2026 -- S 2560

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LC004840

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2026

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A N   A C T

RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES

     Introduced By: Senators DiMario, Murray, Britto, Mack, DiPalma, Lauria, Vargas,
Thompson, Dimitri, and Kallman

     Date Introduced: February 13, 2026

     Referred To: Senate Health & Human Services

     It is enacted by the General Assembly as follows:

     SECTION 1. Chapter 27-18 of the General Laws entitled "Accident and Sickness Insurance

Policies" is hereby amended by adding thereto the following section:

     27-18-96. Coverage of emergency medical services mental health and substance use

disorder treatment.

     (a) As used in this section, "emergency medical services" or "EMS" means the

practitioners, ambulance vehicles, and ambulance service entities licensed in accordance with

chapter 4.1 of title 23 to provide emergency medical care, transportation, and preventive care to

mitigate loss of life or exacerbation of illness or injury, including, but not limited to, EMS

responding to the 911 system established under chapter 21.1 of title 39.

     (b) Emergency medical services shall be permitted to allow licensed providers who

evaluate and treat mental health disorders, including substance use disorders, to accompany EMS.

Such providers shall be permitted to evaluate and treat EMS patients when medically necessary

and appropriate. Such evaluation and treatment shall be permitted to occur in the community.

     (c) Emergency medical services shall be permitted to transport to the following facilities

designated by the director of the department of health:

     (1) Emergency room diversion facilities, as defined in § 23-17.26-2; and

     (2) Community-based behavioral health facilities designed to provide immediate assistance

to a person in crisis.

     (d) Commencing January 1, 2027, every individual or group health insurance contract, plan

or policy issued for delivery or renewed in this state that provides medical coverage that includes

coverage for emergency medical services, shall provide coverage for evaluation and treatment

described in subsection (b) of this section and shall reimburse such services at a rate not lower than

the same service would have been had that service been delivered in a traditional office setting.

     (e) Commencing January 1, 2027, every individual or group health insurance contract, plan

or policy issued for delivery or renewed in this state that provides medical coverage that includes

coverage for emergency medical services, shall provide coverage for transportation and described

in subsection (c) of this section and shall reimburse such services at a rate not lower than the same

rate as for transport to an emergency department.

     (f) Treatment and coverage for mental health disorders, including substance use disorders,

as described in this section shall be provided in accordance with chapter 38.2 of title 27.

     (g) The department of health with the collaboration of the ambulance service coordinating

advisory board shall promulgate any rules, regulations, standing orders, protocols, and procedures

necessary and proper for the efficient administration and enforcement of this section.

     (h) The office of the health insurance commissioner may promulgate such rules and

regulations as are necessary and proper to effectuate the purpose and for the efficient administration

and enforcement of this section.

     SECTION 2. Chapter 27-19 of the General Laws entitled "Nonprofit Hospital Service

Corporations" is hereby amended by adding thereto the following section:

     27-19-88. Coverage of emergency medical services mental health and substance use

disorder treatment.

     (a) As used in this section, "emergency medical services" or "EMS" means the

practitioners, ambulance vehicles, and ambulance service entities licensed in accordance with

chapter 4.1 of title 23 to provide emergency medical care, transportation, and preventive care to

mitigate loss of life or exacerbation of illness or injury, including, but not limited to, EMS

responding to the 911 system established under chapter 21.1 of title 39.

     (b) Emergency medical services shall be permitted to allow licensed providers who

evaluate and treat mental health disorders, including substance use disorders, to accompany EMS.

Such providers shall be permitted to evaluate and treat EMS patients when medically necessary

and appropriate. Such evaluation and treatment shall be permitted to occur in the community.

     (c) Emergency medical services shall be permitted to transport to the following facilities

designated by the director of the department of health:

     (1) Emergency room diversion facilities, as defined in § 23-17.26-2; and

     (2) Community-based behavioral health facilities designed to provide immediate assistance

LC004840 - Page 2 of 7

to a person in crisis.

     (d) Commencing January 1, 2027, every individual or group health insurance contract, plan

or policy issued for delivery or renewed in this state that provides medical coverage that includes

coverage for emergency medical services, shall provide coverage for evaluation and treatment

described in subsection (b) of this section and shall reimburse such services at a rate not lower than

the same service would have been had that service been delivered in a traditional office setting.

     (e) Commencing January 1, 2027, every individual or group health insurance contract, plan

or policy issued for delivery or renewed in this state that provides medical coverage that includes

coverage for emergency medical services, shall provide coverage for transportation and described

in subsection (c) of this section and shall reimburse such services at a rate not lower than the same

rate as for transport to an emergency department.

     (f) Treatment and coverage for mental health disorders, including substance use disorders,

as described in this section shall be provided in accordance with chapter 38.2 of title 27.

     (g) The department of health with the collaboration of the ambulance service coordinating

advisory board shall promulgate any rules, regulations, standing orders, protocols, and procedures

necessary and proper for the efficient administration and enforcement of this section.

     (h) The office of the health insurance commissioner may promulgate such rules and

regulations as are necessary and proper to effectuate the purpose and for the efficient administration

and enforcement of this section.

     SECTION 3. Chapter 27-20 of the General Laws entitled "Nonprofit Medical Service

Corporations" is hereby amended by adding thereto the following section:

     27-20-84. Coverage of emergency medical services mental health and substance use

disorder treatment.

     (a) As used in this section, "emergency medical services" or "EMS" means the

practitioners, ambulance vehicles, and ambulance service entities licensed in accordance with

chapter 4.1 of title 23 to provide emergency medical care, transportation, and preventive care to

mitigate loss of life or exacerbation of illness or injury, including, but not limited to, EMS

responding to the 911 system established under chapter 21.1 of title 39.

     (b) Emergency medical services shall be permitted to allow licensed providers who

evaluate and treat mental health disorders, including substance use disorders, to accompany EMS.

Such providers shall be permitted to evaluate and treat EMS patients when medically necessary

and appropriate. Such evaluation and treatment shall be permitted to occur in the community.

     (c) Emergency medical services shall be permitted to transport to the following facilities

designated by the director of the department of health:

LC004840 - Page 3 of 7

     (1) Emergency room diversion facilities, as defined in § 23-17.26-2; and

     (2) Community-based behavioral health facilities designed to provide immediate assistance

to a person in crisis.

     (d) Commencing January 1, 2027, every individual or group health insurance contract, plan

or policy issued for delivery or renewed in this state that provides medical coverage that includes

coverage for emergency medical services, shall provide coverage for evaluation and treatment

described in subsection (b) of this section and shall reimburse such services at a rate not lower than

the same service would have been had that service been delivered in a traditional office setting.

     (e) Commencing January 1, 2027, every individual or group health insurance contract, plan

or policy issued for delivery or renewed in this state that provides medical coverage that includes

coverage for emergency medical services, shall provide coverage for transportation and described

in subsection (c) of this section and shall reimburse such services at a rate not lower than the same

rate as for transport to an emergency department.

     (f) Treatment and coverage for mental health disorders, including substance use disorders,

as described in this section shall be provided in accordance with chapter 38.2 of title 27.

     (g) The department of health with the collaboration of the ambulance service coordinating

advisory board shall promulgate any rules, regulations, standing orders, protocols, and procedures

necessary and proper for the efficient administration and enforcement of this section.

     (h) The office of the health insurance commissioner may promulgate such rules and

regulations as are necessary and proper to effectuate the purpose and for the efficient administration

and enforcement of this section.

     SECTION 4. Chapter 27-41 of the General Laws entitled "Health Maintenance

Organizations" is hereby amended by adding thereto the following section:

     27-41-101. Coverage of emergency medical services mental health and substance use

disorder treatment.

     (a) As used in this section, "emergency medical services" or "EMS" means the

practitioners, ambulance vehicles, and ambulance service entities licensed in accordance with

chapter 4.1 of title 23 to provide emergency medical care, transportation, and preventive care to

mitigate loss of life or exacerbation of illness or injury, including, but not limited to, EMS

responding to the 911 system established under chapter 21.1 of title 39.

     (b) Emergency medical services shall be permitted to allow licensed providers who

evaluate and treat mental health disorders, including substance use disorders, to accompany EMS.

Such providers shall be permitted to evaluate and treat EMS patients when medically necessary

and appropriate. Such evaluation and treatment shall be permitted to occur in the community.

LC004840 - Page 4 of 7

     (c) Emergency medical services shall be permitted to transport to the following facilities

designated by the director of the department of health:

     (1) Emergency room diversion facilities, as defined in § 23-17.26-2; and

     (2) Community-based behavioral health facilities designed to provide immediate assistance

to a person in crisis.

     (d) Commencing January 1, 2027, every individual or group health insurance contract, plan

or policy issued for delivery or renewed in this state that provides medical coverage that includes

coverage for emergency medical services, shall provide coverage for evaluation and treatment

described in subsection (b) of this section and shall reimburse such services at a rate not lower than

the same service would have been had that service been delivered in a traditional office setting.

     (e) Commencing January 1, 2027, every individual or group health insurance contract, plan

or policy issued for delivery or renewed in this state that provides medical coverage that includes

coverage for emergency medical services, shall provide coverage for transportation and described

in subsection (c) of this section and shall reimburse such services at a rate not lower than the same

rate as for transport to an emergency department.

     (f) Treatment and coverage for mental health disorders, including substance use disorders,

as described in this section shall be provided in accordance with chapter 38.2 of title 27.

     (g) The department of health with the collaboration of the ambulance service coordinating

advisory board shall promulgate any rules, regulations, standing orders, protocols, and procedures

necessary and proper for the efficient administration and enforcement of this section.

     (h) The office of the health insurance commissioner may promulgate such rules and

regulations as are necessary and proper to effectuate the purpose and for the efficient administration

and enforcement of this section.

     SECTION 5. Chapter 42-7.2 of the General Laws entitled "Office of Health and Human

Services" is hereby amended by adding thereto the following section:

     42-7.2-21. Coverage for emergency medical services mental health and substance use

disorder.

     (a) As used in this section, "emergency medical services" or "EMS" means the

practitioners, ambulance vehicles, and ambulance service entities licensed in accordance with

chapter 4.1 of title 23 to provide emergency medical care, transportation, and preventive care to

mitigate loss of life or exacerbation of illness or injury, including, but not limited to, EMS

responding to the 911 system established under chapter 21.1 of title 39.

     (b) Emergency medical services shall be permitted to allow licensed providers who

evaluate and treat mental health disorders, including substance use disorders, to accompany EMS.

LC004840 - Page 5 of 7

Such providers shall be permitted to evaluate and treat EMS patients when medically necessary

and appropriate. Such evaluation and treatment shall be permitted to occur in the community.

     (c) Emergency medical services shall be permitted to transport to the following facilities

designated by the director of the department of health:

     (1) Emergency room diversion facilities, as defined in § 23-17.26-2; and

     (2) Community-based behavioral health facilities designed to provide immediate assistance

to a person in crisis.

     (d) Rhode Island Medicaid and its contracted managed care entities shall provide coverage

for transportation, evaluation, and treatment described in subsections (c) and (d) of this section and

shall reimburse such services at a rate not lower than the same service would have been had that

service been delivered in a traditional office setting or for transport to an emergency department.

     (e) The executive office of health and human services shall set the reimbursement rates for

the services described in this section.

     SECTION 6. This act shall take effect upon passage.

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LC004840

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES

***

     This act would permit licensed providers to accompany emergency medical services and

treat patients within the community for mental health disorders, including substance use disorders.

     This act would take effect upon passage.

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LC004840

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