | (c) Commencing January 1, 2023, every individual or group health insurance contract, plan |
17 | or policy issued for delivery or renewed in this state that provides medical coverage that includes |
18 | coverage for emergency medical services, shall provide coverage for transportation and treatment |
19 | described in subsection (b) of this section and shall reimburse such services at a rate not lower than |
20 | the same service would have been had that service been delivered in a traditional office setting. |
21 | (d) Treatment and coverage for mental health disorders, including substance use disorders, |
22 | as described in this section shall be provided in accordance with chapter 38.2 of title 27. |
23 | (e) The office of the health insurance commissioner and/or Rhode Island department of |
24 | health may promulgate such rules and regulations as are necessary and proper to effectuate the |
25 | purpose and for the efficient administration and enforcement of this section. |
26 | SECTION 5. Chapter 42-7.2 of the General Laws entitled "Office of Health and Human |
27 | Services" is hereby amended by adding thereto the following sections: |
28 | 42-7.2-21. Emergency medical services transport to alternate facilities. |
29 | (a) As used in this section, the following terms shall have the following meaning: |
30 | (1) "Basic life support" or "BLS" means transportation by ground ambulance vehicle and |
31 | medically necessary supplies and services, plus the provision of BLS ambulance services. The |
32 | ambulance must be staffed by at least two (2) people who meet the requirements of state laws and |
33 | regulations where the services are being furnished. Also, at least one of the staff members must be |
34 | licensed, at a minimum, as an emergency medical technician by the state or local authority where |
| LC004627/SUB A - Page 10 of 14 |
1 | the services are furnished and be legally authorized to operate all lifesaving and life-sustaining |
2 | equipment on board the vehicle. |
3 | (2) "Emergency medical services" or "EMS" means the practitioners, ambulance vehicles, |
4 | and ambulance service entities licensed in accordance with chapter 4.1 of title 23 to provide |
5 | emergency medical care, transportation, and preventive care to mitigate loss of life or exacerbation |
6 | of illness or injury, including, but not limited to, EMS responding to the 911 system established |
7 | under chapter 21.1 of title 39. |
8 | (3) "Emergency medical services practitioner" means an individual who is licensed in |
9 | accordance with state laws and regulations to perform emergency medical care and preventive care |
10 | to mitigate loss of life or exacerbation of illness or injury, including emergency medical |
11 | technicians, advanced emergency medical technicians, advanced emergency medical technicians- |
12 | cardiac, and paramedics. |
13 | (4) “Mobile integrated healthcare/community paramedicine” means the provision of |
14 | healthcare using patient-centered, mobile resources in the out-of-hospital environment with EMS |
15 | agency’s licensed paramedic and advanced emergency medical technician-cardiac practitioners |
16 | working in collaboration with physicians, nurses, mid-level practitioners, community health teams |
17 | and social, behavioral and substance use disorder specialists to address the unmet needs of |
18 | individuals experiencing intermittent health care issues. The mobile integrated |
19 | healthcare/community paramedicine program rules, regulations, standing orders, protocols, and |
20 | procedures shall be instituted by the department of health with the collaboration of the ambulance |
21 | service coordinating advisory board. |
22 | (b) This section authorizes emergency medical services in the state participating in a mobile |
23 | integrated healthcare/community paramedicine program to divert non-emergency basic life service |
24 | calls from emergency departments. Emergency medical services practitioners shall assess |
25 | individuals who are in need of emergency medical services and apply the correct level of care |
26 | thereafter, which may include transport to an alternative facility deemed appropriate by the |
27 | emergency medical services practitioner. An alternative facility shall include, but not be limited to: |
28 | (1) An individual’s primary care provider; |
29 | (2) A community health clinic; |
30 | (3) An urgent care facility; |
31 | (4) An emergency room diversion facility, as defined in § 23-17.26-2; and |
32 | (5) A community-based behavioral health facility designed to provide immediate |
33 | assistance to a person in crisis. |
34 | (c) Emergency medical services shall be permitted to transport to the following facilities |
| LC004627/SUB A - Page 11 of 14 |
1 | designated by the director of the department of health: |
2 | (1) Emergency room diversion facilities, as defined in § 23-17.26-2; and |
3 | (2) Community-based behavioral health facilities designed to provide immediate assistance |
4 | to a person in crisis. |
5 | (d) Rhode Island Medicaid and its contracted managed care entities shall provide coverage |
6 | for transport to an alternative facility as identified in subsection (b) of this section and shall |
7 | reimburse the EMS for such services at the same rate as for a non-emergency basic life support |
8 | transport to an emergency department. |
9 | (e) If treatment at an alternative facility is deemed appropriate by the EMS practitioner, the |
10 | emergency medical service shall bill at the rate described in subsection (d) of this section even if |
11 | an advanced life support assessment was provided. |
12 | (f) The executive office of health and human services shall set the reimbursement rates for |
13 | the services described in this section. The department of health in collaboration with the ambulance |
14 | service coordinating advisory board shall promulgate such rules, regulations, standing orders, and |
15 | protocols as are necessary and proper to effectuate the purpose and for the efficient administration |
16 | and enforcement of this chapter. |
17 | 42-7.2-22. Coverage of EMS mental health and substance use disorder treatment. |
18 | (a) As used in this section, "emergency medical services" or "EMS" means the |
19 | practitioners, ambulance vehicles, and ambulance service entities licensed in accordance with |
20 | chapter 4.1 of title 23 to provide emergency medical care, transportation, and preventive care to |
21 | mitigate loss of life or exacerbation of illness or injury, including, but not limited to, EMS |
22 | responding to the 911 system established under chapter 21.1 of title 39. |
23 | (b) Emergency medical services shall be permitted to allow licensed providers who treat |
24 | mental health disorders, including substance use disorders, to accompany EMS. Such providers |
25 | shall be permitted to treat EMS patients when medically necessary and appropriate. Such treatment |
26 | shall be permitted to occur in the community. |
27 | (c) Rhode Island Medicaid and its contracted managed care entities shall provide coverage |
28 | for transportation and treatment described in subsection (b) of this section and shall reimburse such |
29 | services at a rate not lower than the same service would have been had that service been delivered |
30 | in a traditional office setting. |
31 | (d) The executive office of health and human services shall set the reimbursement rates for |
32 | the services described in this section. The department of health in collaboration with the ambulance |
33 | service coordinating advisory board shall promulgate such rules, regulations, standing orders, and |
34 | protocols as are necessary and proper to effectuate the purpose and for the efficient administration |
| LC004627/SUB A - Page 12 of 14 |
1 | and enforcement of this chapter. |
2 | SECTION 6. This act shall take effect upon passage. |
======== | |
LC004627/SUB A | |
======== | |
| LC004627/SUB A - Page 13 of 14 |
EXPLANATION | |
BY THE LEGISLATIVE COUNCIL | |
OF | |
A N A C T | |
RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES | |
*** | |
1 | This act would require health insurers, nonprofit hospital service corporations, nonprofit |
2 | medical service corporations, health maintenance organizations and Rhode Island Medicaid, to |
3 | issue or renew policies that provide coverage for emergency medical services transport to alternate |
4 | facilities and coverage of emergency medical services, mental health and substance use disorder |
5 | treatment, on or after January 1, 2023. |
6 | This act would take effect upon passage. |
======== | |
LC004627/SUB A | |
======== | |
| LC004627/SUB A - Page 14 of 14 |