2023 -- S 0576
========
LC001384
========
S TATE OF RHODE IS LAND
IN GENERAL ASSEMBLY
JANUARY SESSION, A.D. 2023
____________
A N A C T
RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES
Introduced By: Senators Miller, Lawson, Lauria, DiMario, DiPalma, Valverde, and
Murray
Date Introduced: March 07, 2023
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 1
Policies" is hereby amended by adding thereto the following section: 2
27-18-91. Emergency medical services transport to alternate facilities. 3
(a) As used in this section, the following terms shall have the following meanings: 4
(1) "Basic life support" or "BLS" means transportation by ground ambulance vehicle and 5
medically necessary supplies and services, plus the provision of BLS ambulance services. The 6
ambulance must be staffed by at least three (3) people who meet the requirements of state laws and 7
regulations where the services are being furnished. Also, at least two (2) of the staff members must 8
be licensed, at a minimum, as an emergency medical technician by the state or local authority where 9
the services are furnished and be legally authorized to operate all lifesaving and life-sustaining 10
equipment on board the vehicle. 11
(2) "Emergency medical services" or "EMS" means the practitioners, ambulance vehicles, 12
and ambulance service entities licensed in accordance with chapter 4.1 of title 23 to provide 13
emergency medical care, transportation, and preventive care to mitigate loss of life or exacerbation 14
of illness or injury, including, but not limited to, EMS responding to the 911 system established 15
under chapter 21.1 of title 39. 16
(3) "Emergency medical services practitioner" means an individual who is licensed in 17
accordance with state laws and regulations to perform emergency medical care and preventive care 18
to mitigate loss of life or exacerbation of illness or injury, including emergency medical 19
LC001384 - Page 2 of 16
technicians, advanced emergency medical technicians, advanced emergency medical technicians 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 pursuant to 4
an EMS agency’s plan approved by the department of health utilizing licensed paramedic and 5
advanced emergency medical technician-cardiac practitioners working in collaboration with 6
physicians, nurses, mid-level practitioners, community health teams and social, behavioral and 7
substance use disorder specialists to address the unmet needs of individuals experiencing 8
intermittent health care issues. 9
(b) Only those emergency medical services (EMS) agencies who submit plans that meet 10
the minimum requirements for participation set and approved by the department of health shall be 11
eligible to participate in a mobile integrated healthcare/community paramedicine program. 12
(c) This section authorizes emergency medical services in the state that are approved by 13
the department of health to participate in a mobile integrated healthcare/community paramedicine 14
program to divert non-emergency basic life service calls from emergency departments. Pursuant to 15
an EMS agency’s approved plan, emergency medical services practitioners shall assess individuals 16
who are in need of emergency medical services and apply the correct level of care thereafter, which 17
may include transport to an alternative facility deemed appropriate by the emergency medical 18
services practitioner. An alternative facility shall include, but not be limited to: 19
(1) An individual’s primary care provider; 20
(2) A community health clinic; 21
(3) An urgent care facility; 22
(4) An emergency room diversion facility, as defined in § 23-17.26-2; and 23
(5) A community-based behavioral health facility designed to provide immediate 24
assistance to a person in crisis. 25
(d) The department of health with the collaboration of the ambulance service coordinating 26
advisory board shall administer the mobile integrated healthcare/community paramedicine program 27
and shall promulgate any rules, regulations, standing orders, protocols, and procedures necessary 28
and proper for the efficient administration and enforcement of this section. The requirements of 29
this section shall only apply to EMS agencies who apply for and receive approval from the 30
department of health to provide such services. 31
(e) Commencing January 1, 2024, every individual or group health insurance contract, plan 32
or policy issued for delivery or renewed in this state that provides medical coverage that includes 33
coverage for emergency medical services shall provide coverage for transport to an alternative 34
LC001384 - Page 3 of 16
location facility as identified in subsection (c) of this section and shall reimburse the EMS for such 1
services at the same rate as for a basic life support transport to an emergency department. 2
(f) If treatment at an alternative facility is deemed appropriate by the EMS practitioner, the 3
emergency medical service shall bill at the rate described in subsection (e) of this section, even if 4
an advanced life support assessment was provided. 5
(g) The office of the health insurance commissioner may promulgate such rules and 6
regulations as are necessary and proper to effectuate the purpose and for the efficient administration 7
and enforcement of this section. 8
27-18-92. Coverage of emergency medical services mental health and substance use 9
disorder treatment. 10
(a) As used in this section, "emergency medical services" or "EMS" means the 11
practitioners, ambulance vehicles, and ambulance service entities licensed in accordance with 12
chapter 4.1 of title 23 to provide emergency medical care, transportation, and preventive care to 13
mitigate loss of life or exacerbation of illness or injury, including, but not limited to, EMS 14
responding to the 911 system established under chapter 21.1 of title 39. 15
(b) Emergency medical services shall be permitted to allow licensed providers who 16
evaluate and treat mental health disorders, including substance use disorders, to accompany EMS. 17
Such providers shall be permitted to evaluate and treat EMS patients when medically necessary 18
and appropriate. Such evaluation and treatment shall be permitted to occur in the community. 19
(c) Emergency medical services shall be permitted to transport to the following facilities 20
designated by the director of the department of health: 21
(1) Emergency room diversion facilities, as defined in § 23-17.26-2; and 22
(2) Community-based behavioral health facilities designed to provide immediate assistance 23
to a person in crisis. 24
(d) Commencing January 1, 2024, every individual or group health insurance contract, plan 25
or policy issued for delivery or renewed in this state that provides medical coverage that includes 26
coverage for emergency medical services, shall provide coverage for evaluation and treatment 27
described in subsection (b) of this section and shall reimburse such services at a rate not lower than 28
the same service would have been had that service been delivered in a traditional office setting. 29
(e) Commencing January 1, 2024, 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 transportation and described 32
in subsection (c) of this section and shall reimburse such services at a rate not lower than the same 33
rate as for basic life support transport to an emergency department. 34
LC001384 - Page 4 of 16
(f) Treatment and coverage for mental health disorders, including substance use disorders, 1
as described in this section shall be provided in accordance with chapter 38.2 of title 27. 2
(g) The department of health with the collaboration of the ambulance service coordinating 3
advisory board shall promulgate any rules, regulations, standing orders, protocols, and procedures 4
necessary and proper for the efficient administration and enforcement of this section. 5
(h) The office of the health insurance commissioner may promulgate such rules and 6
regulations as are necessary and proper to effectuate the purpose and for the efficient administration 7
and enforcement of this section. 8
SECTION 2. Chapter 27-19 of the General Laws entitled "Nonprofit Hospital Service 9
Corporations" is hereby amended by adding thereto the following sections: 10
27-19-83. Emergency medical services transport to alternate facilities. 11
(a) As used in this section, the following terms shall have the following meaning: 12
(1) "Basic life support" or "BLS" means transportation by ground ambulance vehicle and 13
medically necessary supplies and services, plus the provision of BLS ambulance services. The 14
ambulance must be staffed by at least three (3) people who meet the requirements of state laws and 15
regulations where the services are being furnished. Also, at least two (2) of the staff members must 16
be at a minimum, as an emergency medical technician by the state or local authority where the 17
services are furnished and be legally authorized to operate all lifesaving and life-sustaining 18
equipment on board the vehicle. 19
(2) "Emergency medical services" or "EMS" means the practitioners, ambulance vehicles, 20
and ambulance service entities licensed in accordance with chapter 4.1 of title 23 to provide 21
emergency medical care, transportation, and preventive care to mitigate loss of life or exacerbation 22
of illness or injury, including, but not limited to, EMS responding to the 911 system established 23
under chapter 21.1 of title 39. 24
(3) "Emergency medical services practitioner" means an individual who is licensed in 25
accordance with state laws and regulations to perform emergency medical care and preventive care 26
to mitigate loss of life or exacerbation of illness or injury, including emergency medical 27
technicians, advanced emergency medical technicians, advanced emergency medical technicians-28
cardiac, and paramedics. 29
(4) “Mobile integrated healthcare/community paramedicine” means the provision of 30
healthcare using patient-centered, mobile resources in the out-of-hospital environment pursuant to 31
an EMS agency’s plan approved by the department of health utilizing licensed paramedic and 32
advanced emergency medical technician-cardiac practitioners working in collaboration with 33
physicians, nurses, mid-level practitioners, community health teams and social, behavioral and 34
LC001384 - Page 5 of 16
substance use disorder specialists to address the unmet needs of individuals experiencing 1
intermittent health care issues. 2
(b) Only those emergency medical services (EMS) agencies who submit plans that meet 3
the minimum requirements for participation set and approved by the department of health shall be 4
eligible to participate in a mobile integrated healthcare/community paramedicine program. 5
(c) This section authorizes emergency medical services in the state who are approved by 6
the department of health to participate in a mobile integrated healthcare/community paramedicine 7
program to divert non-emergency basic life service calls from emergency departments. Pursuant to 8
an EMS agency’s approved plan, emergency medical services practitioners shall assess individuals 9
who are in need of emergency medical services and apply the correct level of care thereafter, which 10
may include transport to an alternative facility deemed appropriate by the emergency medical 11
services practitioner. An alternative facility shall include, but not be limited to: 12
(1) An individual’s primary care provider; 13
(2) A community health clinic; 14
(3) An urgent care facility; 15
(4) An emergency room diversion facility, as defined in § 23-17.26-2; and 16
(5) A community-based behavioral health facility designed to provide immediate 17
assistance to a person in crisis. 18
(d) The department of health with the collaboration of the ambulance service coordinating 19
advisory board shall administer the mobile integrated healthcare/community paramedicine program 20
and shall promulgate any rules, regulations, standing orders, protocols, and procedures necessary 21
and proper for the efficient administration and enforcement of this section. The requirements of 22
this section shall only apply to EMS agencies that apply for and receive approval from the 23
department of health to provide such services. 24
(e) Commencing January 1, 2024, every individual or group health insurance contract, plan 25
or policy issued for delivery or renewed in this state that provides medical coverage that includes 26
coverage for emergency medical services shall provide coverage for transport to an alternative 27
location facility as identified in subsection (c) of this section and shall reimburse the EMS for such 28
services at the same rate as for a basic life support transport to an emergency department. 29
(f) If treatment at an alternative facility is deemed appropriate by the EMS practitioner, the 30
emergency medical service shall bill at the rate described in subsection (e) of this section, even if 31
an advanced life support assessment was provided. 32
(g) The office of the health insurance commissioner may promulgate such rules and 33
regulations as are necessary and proper to effectuate the purpose and for the efficient administration 34
LC001384 - Page 6 of 16
and enforcement of this section. 1
27-19-84. Coverage of emergency medical services mental health and substance use 2
disorder treatment. 3
(a) As used in this section, "emergency medical services" or "EMS" means the 4
practitioners, ambulance vehicles, and ambulance service entities licensed in accordance with 5
chapter 4.1 of title 23 to provide emergency medical care, transportation, and preventive care to 6
mitigate loss of life or exacerbation of illness or injury, including, but not limited to, EMS 7
responding to the 911 system established under chapter 21.1 of title 39. 8
(b) Emergency medical services shall be permitted to allow licensed providers who 9
evaluate and treat mental health disorders, including substance use disorders, to accompany EMS. 10
Such providers shall be permitted to evaluate and treat EMS patients when medically necessary 11
and appropriate. Such evaluation and treatment shall be permitted to occur in the community. 12
(c) Emergency medical services shall be permitted to transport to the following facilities 13
designated by the director of the department of health: 14
(1) Emergency room diversion facilities, as defined in § 23-17.26-2; and 15
(2) Community-based behavioral health facilities designed to provide immediate assistance 16
to a person in crisis. 17
(d) Commencing January 1, 2024, 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 evaluation 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
(e) Commencing January 1, 2024, every individual or group health insurance contract, plan 23
or policy issued for delivery or renewed in this state that provides medical coverage that includes 24
coverage for emergency medical services, shall provide coverage for transportation and described 25
in subsection (c) of this section and shall reimburse such services at a rate not lower than the same 26
rate as for basic life support transport to an emergency department. 27
(f) Treatment and coverage for mental health disorders, including substance use disorders, 28
as described in this section shall be provided in accordance with chapter 38.2 of title 27. 29
(g) The department of health with the collaboration of the ambulance service coordinating 30
advisory board shall promulgate any rules, regulations, standing orders, protocols, and procedures 31
necessary and proper for the efficient administration and enforcement of this section. 32
(h) The office of the health insurance commissioner may promulgate such rules and 33
regulations as are necessary and proper to effectuate the purpose and for the efficient administration 34
LC001384 - Page 7 of 16
and enforcement of this section. 1
SECTION 3. Chapter 27-20 of the General Laws entitled "Nonprofit Medical Service 2
Corporations" is hereby amended by adding thereto the following sections: 3
27-20-79. Emergency medical services transport to alternate facilities. 4
(a) As used in this section, the following terms shall have the following meaning: 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 three (3) people who meet the requirements of state laws and 8
regulations where the services are being furnished. Also, at least two (2) of the staff members must 9
be at a minimum, as an emergency medical technician by the state or local authority where the 10
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 20
technicians, advanced emergency medical technicians, advanced emergency medical technicians-21
cardiac, and paramedics. 22
(4) “Mobile integrated healthcare/community paramedicine” means the provision of 23
healthcare using patient-centered, mobile resources in the out-of-hospital environment pursuant to 24
an EMS agency’s plan approved by the department of health utilizing licensed paramedic and 25
advanced emergency medical technician-cardiac practitioners working in collaboration with 26
physicians, nurses, mid-level practitioners, community health teams and social, behavioral and 27
substance use disorder specialists to address the unmet needs of individuals experiencing 28
intermittent health care issues. 29
(b) Only those emergency medical services (EMS) agencies who submit plans that meet 30
the minimum requirements for participation set and approved by the department of health shall be 31
eligible to participate in a mobile integrated healthcare/community paramedicine program. 32
(c) This section authorizes emergency medical services in the state who are approved by 33
the department of health to participate in a mobile integrated healthcare/community paramedicine 34
LC001384 - Page 8 of 16
program to divert non-emergency basic life service calls from emergency departments. Pursuant to 1
an EMS agency’s approved plan, emergency medical services practitioners shall assess individuals 2
who are in need of emergency medical services and apply the correct level of care thereafter, which 3
may include transport to an alternative facility deemed appropriate by the emergency medical 4
services practitioner. An alternative facility shall include, but not be limited to: 5
(1) An individual’s primary care provider; 6
(2) A community health clinic; 7
(3) An urgent care facility; 8
(4) An emergency room diversion facility, as defined in § 23-17.26-2; and 9
(5) A community-based behavioral health facility designed to provide immediate 10
assistance to a person in crisis. 11
(d) The department of health with the collaboration of the ambulance service coordinating 12
advisory board shall administer the mobile integrated healthcare/community paramedicine program 13
and shall promulgate any rules, regulations, standing orders, protocols, and procedures necessary 14
and proper for the efficient administration and enforcement of this section. The requirements of 15
this section shall only apply to EMS agencies that apply for and receive approval from the 16
department of health to provide such services. 17
(e) Commencing January 1, 2024, 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 (c) of this section and shall reimburse the EMS for such 21
services at the same rate as for a basic life support transport to an emergency department. 22
(f) If treatment at an alternative facility is deemed appropriate by the EMS practitioner, the 23
emergency medical service shall bill at the rate described in subsection (e) of this section, even if 24
an advanced life support assessment was provided. 25
(g) The office of the health insurance commissioner may promulgate such rules and 26
regulations as are necessary and proper to effectuate the purpose and for the efficient administration 27
and enforcement of this section. 28
27-20-80. Coverage of emergency medical services mental health and substance use 29
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
LC001384 - Page 9 of 16
responding to the 911 system established under chapter 21.1 of title 39. 1
(b) Emergency medical services shall be permitted to allow licensed providers who 2
evaluate and treat mental health disorders, including substance use disorders, to accompany EMS. 3
Such providers shall be permitted to evaluate and treat EMS patients when medically necessary 4
and appropriate. Such evaluation and treatment shall be permitted to occur in the community. 5
(c) Emergency medical services shall be permitted to transport to the following facilities 6
designated by the director of the department of health: 7
(1) Emergency room diversion facilities, as defined in § 23-17.26-2; and 8
(2) Community-based behavioral health facilities designed to provide immediate assistance 9
to a person in crisis. 10
(d) Commencing January 1, 2024, every individual or group health insurance contract, plan 11
or policy issued for delivery or renewed in this state that provides medical coverage that includes 12
coverage for emergency medical services, shall provide coverage for evaluation and treatment 13
described in subsection (b) of this section and shall reimburse such services at a rate not lower than 14
the same service would have been had that service been delivered in a traditional office setting. 15
(e) Commencing January 1, 2024, every individual or group health insurance contract, plan 16
or policy issued for delivery or renewed in this state that provides medical coverage that includes 17
coverage for emergency medical services, shall provide coverage for transportation and described 18
in subsection (c) of this section and shall reimburse such services at a rate not lower than the same 19
rate as for basic life support transport to an emergency department. 20
(f) Treatment and coverage for mental health disorders, including substance use disorders, 21
as described in this section shall be provided in accordance with chapter 38.2 of title 27. 22
(g) The department of health with the collaboration of the ambulance service coordinating 23
advisory board shall promulgate any rules, regulations, standing orders, protocols, and procedures 24
necessary and proper for the efficient administration and enforcement of this section. 25
(h) The office of the health insurance commissioner may promulgate such rules and 26
regulations as are necessary and proper to effectuate the purpose and for the efficient administration 27
and enforcement of this section. 28
SECTION 4. Chapter 27-41 of the General Laws entitled "Health Maintenance 29
Organizations" is hereby amended by adding thereto the following sections: 30
27-41-96. Emergency medical services transport to alternate facilities. 31
(a) As used in this section, the following terms shall have the following meaning: 32
(1) "Basic life support" or "BLS" means transportation by ground ambulance vehicle and 33
medically necessary supplies and services, plus the provision of BLS ambulance services. The 34
LC001384 - Page 10 of 16
ambulance must be staffed by at least three (3) people who meet the requirements of state laws and 1
regulations where the services are being furnished. Also, at least two (2) of the staff members must 2
be at a minimum, as an emergency medical technician by the state or local authority where the 3
services are furnished and be legally authorized to operate all lifesaving and life-sustaining 4
equipment on board the vehicle. 5
(2) "Emergency medical services" or "EMS" means the practitioners, ambulance vehicles, 6
and ambulance service entities licensed in accordance with chapter 4.1 of title 23 to provide 7
emergency medical care, transportation, and preventive care to mitigate loss of life or exacerbation 8
of illness or injury, including, but not limited to, EMS responding to the 911 system established 9
under chapter 21.1 of title 39. 10
(3) "Emergency medical services practitioner" means an individual who is licensed in 11
accordance with state laws and regulations to perform emergency medical care and preventive care 12
to mitigate loss of life or exacerbation of illness or injury, including emergency medical 13
technicians, advanced emergency medical technicians, advanced emergency medical technicians-14
cardiac, and paramedics. 15
(4) “Mobile integrated healthcare/community paramedicine” means the provision of 16
healthcare using patient-centered, mobile resources in the out-of-hospital environment pursuant to 17
an EMS agency’s plan approved by the department of health utilizing licensed paramedic and 18
advanced emergency medical technician-cardiac practitioners working in collaboration with 19
physicians, nurses, mid-level practitioners, community health teams and social, behavioral and 20
substance use disorder specialists to address the unmet needs of individuals experiencing 21
intermittent health care issues. 22
(b) Only those emergency medical services (EMS) agencies who submit plans that meet 23
the minimum requirements for participation set and approved by the department of health shall be 24
eligible to participate in a mobile integrated healthcare/community paramedicine program. 25
(c) This section authorizes emergency medical services in the state who are approved by 26
the department of health to participate in a mobile integrated healthcare/community paramedicine 27
program to divert non-emergency basic life service calls from emergency departments. Pursuant to 28
an EMS agency’s approved plan, emergency medical services practitioners shall assess individuals 29
who are in need of emergency medical services and apply the correct level of care thereafter, which 30
may include transport to an alternative facility deemed appropriate by the emergency medical 31
services practitioner. An alternative facility shall include, but not be limited to: 32
(1) An individual’s primary care provider; 33
(2) A community health clinic; 34
LC001384 - Page 11 of 16
(3) An urgent care facility; 1
(4) An emergency room diversion facility, as defined in § 23-17.26-2; and 2
(5) A community-based behavioral health facility designed to provide immediate 3
assistance to a person in crisis. 4
(d) The department of health with the collaboration of the ambulance service coordinating 5
advisory board shall administer the mobile integrated healthcare/community paramedicine program 6
and shall promulgate any rules, regulations, standing orders, protocols, and procedures necessary 7
and proper for the efficient administration and enforcement of this section. The requirements of 8
this section shall only apply to EMS agencies that apply for and receive approval from the 9
department of health to provide such services. 10
(e) Commencing January 1, 2024, every individual or group health insurance contract, plan 11
or policy issued for delivery or renewed in this state that provides medical coverage that includes 12
coverage for emergency medical services shall provide coverage for transport to an alternative 13
location facility as identified in subsection (c) of this section and shall reimburse the EMS for such 14
services at the same rate as for a basic life support transport to an emergency department. 15
(f) If treatment at an alternative facility is deemed appropriate by the EMS practitioner, the 16
emergency medical service shall bill at the rate described in subsection (e) of this section, even if 17
an advanced life support assessment was provided. 18
(g) The office of the health insurance commissioner may promulgate such rules and 19
regulations as are necessary and proper to effectuate the purpose and for the efficient administration 20
and enforcement of this section. 21
27-41-97. Coverage of emergency medical services mental health and substance use 22
disorder treatment. 23
(a) As used in this section, "emergency medical services" or "EMS" means the 24
practitioners, ambulance vehicles, and ambulance service entities licensed in accordance with 25
chapter 4.1 of title 23 to provide emergency medical care, transportation, and preventive care to 26
mitigate loss of life or exacerbation of illness or injury, including, but not limited to, EMS 27
responding to the 911 system established under chapter 21.1 of title 39. 28
(b) Emergency medical services shall be permitted to allow licensed providers who 29
evaluate and treat mental health disorders, including substance use disorders, to accompany EMS. 30
Such providers shall be permitted to evaluate and treat EMS patients when medically necessary 31
and appropriate. Such evaluation and treatment shall be permitted to occur in the community. 32
(c) Emergency medical services shall be permitted to transport to the following facilities 33
designated by the director of the department of health: 34
LC001384 - Page 12 of 16
(1) Emergency room diversion facilities, as defined in § 23-17.26-2; and 1
(2) Community-based behavioral health facilities designed to provide immediate assistance 2
to a person in crisis. 3
(d) Commencing January 1, 2024, every individual or group health insurance contract, plan 4
or policy issued for delivery or renewed in this state that provides medical coverage that includes 5
coverage for emergency medical services, shall provide coverage for evaluation and treatment 6
described in subsection (b) of this section and shall reimburse such services at a rate not lower than 7
the same service would have been had that service been delivered in a traditional office setting. 8
(e) Commencing January 1, 2024, every individual or group health insurance contract, plan 9
or policy issued for delivery or renewed in this state that provides medical coverage that includes 10
coverage for emergency medical services, shall provide coverage for transportation and described 11
in subsection (c) of this section and shall reimburse such services at a rate not lower than the same 12
rate as for basic life support transport to an emergency department. 13
(f) Treatment and coverage for mental health disorders, including substance use disorders, 14
as described in this section shall be provided in accordance with chapter 38.2 of title 27. 15
(g) The department of health with the collaboration of the ambulance service coordinating 16
advisory board shall promulgate any rules, regulations, standing orders, protocols, and procedures 17
necessary and proper for the efficient administration and enforcement of this section. 18
(h) The office of the health insurance commissioner may promulgate such rules and 19
regulations as are necessary and proper to effectuate the purpose and for the efficient administration 20
and enforcement of this section. 21
SECTION 5. Chapter 42-7.2 of the General Laws entitled "Office of Health and Human 22
Services" is hereby amended by adding thereto the following sections: 23
42-7.2-21. Emergency medical services transport to alternate facilities. 24
(a) As used in this section, the following terms shall have the following meaning: 25
(1) "Basic life support" or "BLS" means transportation by ground ambulance vehicle and 26
medically necessary supplies and services, plus the provision of BLS ambulance services. The 27
ambulance must be staffed by at least three (3) people who meet the requirements of state laws and 28
regulations where the services are being furnished. Also, at least two (2) of the staff members must 29
be licensed, at a minimum, as an emergency medical technician by the state or local authority where 30
the services are furnished and be legally authorized to operate all lifesaving and life-sustaining 31
equipment on board the vehicle. 32
(2) "Emergency medical services" or "EMS" means the practitioners, ambulance vehicles, 33
and ambulance service entities licensed in accordance with chapter 4.1 of title 23 to provide 34
LC001384 - Page 13 of 16
emergency medical care, transportation, and preventive care to mitigate loss of life or exacerbation 1
of illness or injury, including, but not limited to, EMS responding to the 911 system established 2
under chapter 21.1 of title 39. 3
(3) "Emergency medical services practitioner" means an individual who is licensed in 4
accordance with state laws and regulations to perform emergency medical care and preventive care 5
to mitigate loss of life or exacerbation of illness or injury, including emergency medical 6
technicians, advanced emergency medical technicians, advanced emergency medical technicians-7
cardiac, and paramedics. 8
(4) “Mobile integrated healthcare community paramedicine” means the provision of 9
healthcare using patient-centered, mobile resources in the out-of-hospital environment pursuant to 10
an EMS agency’s plan approved by the department of health utilizing licensed paramedic and 11
advanced emergency medical technician-cardiac practitioners working in collaboration with 12
physicians, nurses, mid-level practitioners, community health teams and social, behavioral and 13
substance use disorder specialists to address the unmet needs of individuals experiencing 14
intermittent health care issues. 15
(b) Only those emergency medical services (EMS) agencies who submit plans that meet 16
the minimum requirements for participation set and approved by the department of health shall be 17
eligible to participate in a mobile integrated healthcare/community paramedicine program. 18
(c) This section authorizes emergency medical services in the state that are approved by 19
the department of health to participate in a mobile integrated healthcare/community paramedicine 20
program to divert non-emergency basic life service calls from emergency departments. Pursuant to 21
an EMS agency’s approved plan, emergency medical services practitioners shall assess individuals 22
who are in need of emergency medical services and apply the correct level of care thereafter, which 23
may include transport to an alternative facility deemed appropriate by the emergency medical 24
services practitioner. An alternative facility shall include, but not be limited to: 25
(1) An individual’s primary care provider; 26
(2) A community health clinic; 27
(3) An urgent care facility; 28
(4) An emergency room diversion facility, as defined in § 23-17.26-2; and 29
(5) A community-based behavioral health facility designed to provide immediate 30
assistance to a person in crisis. 31
(d) The department of health with the collaboration of the ambulance service coordinating 32
advisory board shall administer the mobile integrated healthcare/community paramedicine program 33
and shall promulgate any rules, regulations, standing orders, protocols, and procedures necessary 34
LC001384 - Page 14 of 16
and proper for the efficient administration and enforcement of this section. The requirements of 1
this chapter shall only apply to EMS agencies who apply for and receive approval from the 2
department of health to provide such services. 3
(e) Rhode Island Medicaid and its contracted managed care entities shall provide coverage 4
for transport to an alternative facility as identified in subsection (c) of this section and shall 5
reimburse the EMS for such services at the same rate as for a basic life support transport to an 6
emergency department. 7
(f) If treatment at an alternative facility is deemed appropriate by the EMS practitioner, the 8
emergency medical service shall bill at the rate described in subsection (e) of this section, even if 9
an advanced life support assessment was provided. 10
(g) The executive office of health and human services shall set the reimbursement rates for 11
the services described in this section. 12
42-7.2-22. Coverage for emergency medical services mental health and substance use 13
disorder. 14
(a) As used in this section, "emergency medical services" or "EMS" means the 15
practitioners, ambulance vehicles, and ambulance service entities licensed in accordance with 16
chapter 4.1 of title 23 to provide emergency medical care, transportation, and preventive care to 17
mitigate loss of life or exacerbation of illness or injury, including, but not limited to, EMS 18
responding to the 911 system established under chapter 21.1 of title 39. 19
(b) Emergency medical services shall be permitted to allow licensed providers who 20
evaluate and treat mental health disorders, including substance use disorders, to accompany EMS. 21
Such providers shall be permitted to evaluate and treat EMS patients when medically necessary 22
and appropriate. Such evaluation and treatment shall be permitted to occur in the community. 23
(c) Emergency medical services shall be permitted to transport to the following facilities 24
designated by the director of the department of health: 25
(1) Emergency room diversion facilities, as defined in § 23-17.26-2; and 26
(2) Community-based behavioral health facilities designed to provide immediate assistance 27
to a person in crisis. 28
(d) Rhode Island Medicaid and its contracted managed care entities shall provide coverage 29
for transportation, evaluation, and treatment described in subsections (c) and (d) of this section and 30
shall reimburse such services at a rate not lower than the same service would have been had that 31
service been delivered in a traditional office setting or for basic life support transport to an 32
emergency department. 33
(e) The executive office of health and human services shall set the reimbursement rates for 34
LC001384 - Page 15 of 16
the services described in this section. 1
SECTION 6. This act shall take effect upon passage. 2
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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 authorize emergency medical service agencies approved by the department 1
of health to participate in a mobile integrated healthcare/community paramedicine program, 2
allowing the agencies to transport individuals to alternative facilities such as an individua l’s 3
primary care provider, community health clinic, urgent care facility, emergency room diversion 4
facility, or a community-based behavioral health facility, based on the individual’s need of 5
emergency medical services. This act would further permit licensed providers to accompany 6
emergency medical services and treat patients within the community for mental health disorders, 7
including substance use disorders. This act would further require the health insurance contract, plan 8
or policy to provide coverage for transport to an alternative location facility and treatment by a 9
licensed provider for mental health disorders and substance use disorders within the community. 10
This act would take effect upon passage. 11
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