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| 4 | 4 | | |
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| 5 | 5 | | 2023 -- H 5873 |
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| 6 | 6 | | ======== |
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| 7 | 7 | | LC001385 |
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| 8 | 8 | | ======== |
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| 9 | 9 | | S TATE OF RHODE IS LAND |
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| 10 | 10 | | IN GENERAL ASSEMBLY |
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| 11 | 11 | | JANUARY SESSION, A.D. 2023 |
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| 12 | 12 | | ____________ |
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| 13 | 13 | | |
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| 14 | 14 | | A N A C T |
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| 15 | 15 | | RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES |
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| 16 | 16 | | Introduced By: Representatives Kislak, Ajello, Morales, Vella-Wilkinson, Sanchez, Hull, |
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| 17 | 17 | | Biah, McGaw, Slater, and Tanzi |
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| 18 | 18 | | Date Introduced: March 01, 2023 |
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| 19 | 19 | | Referred To: House Health & Human Services |
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| 20 | 20 | | |
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| 21 | 21 | | |
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| 22 | 22 | | It is enacted by the General Assembly as follows: |
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| 23 | 23 | | SECTION 1. Chapter 27-18 of the General Laws entitled "Accident and Sickness Insurance 1 |
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| 24 | 24 | | Policies" is hereby amended by adding thereto the following section: 2 |
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| 25 | 25 | | 27-18-91. Emergency medical services transport to alternate facilities. 3 |
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| 26 | 26 | | (a) As used in this section, the following terms shall have the following meanings: 4 |
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| 27 | 27 | | (1) "Basic life support" or "BLS" means transportation by ground ambulance vehicle and 5 |
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| 28 | 28 | | medically necessary supplies and services, plus the provision of BLS ambulance services. The 6 |
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| 29 | 29 | | ambulance must be staffed by at least three (3) people who meet the requirements of state laws and 7 |
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| 30 | 30 | | regulations where the services are being furnished. Also, at least two (2) of the staff members must 8 |
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| 31 | 31 | | be licensed, at a minimum, as an emergency medical technician by the state or local authority where 9 |
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| 32 | 32 | | the services are furnished and be legally authorized to operate all lifesaving and life-sustaining 10 |
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| 33 | 33 | | equipment on board the vehicle. 11 |
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| 34 | 34 | | (2) "Emergency medical services" or "EMS" means the practitioners, ambulance vehicles, 12 |
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| 35 | 35 | | and ambulance service entities licensed in accordance with chapter 4.1 of title 23 to provide 13 |
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| 36 | 36 | | emergency medical care, transportation, and preventive care to mitigate loss of life or exacerbation 14 |
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| 37 | 37 | | of illness or injury, including, but not limited to, EMS responding to the 911 system established 15 |
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| 38 | 38 | | under chapter 21.1 of title 39. 16 |
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| 39 | 39 | | (3) "Emergency medical services practitioner" means an individual who is licensed in 17 |
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| 40 | 40 | | accordance with state laws and regulations to perform emergency medical care and preventive care 18 |
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| 41 | 41 | | to mitigate loss of life or exacerbation of illness or injury, including emergency medical 19 |
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| 42 | 42 | | |
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| 43 | 43 | | |
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| 44 | 44 | | LC001385 - Page 2 of 16 |
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| 45 | 45 | | technicians, advanced emergency medical technicians, advanced emergency medical technicians 1 |
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| 46 | 46 | | cardiac, and paramedics. 2 |
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| 47 | 47 | | (4) “Mobile integrated healthcare community paramedicine” means the provision of 3 |
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| 48 | 48 | | healthcare using patient-centered, mobile resources in the out-of-hospital environment pursuant to 4 |
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| 49 | 49 | | an EMS agency’s plan approved by the department of health utilizing licensed paramedic and 5 |
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| 50 | 50 | | advanced emergency medical technician-cardiac practitioners working in collaboration with 6 |
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| 51 | 51 | | physicians, nurses, mid-level practitioners, community health teams and social, behavioral and 7 |
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| 52 | 52 | | substance use disorder specialists to address the unmet needs of individuals experiencing 8 |
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| 53 | 53 | | intermittent health care issues. 9 |
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| 54 | 54 | | (b) Only those emergency medical services (EMS) agencies who submit plans that meet 10 |
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| 55 | 55 | | the minimum requirements for participation set and approved by the department of health shall be 11 |
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| 56 | 56 | | eligible to participate in a mobile integrated healthcare/community paramedicine program. 12 |
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| 57 | 57 | | (c) This section authorizes emergency medical services in the state that are approved by 13 |
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| 58 | 58 | | the department of health to participate in a mobile integrated healthcare/community paramedicine 14 |
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| 59 | 59 | | program to divert non-emergency basic life service calls from emergency departments. Pursuant to 15 |
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| 60 | 60 | | an EMS agency’s approved plan, emergency medical services practitioners shall assess individuals 16 |
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| 61 | 61 | | who are in need of emergency medical services and apply the correct level of care thereafter, which 17 |
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| 62 | 62 | | may include transport to an alternative facility deemed appropriate by the emergency medical 18 |
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| 63 | 63 | | services practitioner. An alternative facility shall include, but not be limited to: 19 |
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| 64 | 64 | | (1) An individual’s primary care provider; 20 |
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| 65 | 65 | | (2) A community health clinic; 21 |
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| 66 | 66 | | (3) An urgent care facility; 22 |
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| 67 | 67 | | (4) An emergency room diversion facility, as defined in § 23-17.26-2; and 23 |
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| 68 | 68 | | (5) A community-based behavioral health facility designed to provide immediate 24 |
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| 69 | 69 | | assistance to a person in crisis. 25 |
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| 70 | 70 | | (d) The department of health with the collaboration of the ambulance service coordinating 26 |
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| 71 | 71 | | advisory board shall administer the mobile integrated healthcare/community paramedicine program 27 |
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| 72 | 72 | | and shall promulgate any rules, regulations, standing orders, protocols, and procedures necessary 28 |
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| 73 | 73 | | and proper for the efficient administration and enforcement of this section. The requirements of 29 |
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| 74 | 74 | | this section shall only apply to EMS agencies who apply for and receive approval from the 30 |
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| 75 | 75 | | department of health to provide such services. 31 |
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| 76 | 76 | | (e) Commencing January 1, 2024, every individual or group health insurance contract, plan 32 |
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| 77 | 77 | | or policy issued for delivery or renewed in this state that provides medical coverage that includes 33 |
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| 78 | 78 | | coverage for emergency medical services shall provide coverage for transport to an alternative 34 |
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| 79 | 79 | | |
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| 80 | 80 | | |
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| 81 | 81 | | LC001385 - Page 3 of 16 |
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| 82 | 82 | | location facility as identified in subsection (c) of this section and shall reimburse the EMS for such 1 |
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| 83 | 83 | | services at the same rate as for a basic life support transport to an emergency department. 2 |
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| 84 | 84 | | (f) If treatment at an alternative facility is deemed appropriate by the EMS practitioner, the 3 |
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| 85 | 85 | | emergency medical service shall bill at the rate described in subsection (e) of this section, even if 4 |
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| 86 | 86 | | an advanced life support assessment was provided. 5 |
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| 87 | 87 | | (g) The office of the health insurance commissioner may promulgate such rules and 6 |
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| 88 | 88 | | regulations as are necessary and proper to effectuate the purpose and for the efficient administration 7 |
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| 89 | 89 | | and enforcement of this section. 8 |
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| 90 | 90 | | 27-18-92. Coverage of emergency medical services mental health and substance use 9 |
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| 91 | 91 | | disorder treatment. 10 |
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| 92 | 92 | | (a) As used in this section, "emergency medical services" or "EMS" means the 11 |
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| 93 | 93 | | practitioners, ambulance vehicles, and ambulance service entities licensed in accordance with 12 |
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| 94 | 94 | | chapter 4.1 of title 23 to provide emergency medical care, transportation, and preventive care to 13 |
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| 95 | 95 | | mitigate loss of life or exacerbation of illness or injury, including, but not limited to, EMS 14 |
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| 96 | 96 | | responding to the 911 system established under chapter 21.1 of title 39. 15 |
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| 97 | 97 | | (b) Emergency medical services shall be permitted to allow licensed providers who 16 |
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| 98 | 98 | | evaluate and treat mental health disorders, including substance use disorders, to accompany EMS. 17 |
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| 99 | 99 | | Such providers shall be permitted to evaluate and treat EMS patients when medically necessary 18 |
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| 100 | 100 | | and appropriate. Such evaluation and treatment shall be permitted to occur in the community. 19 |
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| 101 | 101 | | (c) Emergency medical services shall be permitted to transport to the following facilities 20 |
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| 102 | 102 | | designated by the director of the department of health: 21 |
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| 103 | 103 | | (1) Emergency room diversion facilities, as defined in § 23-17.26-2; and 22 |
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| 104 | 104 | | (2) Community-based behavioral health facilities designed to provide immediate assistance 23 |
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| 105 | 105 | | to a person in crisis. 24 |
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| 106 | 106 | | (d) Commencing January 1, 2024, every individual or group health insurance contract, plan 25 |
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| 107 | 107 | | or policy issued for delivery or renewed in this state that provides medical coverage that includes 26 |
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| 108 | 108 | | coverage for emergency medical services, shall provide coverage for evaluation and treatment 27 |
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| 109 | 109 | | described in subsection (b) of this section and shall reimburse such services at a rate not lower than 28 |
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| 110 | 110 | | the same service would have been had that service been delivered in a traditional office setting. 29 |
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| 111 | 111 | | (e) Commencing January 1, 2024, every individual or group health insurance contract, plan 30 |
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| 112 | 112 | | or policy issued for delivery or renewed in this state that provides medical coverage that includes 31 |
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| 113 | 113 | | coverage for emergency medical services, shall provide coverage for transportation and described 32 |
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| 114 | 114 | | in subsection (c) of this section and shall reimburse such services at a rate not lower than the same 33 |
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| 115 | 115 | | rate as for basic life support transport to an emergency department. 34 |
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| 116 | 116 | | |
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| 117 | 117 | | |
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| 118 | 118 | | LC001385 - Page 4 of 16 |
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| 119 | 119 | | (f) Treatment and coverage for mental health disorders, including substance use disorders, 1 |
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| 120 | 120 | | as described in this section shall be provided in accordance with chapter 38.2 of title 27. 2 |
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| 121 | 121 | | (g) The department of health with the collaboration of the ambulance service coordinating 3 |
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| 122 | 122 | | advisory board shall promulgate any rules, regulations, standing orders, protocols, and procedures 4 |
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| 123 | 123 | | necessary and proper for the efficient administration and enforcement of this section. 5 |
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| 124 | 124 | | (h) The office of the health insurance commissioner may promulgate such rules and 6 |
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| 125 | 125 | | regulations as are necessary and proper to effectuate the purpose and for the efficient administration 7 |
|---|
| 126 | 126 | | and enforcement of this section. 8 |
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| 127 | 127 | | SECTION 2. Chapter 27-19 of the General Laws entitled "Nonprofit Hospital Service 9 |
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| 128 | 128 | | Corporations" is hereby amended by adding thereto the following sections: 10 |
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| 129 | 129 | | 27-19-83. Emergency medical services transport to alternate facilities. 11 |
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| 130 | 130 | | (a) As used in this section, the following terms shall have the following meaning: 12 |
|---|
| 131 | 131 | | (1) "Basic life support" or "BLS" means transportation by ground ambulance vehicle and 13 |
|---|
| 132 | 132 | | medically necessary supplies and services, plus the provision of BLS ambulance services. The 14 |
|---|
| 133 | 133 | | ambulance must be staffed by at least three (3) people who meet the requirements of state laws and 15 |
|---|
| 134 | 134 | | regulations where the services are being furnished. Also, at least two (2) of the staff members must 16 |
|---|
| 135 | 135 | | be at a minimum, as an emergency medical technician by the state or local authority where the 17 |
|---|
| 136 | 136 | | services are furnished and be legally authorized to operate all lifesaving and life-sustaining 18 |
|---|
| 137 | 137 | | equipment on board the vehicle. 19 |
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| 138 | 138 | | (2) "Emergency medical services" or "EMS" means the practitioners, ambulance vehicles, 20 |
|---|
| 139 | 139 | | and ambulance service entities licensed in accordance with chapter 4.1 of title 23 to provide 21 |
|---|
| 140 | 140 | | emergency medical care, transportation, and preventive care to mitigate loss of life or exacerbation 22 |
|---|
| 141 | 141 | | of illness or injury, including, but not limited to, EMS responding to the 911 system established 23 |
|---|
| 142 | 142 | | under chapter 21.1 of title 39. 24 |
|---|
| 143 | 143 | | (3) "Emergency medical services practitioner" means an individual who is licensed in 25 |
|---|
| 144 | 144 | | accordance with state laws and regulations to perform emergency medical care and preventive care 26 |
|---|
| 145 | 145 | | to mitigate loss of life or exacerbation of illness or injury, including emergency medical 27 |
|---|
| 146 | 146 | | technicians, advanced emergency medical technicians, advanced emergency medical technicians-28 |
|---|
| 147 | 147 | | cardiac, and paramedics. 29 |
|---|
| 148 | 148 | | (4) “Mobile integrated healthcare/community paramedicine” means the provision of 30 |
|---|
| 149 | 149 | | healthcare using patient-centered, mobile resources in the out-of-hospital environment pursuant to 31 |
|---|
| 150 | 150 | | an EMS agency’s plan approved by the department of health utilizing licensed paramedic and 32 |
|---|
| 151 | 151 | | advanced emergency medical technician-cardiac practitioners working in collaboration with 33 |
|---|
| 152 | 152 | | physicians, nurses, mid-level practitioners, community health teams and social, behavioral and 34 |
|---|
| 153 | 153 | | |
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| 154 | 154 | | |
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| 155 | 155 | | LC001385 - Page 5 of 16 |
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| 156 | 156 | | substance use disorder specialists to address the unmet needs of individuals experiencing 1 |
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| 157 | 157 | | intermittent health care issues. 2 |
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| 158 | 158 | | (b) Only those emergency medical services (EMS) agencies who submit plans that meet 3 |
|---|
| 159 | 159 | | the minimum requirements for participation set and approved by the department of health shall be 4 |
|---|
| 160 | 160 | | eligible to participate in a mobile integrated healthcare/community paramedicine program. 5 |
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| 161 | 161 | | (c) This section authorizes emergency medical services in the state who are approved by 6 |
|---|
| 162 | 162 | | the department of health to participate in a mobile integrated healthcare/community paramedicine 7 |
|---|
| 163 | 163 | | program to divert non-emergency basic life service calls from emergency departments. Pursuant to 8 |
|---|
| 164 | 164 | | an EMS agency’s approved plan, emergency medical services practitioners shall assess individuals 9 |
|---|
| 165 | 165 | | who are in need of emergency medical services and apply the correct level of care thereafter, which 10 |
|---|
| 166 | 166 | | may include transport to an alternative facility deemed appropriate by the emergency medical 11 |
|---|
| 167 | 167 | | services practitioner. An alternative facility shall include, but not be limited to: 12 |
|---|
| 168 | 168 | | (1) An individual’s primary care provider; 13 |
|---|
| 169 | 169 | | (2) A community health clinic; 14 |
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| 170 | 170 | | (3) An urgent care facility; 15 |
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| 171 | 171 | | (4) An emergency room diversion facility, as defined in § 23-17.26-2; and 16 |
|---|
| 172 | 172 | | (5) A community-based behavioral health facility designed to provide immediate 17 |
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| 173 | 173 | | assistance to a person in crisis. 18 |
|---|
| 174 | 174 | | (d) The department of health with the collaboration of the ambulance service coordinating 19 |
|---|
| 175 | 175 | | advisory board shall administer the mobile integrated healthcare/community paramedicine program 20 |
|---|
| 176 | 176 | | and shall promulgate any rules, regulations, standing orders, protocols, and procedures necessary 21 |
|---|
| 177 | 177 | | and proper for the efficient administration and enforcement of this section. The requirements of 22 |
|---|
| 178 | 178 | | this section shall only apply to EMS agencies that apply for and receive approval from the 23 |
|---|
| 179 | 179 | | department of health to provide such services. 24 |
|---|
| 180 | 180 | | (e) Commencing January 1, 2024, every individual or group health insurance contract, plan 25 |
|---|
| 181 | 181 | | or policy issued for delivery or renewed in this state that provides medical coverage that includes 26 |
|---|
| 182 | 182 | | coverage for emergency medical services shall provide coverage for transport to an alternative 27 |
|---|
| 183 | 183 | | location facility as identified in subsection (c) of this section and shall reimburse the EMS for such 28 |
|---|
| 184 | 184 | | services at the same rate as for a basic life support transport to an emergency department. 29 |
|---|
| 185 | 185 | | (f) If treatment at an alternative facility is deemed appropriate by the EMS practitioner, the 30 |
|---|
| 186 | 186 | | emergency medical service shall bill at the rate described in subsection (e) of this section, even if 31 |
|---|
| 187 | 187 | | an advanced life support assessment was provided. 32 |
|---|
| 188 | 188 | | (g) The office of the health insurance commissioner may promulgate such rules and 33 |
|---|
| 189 | 189 | | regulations as are necessary and proper to effectuate the purpose and for the efficient administration 34 |
|---|
| 190 | 190 | | |
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| 191 | 191 | | |
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| 192 | 192 | | LC001385 - Page 6 of 16 |
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| 193 | 193 | | and enforcement of this section. 1 |
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| 194 | 194 | | 27-19-84. Coverage of emergency medical services mental health and substance use 2 |
|---|
| 195 | 195 | | disorder treatment. 3 |
|---|
| 196 | 196 | | (a) As used in this section, "emergency medical services" or "EMS" means the 4 |
|---|
| 197 | 197 | | practitioners, ambulance vehicles, and ambulance service entities licensed in accordance with 5 |
|---|
| 198 | 198 | | chapter 4.1 of title 23 to provide emergency medical care, transportation, and preventive care to 6 |
|---|
| 199 | 199 | | mitigate loss of life or exacerbation of illness or injury, including, but not limited to, EMS 7 |
|---|
| 200 | 200 | | responding to the 911 system established under chapter 21.1 of title 39. 8 |
|---|
| 201 | 201 | | (b) Emergency medical services shall be permitted to allow licensed providers who 9 |
|---|
| 202 | 202 | | evaluate and treat mental health disorders, including substance use disorders, to accompany EMS. 10 |
|---|
| 203 | 203 | | Such providers shall be permitted to evaluate and treat EMS patients when medically necessary 11 |
|---|
| 204 | 204 | | and appropriate. Such evaluation and treatment shall be permitted to occur in the community. 12 |
|---|
| 205 | 205 | | (c) Emergency medical services shall be permitted to transport to the following facilities 13 |
|---|
| 206 | 206 | | designated by the director of the department of health: 14 |
|---|
| 207 | 207 | | (1) Emergency room diversion facilities, as defined in § 23-17.26-2; and 15 |
|---|
| 208 | 208 | | (2) Community-based behavioral health facilities designed to provide immediate assistance 16 |
|---|
| 209 | 209 | | to a person in crisis. 17 |
|---|
| 210 | 210 | | (d) Commencing January 1, 2024, every individual or group health insurance contract, plan 18 |
|---|
| 211 | 211 | | or policy issued for delivery or renewed in this state that provides medical coverage that includes 19 |
|---|
| 212 | 212 | | coverage for emergency medical services, shall provide coverage for evaluation and treatment 20 |
|---|
| 213 | 213 | | described in subsection (b) of this section and shall reimburse such services at a rate not lower than 21 |
|---|
| 214 | 214 | | the same service would have been had that service been delivered in a traditional office setting. 22 |
|---|
| 215 | 215 | | (e) Commencing January 1, 2024, every individual or group health insurance contract, plan 23 |
|---|
| 216 | 216 | | or policy issued for delivery or renewed in this state that provides medical coverage that includes 24 |
|---|
| 217 | 217 | | coverage for emergency medical services, shall provide coverage for transportation and described 25 |
|---|
| 218 | 218 | | in subsection (c) of this section and shall reimburse such services at a rate not lower than the same 26 |
|---|
| 219 | 219 | | rate as for basic life support transport to an emergency department. 27 |
|---|
| 220 | 220 | | (f) Treatment and coverage for mental health disorders, including substance use disorders, 28 |
|---|
| 221 | 221 | | as described in this section shall be provided in accordance with chapter 38.2 of title 27. 29 |
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| 222 | 222 | | (g) The department of health with the collaboration of the ambulance service coordinating 30 |
|---|
| 223 | 223 | | advisory board shall promulgate any rules, regulations, standing orders, protocols, and procedures 31 |
|---|
| 224 | 224 | | necessary and proper for the efficient administration and enforcement of this section. 32 |
|---|
| 225 | 225 | | (h) The office of the health insurance commissioner may promulgate such rules and 33 |
|---|
| 226 | 226 | | regulations as are necessary and proper to effectuate the purpose and for the efficient administration 34 |
|---|
| 227 | 227 | | |
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| 228 | 228 | | |
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| 229 | 229 | | LC001385 - Page 7 of 16 |
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| 230 | 230 | | and enforcement of this section. 1 |
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| 231 | 231 | | SECTION 3. Chapter 27-20 of the General Laws entitled "Nonprofit Medical Service 2 |
|---|
| 232 | 232 | | Corporations" is hereby amended by adding thereto the following sections: 3 |
|---|
| 233 | 233 | | 27-20-79. Emergency medical services transport to alternate facilities. 4 |
|---|
| 234 | 234 | | (a) As used in this section, the following terms shall have the following meaning: 5 |
|---|
| 235 | 235 | | (1) "Basic life support" or "BLS" means transportation by ground ambulance vehicle and 6 |
|---|
| 236 | 236 | | medically necessary supplies and services, plus the provision of BLS ambulance services. The 7 |
|---|
| 237 | 237 | | ambulance must be staffed by at least three (3) people who meet the requirements of state laws and 8 |
|---|
| 238 | 238 | | regulations where the services are being furnished. Also, at least two (2) of the staff members must 9 |
|---|
| 239 | 239 | | be at a minimum, as an emergency medical technician by the state or local authority where the 10 |
|---|
| 240 | 240 | | services are furnished and be legally authorized to operate all lifesaving and life-sustaining 11 |
|---|
| 241 | 241 | | equipment on board the vehicle. 12 |
|---|
| 242 | 242 | | (2) "Emergency medical services" or "EMS" means the practitioners, ambulance vehicles, 13 |
|---|
| 243 | 243 | | and ambulance service entities licensed in accordance with chapter 4.1 of title 23 to provide 14 |
|---|
| 244 | 244 | | emergency medical care, transportation, and preventive care to mitigate loss of life or exacerbation 15 |
|---|
| 245 | 245 | | of illness or injury, including, but not limited to, EMS responding to the 911 system established 16 |
|---|
| 246 | 246 | | under chapter 21.1 of title 39. 17 |
|---|
| 247 | 247 | | (3) "Emergency medical services practitioner" means an individual who is licensed in 18 |
|---|
| 248 | 248 | | accordance with state laws and regulations to perform emergency medical care and preventive care 19 |
|---|
| 249 | 249 | | to mitigate loss of life or exacerbation of illness or injury, including emergency medical 20 |
|---|
| 250 | 250 | | technicians, advanced emergency medical technicians, advanced emergency medical technicians-21 |
|---|
| 251 | 251 | | cardiac, and paramedics. 22 |
|---|
| 252 | 252 | | (4) “Mobile integrated healthcare/community paramedicine” means the provision of 23 |
|---|
| 253 | 253 | | healthcare using patient-centered, mobile resources in the out-of-hospital environment pursuant to 24 |
|---|
| 254 | 254 | | an EMS agency’s plan approved by the department of health utilizing licensed paramedic and 25 |
|---|
| 255 | 255 | | advanced emergency medical technician-cardiac practitioners working in collaboration with 26 |
|---|
| 256 | 256 | | physicians, nurses, mid-level practitioners, community health teams and social, behavioral and 27 |
|---|
| 257 | 257 | | substance use disorder specialists to address the unmet needs of individuals experiencing 28 |
|---|
| 258 | 258 | | intermittent health care issues. 29 |
|---|
| 259 | 259 | | (b) Only those emergency medical services (EMS) agencies who submit plans that meet 30 |
|---|
| 260 | 260 | | the minimum requirements for participation set and approved by the department of health shall be 31 |
|---|
| 261 | 261 | | eligible to participate in a mobile integrated healthcare/community paramedicine program. 32 |
|---|
| 262 | 262 | | (c) This section authorizes emergency medical services in the state who are approved by 33 |
|---|
| 263 | 263 | | the department of health to participate in a mobile integrated healthcare/community paramedicine 34 |
|---|
| 264 | 264 | | |
|---|
| 265 | 265 | | |
|---|
| 266 | 266 | | LC001385 - Page 8 of 16 |
|---|
| 267 | 267 | | program to divert non-emergency basic life service calls from emergency departments. Pursuant to 1 |
|---|
| 268 | 268 | | an EMS agency’s approved plan, emergency medical services practitioners shall assess individuals 2 |
|---|
| 269 | 269 | | who are in need of emergency medical services and apply the correct level of care thereafter, which 3 |
|---|
| 270 | 270 | | may include transport to an alternative facility deemed appropriate by the emergency medical 4 |
|---|
| 271 | 271 | | services practitioner. An alternative facility shall include, but not be limited to: 5 |
|---|
| 272 | 272 | | (1) An individual’s primary care provider; 6 |
|---|
| 273 | 273 | | (2) A community health clinic; 7 |
|---|
| 274 | 274 | | (3) An urgent care facility; 8 |
|---|
| 275 | 275 | | (4) An emergency room diversion facility, as defined in § 23-17.26-2; and 9 |
|---|
| 276 | 276 | | (5) A community-based behavioral health facility designed to provide immediate 10 |
|---|
| 277 | 277 | | assistance to a person in crisis. 11 |
|---|
| 278 | 278 | | (d) The department of health with the collaboration of the ambulance service coordinating 12 |
|---|
| 279 | 279 | | advisory board shall administer the mobile integrated healthcare/community paramedicine program 13 |
|---|
| 280 | 280 | | and shall promulgate any rules, regulations, standing orders, protocols, and procedures necessary 14 |
|---|
| 281 | 281 | | and proper for the efficient administration and enforcement of this section. The requirements of 15 |
|---|
| 282 | 282 | | this section shall only apply to EMS agencies that apply for and receive approval from the 16 |
|---|
| 283 | 283 | | department of health to provide such services. 17 |
|---|
| 284 | 284 | | (e) Commencing January 1, 2024, every individual or group health insurance contract, plan 18 |
|---|
| 285 | 285 | | or policy issued for delivery or renewed in this state that provides medical coverage that includes 19 |
|---|
| 286 | 286 | | coverage for emergency medical services shall provide coverage for transport to an alternative 20 |
|---|
| 287 | 287 | | location facility as identified in subsection (c) of this section and shall reimburse the EMS for such 21 |
|---|
| 288 | 288 | | services at the same rate as for a basic life support transport to an emergency department. 22 |
|---|
| 289 | 289 | | (f) If treatment at an alternative facility is deemed appropriate by the EMS practitioner, the 23 |
|---|
| 290 | 290 | | emergency medical service shall bill at the rate described in subsection (e) of this section, even if 24 |
|---|
| 291 | 291 | | an advanced life support assessment was provided. 25 |
|---|
| 292 | 292 | | (g) The office of the health insurance commissioner may promulgate such rules and 26 |
|---|
| 293 | 293 | | regulations as are necessary and proper to effectuate the purpose and for the efficient administration 27 |
|---|
| 294 | 294 | | and enforcement of this section. 28 |
|---|
| 295 | 295 | | 27-20-80. Coverage of emergency medical services mental health and substance use 29 |
|---|
| 296 | 296 | | disorder treatment. 30 |
|---|
| 297 | 297 | | (a) As used in this section, "emergency medical services" or "EMS" means the 31 |
|---|
| 298 | 298 | | practitioners, ambulance vehicles, and ambulance service entities licensed in accordance with 32 |
|---|
| 299 | 299 | | chapter 4.1 of title 23 to provide emergency medical care, transportation, and preventive care to 33 |
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| 300 | 300 | | mitigate loss of life or exacerbation of illness or injury, including, but not limited to, EMS 34 |
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| 301 | 301 | | |
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| 302 | 302 | | |
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| 303 | 303 | | LC001385 - Page 9 of 16 |
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| 304 | 304 | | responding to the 911 system established under chapter 21.1 of title 39. 1 |
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| 305 | 305 | | (b) Emergency medical services shall be permitted to allow licensed providers who 2 |
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| 306 | 306 | | evaluate and treat mental health disorders, including substance use disorders, to accompany EMS. 3 |
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| 307 | 307 | | Such providers shall be permitted to evaluate and treat EMS patients when medically necessary 4 |
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| 308 | 308 | | and appropriate. Such evaluation and treatment shall be permitted to occur in the community. 5 |
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| 309 | 309 | | (c) Emergency medical services shall be permitted to transport to the following facilities 6 |
|---|
| 310 | 310 | | designated by the director of the department of health: 7 |
|---|
| 311 | 311 | | (1) Emergency room diversion facilities, as defined in § 23-17.26-2; and 8 |
|---|
| 312 | 312 | | (2) Community-based behavioral health facilities designed to provide immediate assistance 9 |
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| 313 | 313 | | to a person in crisis. 10 |
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| 314 | 314 | | (d) Commencing January 1, 2024, every individual or group health insurance contract, plan 11 |
|---|
| 315 | 315 | | or policy issued for delivery or renewed in this state that provides medical coverage that includes 12 |
|---|
| 316 | 316 | | coverage for emergency medical services, shall provide coverage for evaluation and treatment 13 |
|---|
| 317 | 317 | | described in subsection (b) of this section and shall reimburse such services at a rate not lower than 14 |
|---|
| 318 | 318 | | the same service would have been had that service been delivered in a traditional office setting. 15 |
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| 319 | 319 | | (e) Commencing January 1, 2024, every individual or group health insurance contract, plan 16 |
|---|
| 320 | 320 | | or policy issued for delivery or renewed in this state that provides medical coverage that includes 17 |
|---|
| 321 | 321 | | coverage for emergency medical services, shall provide coverage for transportation and described 18 |
|---|
| 322 | 322 | | in subsection (c) of this section and shall reimburse such services at a rate not lower than the same 19 |
|---|
| 323 | 323 | | rate as for basic life support transport to an emergency department. 20 |
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| 324 | 324 | | (f) Treatment and coverage for mental health disorders, including substance use disorders, 21 |
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| 325 | 325 | | as described in this section shall be provided in accordance with chapter 38.2 of title 27. 22 |
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| 326 | 326 | | (g) The department of health with the collaboration of the ambulance service coordinating 23 |
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| 327 | 327 | | advisory board shall promulgate any rules, regulations, standing orders, protocols, and procedures 24 |
|---|
| 328 | 328 | | necessary and proper for the efficient administration and enforcement of this section. 25 |
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| 329 | 329 | | (h) The office of the health insurance commissioner may promulgate such rules and 26 |
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| 330 | 330 | | regulations as are necessary and proper to effectuate the purpose and for the efficient administration 27 |
|---|
| 331 | 331 | | and enforcement of this section. 28 |
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| 332 | 332 | | SECTION 4. Chapter 27-41 of the General Laws entitled "Health Maintenance 29 |
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| 333 | 333 | | Organizations" is hereby amended by adding thereto the following sections: 30 |
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| 334 | 334 | | 27-41-96. Emergency medical services transport to alternate facilities. 31 |
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| 335 | 335 | | (a) As used in this section, the following terms shall have the following meaning: 32 |
|---|
| 336 | 336 | | (1) "Basic life support" or "BLS" means transportation by ground ambulance vehicle and 33 |
|---|
| 337 | 337 | | medically necessary supplies and services, plus the provision of BLS ambulance services. The 34 |
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| 338 | 338 | | |
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| 339 | 339 | | |
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| 340 | 340 | | LC001385 - Page 10 of 16 |
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| 341 | 341 | | ambulance must be staffed by at least three (3) people who meet the requirements of state laws and 1 |
|---|
| 342 | 342 | | regulations where the services are being furnished. Also, at least two (2) of the staff members must 2 |
|---|
| 343 | 343 | | be at a minimum, as an emergency medical technician by the state or local authority where the 3 |
|---|
| 344 | 344 | | services are furnished and be legally authorized to operate all lifesaving and life-sustaining 4 |
|---|
| 345 | 345 | | equipment on board the vehicle. 5 |
|---|
| 346 | 346 | | (2) "Emergency medical services" or "EMS" means the practitioners, ambulance vehicles, 6 |
|---|
| 347 | 347 | | and ambulance service entities licensed in accordance with chapter 4.1 of title 23 to provide 7 |
|---|
| 348 | 348 | | emergency medical care, transportation, and preventive care to mitigate loss of life or exacerbation 8 |
|---|
| 349 | 349 | | of illness or injury, including, but not limited to, EMS responding to the 911 system established 9 |
|---|
| 350 | 350 | | under chapter 21.1 of title 39. 10 |
|---|
| 351 | 351 | | (3) "Emergency medical services practitioner" means an individual who is licensed in 11 |
|---|
| 352 | 352 | | accordance with state laws and regulations to perform emergency medical care and preventive care 12 |
|---|
| 353 | 353 | | to mitigate loss of life or exacerbation of illness or injury, including emergency medical 13 |
|---|
| 354 | 354 | | technicians, advanced emergency medical technicians, advanced emergency medical technicians-14 |
|---|
| 355 | 355 | | cardiac, and paramedics. 15 |
|---|
| 356 | 356 | | (4) “Mobile integrated healthcare/community paramedicine” means the provision of 16 |
|---|
| 357 | 357 | | healthcare using patient-centered, mobile resources in the out-of-hospital environment pursuant to 17 |
|---|
| 358 | 358 | | an EMS agency’s plan approved by the department of health utilizing licensed paramedic and 18 |
|---|
| 359 | 359 | | advanced emergency medical technician-cardiac practitioners working in collaboration with 19 |
|---|
| 360 | 360 | | physicians, nurses, mid-level practitioners, community health teams and social, behavioral and 20 |
|---|
| 361 | 361 | | substance use disorder specialists to address the unmet needs of individuals experiencing 21 |
|---|
| 362 | 362 | | intermittent health care issues. 22 |
|---|
| 363 | 363 | | (b) Only those emergency medical services (EMS) agencies who submit plans that meet 23 |
|---|
| 364 | 364 | | the minimum requirements for participation set and approved by the department of health shall be 24 |
|---|
| 365 | 365 | | eligible to participate in a mobile integrated healthcare/community paramedicine program. 25 |
|---|
| 366 | 366 | | (c) This section authorizes emergency medical services in the state who are approved by 26 |
|---|
| 367 | 367 | | the department of health to participate in a mobile integrated healthcare/community paramedicine 27 |
|---|
| 368 | 368 | | program to divert non-emergency basic life service calls from emergency departments. Pursuant to 28 |
|---|
| 369 | 369 | | an EMS agency’s approved plan, emergency medical services practitioners shall assess individuals 29 |
|---|
| 370 | 370 | | who are in need of emergency medical services and apply the correct level of care thereafter, which 30 |
|---|
| 371 | 371 | | may include transport to an alternative facility deemed appropriate by the emergency medical 31 |
|---|
| 372 | 372 | | services practitioner. An alternative facility shall include, but not be limited to: 32 |
|---|
| 373 | 373 | | (1) An individual’s primary care provider; 33 |
|---|
| 374 | 374 | | (2) A community health clinic; 34 |
|---|
| 375 | 375 | | |
|---|
| 376 | 376 | | |
|---|
| 377 | 377 | | LC001385 - Page 11 of 16 |
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| 378 | 378 | | (3) An urgent care facility; 1 |
|---|
| 379 | 379 | | (4) An emergency room diversion facility, as defined in § 23-17.26-2; and 2 |
|---|
| 380 | 380 | | (5) A community-based behavioral health facility designed to provide immediate 3 |
|---|
| 381 | 381 | | assistance to a person in crisis. 4 |
|---|
| 382 | 382 | | (d) The department of health with the collaboration of the ambulance service coordinating 5 |
|---|
| 383 | 383 | | advisory board shall administer the mobile integrated healthcare/community paramedicine program 6 |
|---|
| 384 | 384 | | and shall promulgate any rules, regulations, standing orders, protocols, and procedures necessary 7 |
|---|
| 385 | 385 | | and proper for the efficient administration and enforcement of this section. The requirements of 8 |
|---|
| 386 | 386 | | this section shall only apply to EMS agencies that apply for and receive approval from the 9 |
|---|
| 387 | 387 | | department of health to provide such services. 10 |
|---|
| 388 | 388 | | (e) Commencing January 1, 2024, every individual or group health insurance contract, plan 11 |
|---|
| 389 | 389 | | or policy issued for delivery or renewed in this state that provides medical coverage that includes 12 |
|---|
| 390 | 390 | | coverage for emergency medical services shall provide coverage for transport to an alternative 13 |
|---|
| 391 | 391 | | location facility as identified in subsection (c) of this section and shall reimburse the EMS for such 14 |
|---|
| 392 | 392 | | services at the same rate as for a basic life support transport to an emergency department. 15 |
|---|
| 393 | 393 | | (f) If treatment at an alternative facility is deemed appropriate by the EMS practitioner, the 16 |
|---|
| 394 | 394 | | emergency medical service shall bill at the rate described in subsection (e) of this section, even if 17 |
|---|
| 395 | 395 | | an advanced life support assessment was provided. 18 |
|---|
| 396 | 396 | | (g) The office of the health insurance commissioner may promulgate such rules and 19 |
|---|
| 397 | 397 | | regulations as are necessary and proper to effectuate the purpose and for the efficient administration 20 |
|---|
| 398 | 398 | | and enforcement of this section. 21 |
|---|
| 399 | 399 | | 27-41-97. Coverage of emergency medical services mental health and substance use 22 |
|---|
| 400 | 400 | | disorder treatment. 23 |
|---|
| 401 | 401 | | (a) As used in this section, "emergency medical services" or "EMS" means the 24 |
|---|
| 402 | 402 | | practitioners, ambulance vehicles, and ambulance service entities licensed in accordance with 25 |
|---|
| 403 | 403 | | chapter 4.1 of title 23 to provide emergency medical care, transportation, and preventive care to 26 |
|---|
| 404 | 404 | | mitigate loss of life or exacerbation of illness or injury, including, but not limited to, EMS 27 |
|---|
| 405 | 405 | | responding to the 911 system established under chapter 21.1 of title 39. 28 |
|---|
| 406 | 406 | | (b) Emergency medical services shall be permitted to allow licensed providers who 29 |
|---|
| 407 | 407 | | evaluate and treat mental health disorders, including substance use disorders, to accompany EMS. 30 |
|---|
| 408 | 408 | | Such providers shall be permitted to evaluate and treat EMS patients when medically necessary 31 |
|---|
| 409 | 409 | | and appropriate. Such evaluation and treatment shall be permitted to occur in the community. 32 |
|---|
| 410 | 410 | | (c) Emergency medical services shall be permitted to transport to the following facilities 33 |
|---|
| 411 | 411 | | designated by the director of the department of health: 34 |
|---|
| 412 | 412 | | |
|---|
| 413 | 413 | | |
|---|
| 414 | 414 | | LC001385 - Page 12 of 16 |
|---|
| 415 | 415 | | (1) Emergency room diversion facilities, as defined in § 23-17.26-2; and 1 |
|---|
| 416 | 416 | | (2) Community-based behavioral health facilities designed to provide immediate assistance 2 |
|---|
| 417 | 417 | | to a person in crisis. 3 |
|---|
| 418 | 418 | | (d) Commencing January 1, 2024, every individual or group health insurance contract, plan 4 |
|---|
| 419 | 419 | | or policy issued for delivery or renewed in this state that provides medical coverage that includes 5 |
|---|
| 420 | 420 | | coverage for emergency medical services, shall provide coverage for evaluation and treatment 6 |
|---|
| 421 | 421 | | described in subsection (b) of this section and shall reimburse such services at a rate not lower than 7 |
|---|
| 422 | 422 | | the same service would have been had that service been delivered in a traditional office setting. 8 |
|---|
| 423 | 423 | | (e) Commencing January 1, 2024, every individual or group health insurance contract, plan 9 |
|---|
| 424 | 424 | | or policy issued for delivery or renewed in this state that provides medical coverage that includes 10 |
|---|
| 425 | 425 | | coverage for emergency medical services, shall provide coverage for transportation and described 11 |
|---|
| 426 | 426 | | in subsection (c) of this section and shall reimburse such services at a rate not lower than the same 12 |
|---|
| 427 | 427 | | rate as for basic life support transport to an emergency department. 13 |
|---|
| 428 | 428 | | (f) Treatment and coverage for mental health disorders, including substance use disorders, 14 |
|---|
| 429 | 429 | | as described in this section shall be provided in accordance with chapter 38.2 of title 27. 15 |
|---|
| 430 | 430 | | (g) The department of health with the collaboration of the ambulance service coordinating 16 |
|---|
| 431 | 431 | | advisory board shall promulgate any rules, regulations, standing orders, protocols, and procedures 17 |
|---|
| 432 | 432 | | necessary and proper for the efficient administration and enforcement of this section. 18 |
|---|
| 433 | 433 | | (h) The office of the health insurance commissioner may promulgate such rules and 19 |
|---|
| 434 | 434 | | regulations as are necessary and proper to effectuate the purpose and for the efficient administration 20 |
|---|
| 435 | 435 | | and enforcement of this section. 21 |
|---|
| 436 | 436 | | SECTION 5. Chapter 42-7.2 of the General Laws entitled "Office of Health and Human 22 |
|---|
| 437 | 437 | | Services" is hereby amended by adding thereto the following sections: 23 |
|---|
| 438 | 438 | | 42-7.2-21. Emergency medical services transport to alternate facilities. 24 |
|---|
| 439 | 439 | | (a) As used in this section, the following terms shall have the following meaning: 25 |
|---|
| 440 | 440 | | (1) "Basic life support" or "BLS" means transportation by ground ambulance vehicle and 26 |
|---|
| 441 | 441 | | medically necessary supplies and services, plus the provision of BLS ambulance services. The 27 |
|---|
| 442 | 442 | | ambulance must be staffed by at least three (3) people who meet the requirements of state laws and 28 |
|---|
| 443 | 443 | | regulations where the services are being furnished. Also, at least two (2) of the staff members must 29 |
|---|
| 444 | 444 | | be licensed, at a minimum, as an emergency medical technician by the state or local authority where 30 |
|---|
| 445 | 445 | | the services are furnished and be legally authorized to operate all lifesaving and life-sustaining 31 |
|---|
| 446 | 446 | | equipment on board the vehicle. 32 |
|---|
| 447 | 447 | | (2) "Emergency medical services" or "EMS" means the practitioners, ambulance vehicles, 33 |
|---|
| 448 | 448 | | and ambulance service entities licensed in accordance with chapter 4.1 of title 23 to provide 34 |
|---|
| 449 | 449 | | |
|---|
| 450 | 450 | | |
|---|
| 451 | 451 | | LC001385 - Page 13 of 16 |
|---|
| 452 | 452 | | emergency medical care, transportation, and preventive care to mitigate loss of life or exacerbation 1 |
|---|
| 453 | 453 | | of illness or injury, including, but not limited to, EMS responding to the 911 system established 2 |
|---|
| 454 | 454 | | under chapter 21.1 of title 39. 3 |
|---|
| 455 | 455 | | (3) "Emergency medical services practitioner" means an individual who is licensed in 4 |
|---|
| 456 | 456 | | accordance with state laws and regulations to perform emergency medical care and preventive care 5 |
|---|
| 457 | 457 | | to mitigate loss of life or exacerbation of illness or injury, including emergency medical 6 |
|---|
| 458 | 458 | | technicians, advanced emergency medical technicians, advanced emergency medical technicians-7 |
|---|
| 459 | 459 | | cardiac, and paramedics. 8 |
|---|
| 460 | 460 | | (4) “Mobile integrated healthcare community paramedicine” means the provision of 9 |
|---|
| 461 | 461 | | healthcare using patient-centered, mobile resources in the out-of-hospital environment pursuant to 10 |
|---|
| 462 | 462 | | an EMS agency’s plan approved by the department of health utilizing licensed paramedic and 11 |
|---|
| 463 | 463 | | advanced emergency medical technician-cardiac practitioners working in collaboration with 12 |
|---|
| 464 | 464 | | physicians, nurses, mid-level practitioners, community health teams and social, behavioral and 13 |
|---|
| 465 | 465 | | substance use disorder specialists to address the unmet needs of individuals experiencing 14 |
|---|
| 466 | 466 | | intermittent health care issues. 15 |
|---|
| 467 | 467 | | (b) Only those emergency medical services (EMS) agencies who submit plans that meet 16 |
|---|
| 468 | 468 | | the minimum requirements for participation set and approved by the department of health shall be 17 |
|---|
| 469 | 469 | | eligible to participate in a mobile integrated healthcare/community paramedicine program. 18 |
|---|
| 470 | 470 | | (c) This section authorizes emergency medical services in the state that are approved by 19 |
|---|
| 471 | 471 | | the department of health to participate in a mobile integrated healthcare/community paramedicine 20 |
|---|
| 472 | 472 | | program to divert non-emergency basic life service calls from emergency departments. Pursuant to 21 |
|---|
| 473 | 473 | | an EMS agency’s approved plan, emergency medical services practitioners shall assess individuals 22 |
|---|
| 474 | 474 | | who are in need of emergency medical services and apply the correct level of care thereafter, which 23 |
|---|
| 475 | 475 | | may include transport to an alternative facility deemed appropriate by the emergency medical 24 |
|---|
| 476 | 476 | | services practitioner. An alternative facility shall include, but not be limited to: 25 |
|---|
| 477 | 477 | | (1) An individual’s primary care provider; 26 |
|---|
| 478 | 478 | | (2) A community health clinic; 27 |
|---|
| 479 | 479 | | (3) An urgent care facility; 28 |
|---|
| 480 | 480 | | (4) An emergency room diversion facility, as defined in § 23-17.26-2; and 29 |
|---|
| 481 | 481 | | (5) A community-based behavioral health facility designed to provide immediate 30 |
|---|
| 482 | 482 | | assistance to a person in crisis. 31 |
|---|
| 483 | 483 | | (d) The department of health with the collaboration of the ambulance service coordinating 32 |
|---|
| 484 | 484 | | advisory board shall administer the mobile integrated healthcare/community paramedicine program 33 |
|---|
| 485 | 485 | | and shall promulgate any rules, regulations, standing orders, protocols, and procedures necessary 34 |
|---|
| 486 | 486 | | |
|---|
| 487 | 487 | | |
|---|
| 488 | 488 | | LC001385 - Page 14 of 16 |
|---|
| 489 | 489 | | and proper for the efficient administration and enforcement of this section. The requirements of 1 |
|---|
| 490 | 490 | | this chapter shall only apply to EMS agencies who apply for and receive approval from the 2 |
|---|
| 491 | 491 | | department of health to provide such services. 3 |
|---|
| 492 | 492 | | (e) Rhode Island Medicaid and its contracted managed care entities shall provide coverage 4 |
|---|
| 493 | 493 | | for transport to an alternative facility as identified in subsection (c) of this section and shall 5 |
|---|
| 494 | 494 | | reimburse the EMS for such services at the same rate as for a basic life support transport to an 6 |
|---|
| 495 | 495 | | emergency department. 7 |
|---|
| 496 | 496 | | (f) If treatment at an alternative facility is deemed appropriate by the EMS practitioner, the 8 |
|---|
| 497 | 497 | | emergency medical service shall bill at the rate described in subsection (e) of this section, even if 9 |
|---|
| 498 | 498 | | an advanced life support assessment was provided. 10 |
|---|
| 499 | 499 | | (g) The executive office of health and human services shall set the reimbursement rates for 11 |
|---|
| 500 | 500 | | the services described in this section. 12 |
|---|
| 501 | 501 | | 42-7.2-22. Coverage for emergency medical services mental health and substance use 13 |
|---|
| 502 | 502 | | disorder. 14 |
|---|
| 503 | 503 | | (a) As used in this section, "emergency medical services" or "EMS" means the 15 |
|---|
| 504 | 504 | | practitioners, ambulance vehicles, and ambulance service entities licensed in accordance with 16 |
|---|
| 505 | 505 | | chapter 4.1 of title 23 to provide emergency medical care, transportation, and preventive care to 17 |
|---|
| 506 | 506 | | mitigate loss of life or exacerbation of illness or injury, including, but not limited to, EMS 18 |
|---|
| 507 | 507 | | responding to the 911 system established under chapter 21.1 of title 39. 19 |
|---|
| 508 | 508 | | (b) Emergency medical services shall be permitted to allow licensed providers who 20 |
|---|
| 509 | 509 | | evaluate and treat mental health disorders, including substance use disorders, to accompany EMS. 21 |
|---|
| 510 | 510 | | Such providers shall be permitted to evaluate and treat EMS patients when medically necessary 22 |
|---|
| 511 | 511 | | and appropriate. Such evaluation and treatment shall be permitted to occur in the community. 23 |
|---|
| 512 | 512 | | (c) Emergency medical services shall be permitted to transport to the following facilities 24 |
|---|
| 513 | 513 | | designated by the director of the department of health: 25 |
|---|
| 514 | 514 | | (1) Emergency room diversion facilities, as defined in § 23-17.26-2; and 26 |
|---|
| 515 | 515 | | (2) Community-based behavioral health facilities designed to provide immediate assistance 27 |
|---|
| 516 | 516 | | to a person in crisis. 28 |
|---|
| 517 | 517 | | (d) Rhode Island Medicaid and its contracted managed care entities shall provide coverage 29 |
|---|
| 518 | 518 | | for transportation, evaluation, and treatment described in subsections (c) and (d) of this section and 30 |
|---|
| 519 | 519 | | shall reimburse such services at a rate not lower than the same service would have been had that 31 |
|---|
| 520 | 520 | | service been delivered in a traditional office setting or for basic life support transport to an 32 |
|---|
| 521 | 521 | | emergency department. 33 |
|---|
| 522 | 522 | | (e) The executive office of health and human services shall set the reimbursement rates for 34 |
|---|
| 523 | 523 | | |
|---|
| 524 | 524 | | |
|---|
| 525 | 525 | | LC001385 - Page 15 of 16 |
|---|
| 526 | 526 | | the services described in this section. 1 |
|---|
| 527 | 527 | | SECTION 6. This act shall take effect upon passage. 2 |
|---|
| 528 | 528 | | ======== |
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| 529 | 529 | | LC001385 |
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| 530 | 530 | | ======== |
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| 531 | 531 | | |
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| 532 | 532 | | |
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| 533 | 533 | | LC001385 - Page 16 of 16 |
|---|
| 534 | 534 | | EXPLANATION |
|---|
| 535 | 535 | | BY THE LEGISLATIVE COUNCIL |
|---|
| 536 | 536 | | OF |
|---|
| 537 | 537 | | A N A C T |
|---|
| 538 | 538 | | RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES |
|---|
| 539 | 539 | | *** |
|---|
| 540 | 540 | | This act would authorize emergency medical service agencies approved by the department 1 |
|---|
| 541 | 541 | | of health to participate in a mobile integrated healthcare/community paramedicine program, 2 |
|---|
| 542 | 542 | | allowing the agencies to transport individuals to alternative facilities such as an individua l’s 3 |
|---|
| 543 | 543 | | primary care provider, community health clinic, urgent care facility, emergency room diversion 4 |
|---|
| 544 | 544 | | facility, or a community-based behavioral health facility, based on the individual’s need of 5 |
|---|
| 545 | 545 | | emergency medical services. This act would further permit licensed providers to accompany 6 |
|---|
| 546 | 546 | | emergency medical services and treat patients within the community for mental health disorders, 7 |
|---|
| 547 | 547 | | including substance use disorders. This act would further require the health insurance contract, plan 8 |
|---|
| 548 | 548 | | or policy to provide coverage for transport to an alternative location facility and treatment by a 9 |
|---|
| 549 | 549 | | licensed provider for mental health disorders and substance use disorders within the community. 10 |
|---|
| 550 | 550 | | This act would take effect upon passage. 11 |
|---|
| 551 | 551 | | ======== |
|---|
| 552 | 552 | | LC001385 |
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| 553 | 553 | | ======== |
|---|