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132nd MAINE LEGISLATURE
FIRST SPECIAL SESSION-2025
Legislative Document No. 1429H.P. 938 House of Representatives, April 3, 2025
An Act to Provide Full Reimbursement for Emergency Ambulance
Services Provided to MaineCare Members
Reference to the Committee on Health and Human Services suggested and ordered printed.
ROBERT B. HUNT
Clerk
Presented by Representative FREDETTE of Newport. Page 1 - 132LR1045(01)
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2 as amended by PL 2019, c. 530, Pt. B, ยง1, is further
3 amended to read:
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5 The Except as provided in section 3174-PPP, the department shall reimburse for
6 ambulance services under MaineCare at a level that is not less than the average allowable
7 reimbursement rate under Medicare for such services or at the highest percent of that level
8 that is possible within resources appropriated for those purposes. Beginning March 1,
9 2015, the department shall reimburse for ambulance services under MaineCare at a level
10 that is not less than 65% of the average allowable reimbursement rate under Medicare for
11 such services. Beginning January 1, 2020, the department shall reimburse for ambulance
12 services under MaineCare at a level that is not less than the average allowable
13 reimbursement rate under Medicare for such services and shall reimburse for neonatal
14 transport services under MaineCare at the average rate for critical care transport services
15 under Medicare.
16 is enacted to read:
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19 following terms have the following meanings.
20 A. "Emergency ambulance services" means services provided, in response to an
21 emergency call for assistance, by:
22 (1) Municipal and quasi-municipal ambulance services;
23 (2) Fire department emergency medical services; and
24 (3) Private ambulance services, as applicable under MaineCare guidelines.
25 B. "Full rate" means the reimbursement rate determined to be usual, customary and
26 reasonable by the department and consistent with federal guidelines and applicable
27 state law.
28 The department shall reimburse providers of
29 emergency ambulance services for MaineCare members at the full rate for services eligible
30 under the MaineCare program.
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32 and federal sources to meet the reimbursement requirements under subsection 2. The
33 department shall prioritize the use of available federal matching funds to minimize the
34 effect on state resources.
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36 submit a report to the joint standing committee of the Legislature having jurisdiction over
37 health and human services matters relating to reimbursement under this section. The report
38 must include, but is not limited to:
39 A. Data on the number of reimbursed emergency ambulance services;
40 B. The total amount of funds disbursed for reimbursed emergency ambulance services;
41 and Page 2 - 132LR1045(01)
1 C. Recommendations for improving reimbursement policies and ensuring the
2 sustainability of emergency ambulance services statewide.
3 The department shall adopt rules to implement this section. Rules
4 adopted pursuant to this subsection are routine technical rules as defined in Title 5, chapter
5 375, subchapter 2-A.
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7 This bill requires the Department of Health and Human Services to reimburse providers
8 of emergency ambulance services at the full rate for services provided to MaineCare
9 members. It applies to municipal, quasi-municipal and private ambulance services and fire
10 department emergency medical services. The bill also requires the department to adopt
11 rules to implement the reimbursement requirement and to submit an annual report to the
12 Legislature.
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