2025 -- S 0794
========
LC001167
========
S T A T E O F R H O D E I S L A N D
IN GENERAL ASSEMBLY
JANUARY SESSION, A.D. 2025
____________
A N A C T
RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES
Introduced By: Senators DiMario, Murray, Lauria, Valverde, Ujifusa, Thompson, Urso,
Appollonio, and Bissaillon
Date Introduced: March 14, 2025
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 sections: 2
27-18-95. Emergency medical services transport to alternate facilities. 3
(a) As used in this section, the following terms shall have the following meanings: 4
(1) "Emergency medical services" or "EMS" means the practitioners, ambulance vehicles, 5
and ambulance service entities licensed in accordance with chapter 4.1 of title 23 to provide 6
emergency medical care, transportation, and preventive care to mitigate loss of life or exacerbation 7
of illness or injury, including, but not limited to, EMS responding to the 911 system established 8
under chapter 21.1 of title 39. 9
(2) "Emergency medical services practitioner" means an individual who is licensed in 10
accordance with state laws and regulations to perform emergency medical care and preventive care 11
to mitigate loss of life or exacerbation of illness or injury, including emergency medical 12
technicians, advanced emergency medical technicians, advanced emergency medical technicians 13
cardiac, and paramedics. 14
(3) “Mobile integrated healthcare community paramedicine” means the provision of 15
healthcare using patient-centered, mobile resources in the out-of-hospital environment pursuant to 16
an EMS agency’s plan approved by the department of health utilizing licensed paramedic and 17
advanced emergency medical technician-cardiac practitioners working in collaboration with 18
physicians, nurses, mid-level practitioners, community health teams and social, behavioral and 19
LC001167 - Page 2 of 15
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 that 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 within their 8
service area as provided by department of health regulations. Pursuant to an EMS agency’s 9
approved plan, emergency medical services practitioners shall assess individuals who are in need 10
of emergency medical services and apply the correct level of care thereafter, which may include 11
transport to an alternative facility deemed appropriate by the emergency medical services 12
practitioner. An alternative facility shall include, but not be limited to: 13
(1) An individual’s primary care provider; 14
(2) A community health clinic; 15
(3) An urgent care facility; 16
(4) An emergency room diversion facility, as defined in § 23-17.26-2; and 17
(5) A community-based behavioral health facility designed to provide immediate 18
assistance to a person in crisis. 19
(d) The department of health with the collaboration of the ambulance service coordinating 20
advisory board shall administer the mobile integrated healthcare/community paramedicine program 21
and shall promulgate any rules, regulations, standing orders, protocols, and procedures necessary 22
and proper for the efficient administration and enforcement of this section. The requirements of 23
this section shall only apply to EMS agencies who apply for and receive approval from the 24
department of health to provide such services. 25
(e) Commencing January 1, 2026, every individual or group health insurance contract, plan 26
or policy issued for delivery or renewed in this state that provides medical coverage that includes 27
coverage for emergency medical services shall provide coverage for transport to an alternative 28
location facility as identified in subsection (c) of this section and shall reimburse the EMS for such 29
services at the same rate as for a transport to an emergency department. 30
(f) If treatment at an alternative facility is deemed appropriate by the EMS practitioner, the 31
emergency medical service shall bill at the rate described in subsection (e) of this section, even if 32
an advanced life support assessment was provided. 33
(g) The office of the health insurance commissioner may promulgate such rules and 34
LC001167 - Page 3 of 15
regulations as are necessary and proper to effectuate the purpose and for the efficient administration 1
and enforcement of this section. 2
27-18-96. Coverage of emergency medical services mental health and substance use 3
disorder treatment. 4
(a) As used in this section, "emergency medical services" or "EMS" means the 5
practitioners, ambulance vehicles, and ambulance service entities licensed in accordance with 6
chapter 4.1 of title 23 to provide emergency medical care, transportation, and preventive care to 7
mitigate loss of life or exacerbation of illness or injury, including, but not limited to, EMS 8
responding to the 911 system established under chapter 21.1 of title 39. 9
(b) Emergency medical services shall be permitted to allow licensed providers who 10
evaluate and treat mental health disorders, including substance use disorders, to accompany EMS. 11
Such providers shall be permitted to evaluate and treat EMS patients when medically necessary 12
and appropriate. Such evaluation and treatment shall be permitted to occur in the community. 13
(c) Emergency medical services shall be permitted to transport to the following facilities 14
designated by the director of the department of health: 15
(1) Emergency room diversion facilities, as defined in § 23-17.26-2; and 16
(2) Community-based behavioral health facilities designed to provide immediate assistance 17
to a person in crisis. 18
(d) Commencing January 1, 2026, every individual or group health insurance contract, plan 19
or policy issued for delivery or renewed in this state that provides medical coverage that includes 20
coverage for emergency medical services, shall provide coverage for evaluation and treatment 21
described in subsection (b) of this section and shall reimburse such services at a rate not lower than 22
the same service would have been had that service been delivered in a traditional office setting. 23
(e) Commencing January 1, 2026, every individual or group health insurance contract, plan 24
or policy issued for delivery or renewed in this state that provides medical coverage that includes 25
coverage for emergency medical services, shall provide coverage for transportation and described 26
in subsection (c) of this section and shall reimburse such services at a rate not lower than the same 27
rate as for transport to an emergency department. 28
(f) Treatment and coverage for mental health disorders, including substance use disorders, 29
as described in this section shall be provided in accordance with chapter 38.2 of title 27. 30
(g) The department of health with the collaboration of the ambulance service coordinating 31
advisory board shall promulgate any rules, regulations, standing orders, protocols, and procedures 32
necessary and proper for the efficient administration and enforcement of this section. 33
(h) The office of the health insurance commissioner may promulgate such rules and 34
LC001167 - Page 4 of 15
regulations as are necessary and proper to effectuate the purpose and for the efficient administration 1
and enforcement of this section. 2
SECTION 2. Chapter 27-19 of the General Laws entitled "Nonprofit Hospital Service 3
Corporations" is hereby amended by adding thereto the following sections: 4
27-19-87. Emergency medical services transport to alternate facilities. 5
(a) As used in this section, the following terms shall have the following meaning: 6
(1) "Emergency medical services" or "EMS" means the practitioners, ambulance vehicles, 7
and ambulance service entities licensed in accordance with chapter 4.1 of title 23 to provide 8
emergency medical care, transportation, and preventive care to mitigate loss of life or exacerbation 9
of illness or injury, including, but not limited to, EMS responding to the 911 system established 10
under chapter 21.1 of title 39. 11
(2) "Emergency medical services practitioner" means an individual who is licensed in 12
accordance with state laws and regulations to perform emergency medical care and preventive care 13
to mitigate loss of life or exacerbation of illness or injury, including emergency medical 14
technicians, advanced emergency medical technicians, advanced emergency medical technicians-15
cardiac, and paramedics. 16
(3) “Mobile integrated healthcare/community paramedicine” means the provision of 17
healthcare using patient-centered, mobile resources in the out-of-hospital environment pursuant to 18
an EMS agency’s plan approved by the department of health utilizing licensed paramedic and 19
advanced emergency medical technician-cardiac practitioners working in collaboration with 20
physicians, nurses, mid-level practitioners, community health teams and social, behavioral and 21
substance use disorder specialists to address the unmet needs of individuals experiencing 22
intermittent health care issues. 23
(b) Only those emergency medical services (EMS) agencies who submit plans that meet 24
the minimum requirements for participation set and approved by the department of health shall be 25
eligible to participate in a mobile integrated healthcare/community paramedicine program. 26
(c) This section authorizes emergency medical services in the state who are approved by 27
the department of health to participate in a mobile integrated healthcare/community paramedicine 28
program to divert non-emergency basic life service calls from emergency departments within their 29
service area as provided by department of health regulations. Pursuant to an EMS agency’s 30
approved plan, emergency medical services practitioners shall assess individuals who are in need 31
of emergency medical services and apply the correct level of care thereafter, which may include 32
transport to an alternative facility deemed appropriate by the emergency medical services 33
practitioner. An alternative facility shall include, but not be limited to: 34
LC001167 - Page 5 of 15
(1) An individual’s primary care provider; 1
(2) A community health clinic; 2
(3) An urgent care facility; 3
(4) An emergency room diversion facility, as defined in § 23-17.26-2; and 4
(5) A community-based behavioral health facility designed to provide immediate 5
assistance to a person in crisis. 6
(d) The department of health with the collaboration of the ambulance service coordinating 7
advisory board shall administer the mobile integrated healthcare/community paramedicine program 8
and shall promulgate any rules, regulations, standing orders, protocols, and procedures necessary 9
and proper for the efficient administration and enforcement of this section. The requirements of 10
this section shall only apply to EMS agencies that apply for and receive approval from the 11
department of health to provide such services. 12
(e) Commencing January 1, 2026, every individual or group health insurance contract, plan 13
or policy issued for delivery or renewed in this state that provides medical coverage that includes 14
coverage for emergency medical services shall provide coverage for transport to an alternative 15
location facility as identified in subsection (c) of this section and shall reimburse the EMS for such 16
services at the same rate as for a transport to an emergency department. 17
(f) If treatment at an alternative facility is deemed appropriate by the EMS practitioner, the 18
emergency medical service shall bill at the rate described in subsection (e) of this section, even if 19
an advanced life support assessment was provided. 20
(g) The office of the health insurance commissioner may promulgate such rules and 21
regulations as are necessary and proper to effectuate the purpose and for the efficient administration 22
and enforcement of this section. 23
27-19-88. Coverage of emergency medical services mental health and substance use 24
disorder treatment. 25
(a) As used in this section, "emergency medical services" or "EMS" means the 26
practitioners, ambulance vehicles, and ambulance service entities licensed in accordance with 27
chapter 4.1 of title 23 to provide emergency medical care, transportation, and preventive care to 28
mitigate loss of life or exacerbation of illness or injury, including, but not limited to, EMS 29
responding to the 911 system established under chapter 21.1 of title 39. 30
(b) Emergency medical services shall be permitted to allow licensed providers who 31
evaluate and treat mental health disorders, including substance use disorders, to accompany EMS. 32
Such providers shall be permitted to evaluate and treat EMS patients when medically necessary 33
and appropriate. Such evaluation and treatment shall be permitted to occur in the community. 34
LC001167 - Page 6 of 15
(c) Emergency medical services shall be permitted to transport to the following facilities 1
designated by the director of the department of health: 2
(1) Emergency room diversion facilities, as defined in § 23-17.26-2; and 3
(2) Community-based behavioral health facilities designed to provide immediate assistance 4
to a person in crisis. 5
(d) Commencing January 1, 2026, every individual or group health insurance contract, plan 6
or policy issued for delivery or renewed in this state that provides medical coverage that includes 7
coverage for emergency medical services, shall provide coverage for evaluation and treatment 8
described in subsection (b) of this section and shall reimburse such services at a rate not lower than 9
the same service would have been had that service been delivered in a traditional office setting. 10
(e) Commencing January 1, 2026, 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 transportation and described 13
in subsection (c) of this section and shall reimburse such services at a rate not lower than the same 14
rate as for transport to an emergency department. 15
(f) Treatment and coverage for mental health disorders, including substance use disorders, 16
as described in this section shall be provided in accordance with chapter 38.2 of title 27. 17
(g) The department of health with the collaboration of the ambulance service coordinating 18
advisory board shall promulgate any rules, regulations, standing orders, protocols, and procedures 19
necessary and proper for the efficient administration and enforcement of this section. 20
(h) The office of the health insurance commissioner may promulgate such rules and 21
regulations as are necessary and proper to effectuate the purpose and for the efficient administration 22
and enforcement of this section. 23
SECTION 3. Chapter 27-20 of the General Laws entitled "Nonprofit Medical Service 24
Corporations" is hereby amended by adding thereto the following sections: 25
27-20-83. Emergency medical services transport to alternate facilities. 26
(a) As used in this section, the following terms shall have the following meaning: 27
(1) "Emergency medical services practitioner" means an individual who is licensed in 28
accordance with state laws and regulations to perform emergency medical care and preventive care 29
to mitigate loss of life or exacerbation of illness or injury, including emergency medical 30
technicians, advanced emergency medical technicians, advanced emergency medical technicians-31
cardiac, and paramedics. 32
(2) “Mobile integrated healthcare/community paramedicine” means the provision of 33
healthcare using patient-centered, mobile resources in the out-of-hospital environment pursuant to 34
LC001167 - Page 7 of 15
an EMS agency’s plan approved by the department of health utilizing licensed paramedic and 1
advanced emergency medical technician-cardiac practitioners working in collaboration with 2
physicians, nurses, mid-level practitioners, community health teams and social, behavioral and 3
substance use disorder specialists to address the unmet needs of individuals experiencing 4
intermittent health care issues. 5
(b) Only those emergency medical services (EMS) agencies who submit plans that meet 6
the minimum requirements for participation set and approved by the department of health shall be 7
eligible to participate in a mobile integrated healthcare/community paramedicine program. 8
(c) This section authorizes emergency medical services in the state who are approved by 9
the department of health to participate in a mobile integrated healthcare/community paramedicine 10
program to divert non-emergency basic life service calls from emergency departments within their 11
service area as provided by department of health regulations. Pursuant to an EMS agency’s 12
approved plan, emergency medical services practitioners shall assess individuals who are in need 13
of emergency medical services and apply the correct level of care thereafter, which may include 14
transport to an alternative facility deemed appropriate by the emergency medical services 15
practitioner. An alternative facility shall include, but not be limited to: 16
(1) An individual’s primary care provider; 17
(2) A community health clinic; 18
(3) An urgent care facility; 19
(4) An emergency room diversion facility, as defined in § 23-17.26-2; and 20
(5) A community-based behavioral health facility designed to provide immediate 21
assistance to a person in crisis. 22
(d) The department of health with the collaboration of the ambulance service coordinating 23
advisory board shall administer the mobile integrated healthcare/community paramedicine program 24
and shall promulgate any rules, regulations, standing orders, protocols, and procedures necessary 25
and proper for the efficient administration and enforcement of this section. The requirements of 26
this section shall only apply to EMS agencies that apply for and receive approval from the 27
department of health to provide such services. 28
(e) Commencing January 1, 2026, every individual or group health insurance contract, plan 29
or policy issued for delivery or renewed in this state that provides medical coverage that includes 30
coverage for emergency medical services shall provide coverage for transport to an alternative 31
location facility as identified in subsection (c) of this section and shall reimburse the EMS for such 32
services at the same rate as for a transport to an emergency department. 33
(f) If treatment at an alternative facility is deemed appropriate by the EMS practitioner, the 34
LC001167 - Page 8 of 15
emergency medical service shall bill at the rate described in subsection (e) of this section, even if 1
an advanced life support assessment was provided. 2
(g) The office of the health insurance commissioner may promulgate such rules and 3
regulations as are necessary and proper to effectuate the purpose and for the efficient administration 4
and enforcement of this section. 5
27-20-84. Coverage of emergency medical services mental health and substance use 6
disorder treatment. 7
(a) As used in this section, "emergency medical services" or "EMS" means the 8
practitioners, ambulance vehicles, and ambulance service entities licensed in accordance with 9
chapter 4.1 of title 23 to provide emergency medical care, transportation, and preventive care to 10
mitigate loss of life or exacerbation of illness or injury, including, but not limited to, EMS 11
responding to the 911 system established under chapter 21.1 of title 39. 12
(b) Emergency medical services shall be permitted to allow licensed providers who 13
evaluate and treat mental health disorders, including substance use disorders, to accompany EMS. 14
Such providers shall be permitted to evaluate and treat EMS patients when medically necessary 15
and appropriate. Such evaluation and treatment shall be permitted to occur in the community. 16
(c) Emergency medical services shall be permitted to transport to the following facilities 17
designated by the director of the department of health: 18
(1) Emergency room diversion facilities, as defined in § 23-17.26-2; and 19
(2) Community-based behavioral health facilities designed to provide immediate assistance 20
to a person in crisis. 21
(d) Commencing January 1, 2026, every individual or group health insurance contract, plan 22
or policy issued for delivery or renewed in this state that provides medical coverage that includes 23
coverage for emergency medical services, shall provide coverage for evaluation and treatment 24
described in subsection (b) of this section and shall reimburse such services at a rate not lower than 25
the same service would have been had that service been delivered in a traditional office setting. 26
(e) Commencing January 1, 2026, every individual or group health insurance contract, plan 27
or policy issued for delivery or renewed in this state that provides medical coverage that includes 28
coverage for emergency medical services, shall provide coverage for transportation and described 29
in subsection (c) of this section and shall reimburse such services at a rate not lower than the same 30
rate as for transport to an emergency department. 31
(f) Treatment and coverage for mental health disorders, including substance use disorders, 32
as described in this section shall be provided in accordance with chapter 38.2 of title 27. 33
(g) The department of health with the collaboration of the ambulance service coordinating 34
LC001167 - Page 9 of 15
advisory board shall promulgate any rules, regulations, standing orders, protocols, and procedures 1
necessary and proper for the efficient administration and enforcement of this section. 2
(h) The office of the health insurance commissioner may promulgate such rules and 3
regulations as are necessary and proper to effectuate the purpose and for the efficient administration 4
and enforcement of this section. 5
SECTION 4. Chapter 27-41 of the General Laws entitled "Health Maintenance 6
Organizations" is hereby amended by adding thereto the following sections: 7
27-41-100. Emergency medical services transport to alternate facilities. 8
(a) As used in this section, the following terms shall have the following meaning: 9
(1) "Emergency medical services" or "EMS" means the practitioners, ambulance vehicles, 10
and ambulance service entities licensed in accordance with chapter 4.1 of title 23 to provide 11
emergency medical care, transportation, and preventive care to mitigate loss of life or exacerbation 12
of illness or injury, including, but not limited to, EMS responding to the 911 system established 13
under chapter 21.1 of title 39. 14
(2) "Emergency medical services practitioner" means an individual who is licensed in 15
accordance with state laws and regulations to perform emergency medical care and preventive care 16
to mitigate loss of life or exacerbation of illness or injury, including emergency medical 17
technicians, advanced emergency medical technicians, advanced emergency medical technicians-18
cardiac, and paramedics. 19
(3) “Mobile integrated healthcare/community paramedicine” means the provision of 20
healthcare using patient-centered, mobile resources in the out-of-hospital environment pursuant to 21
an EMS agency’s plan approved by the department of health utilizing licensed paramedic and 22
advanced emergency medical technician-cardiac practitioners working in collaboration with 23
physicians, nurses, mid-level practitioners, community health teams and social, behavioral and 24
substance use disorder specialists to address the unmet needs of individuals experiencing 25
intermittent health care issues. 26
(b) Only those emergency medical services (EMS) agencies who submit plans that meet 27
the minimum requirements for participation set and approved by the department of health shall be 28
eligible to participate in a mobile integrated healthcare/community paramedicine program. 29
(c) This section authorizes emergency medical services in the state who are approved by 30
the department of health to participate in a mobile integrated healthcare/community paramedicine 31
program to divert non-emergency basic life service calls from emergency departments within their 32
service area as provided by department of health regulations. Pursuant to an EMS agency’s 33
approved plan, emergency medical services practitioners shall assess individuals who are in need 34
LC001167 - Page 10 of 15
of emergency medical services and apply the correct level of care thereafter, which may include 1
transport to an alternative facility deemed appropriate by the emergency medical services 2
practitioner. An alternative facility shall include, but not be limited to: 3
(1) An individual’s primary care provider; 4
(2) A community health clinic; 5
(3) An urgent care facility; 6
(4) An emergency room diversion facility, as defined in § 23-17.26-2; and 7
(5) A community-based behavioral health facility designed to provide immediate 8
assistance to a person in crisis. 9
(d) The department of health with the collaboration of the ambulance service coordinating 10
advisory board shall administer the mobile integrated healthcare/community paramedicine program 11
and shall promulgate any rules, regulations, standing orders, protocols, and procedures necessary 12
and proper for the efficient administration and enforcement of this section. The requirements of 13
this section shall only apply to EMS agencies that apply for and receive approval from the 14
department of health to provide such services. 15
(e) Commencing January 1, 2026, 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 transport to an alternative 18
location facility as identified in subsection (c) of this section and shall reimburse the EMS for such 19
services at the same rate as for a transport to an emergency department. 20
(f) If treatment at an alternative facility is deemed appropriate by the EMS practitioner, the 21
emergency medical service shall bill at the rate described in subsection (e) of this section, even if 22
an advanced life support assessment was provided. 23
(g) The office of the health insurance commissioner may promulgate such rules and 24
regulations as are necessary and proper to effectuate the purpose and for the efficient administration 25
and enforcement of this section. 26
27-41-101. Coverage of emergency medical services mental health and substance use 27
disorder treatment. 28
(a) As used in this section, "emergency medical services" or "EMS" means the 29
practitioners, ambulance vehicles, and ambulance service entities licensed in accordance with 30
chapter 4.1 of title 23 to provide emergency medical care, transportation, and preventive care to 31
mitigate loss of life or exacerbation of illness or injury, including, but not limited to, EMS 32
responding to the 911 system established under chapter 21.1 of title 39. 33
(b) Emergency medical services shall be permitted to allow licensed providers who 34
LC001167 - Page 11 of 15
evaluate and treat mental health disorders, including substance use disorders, to accompany EMS. 1
Such providers shall be permitted to evaluate and treat EMS patients when medically necessary 2
and appropriate. Such evaluation and treatment shall be permitted to occur in the community. 3
(c) Emergency medical services shall be permitted to transport to the following facilities 4
designated by the director of the department of health: 5
(1) Emergency room diversion facilities, as defined in § 23-17.26-2; and 6
(2) Community-based behavioral health facilities designed to provide immediate assistance 7
to a person in crisis. 8
(d) Commencing January 1, 2026, 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 evaluation and treatment 11
described in subsection (b) of this section and shall reimburse such services at a rate not lower than 12
the same service would have been had that service been delivered in a traditional office setting. 13
(e) Commencing January 1, 2026, every individual or group health insurance contract, plan 14
or policy issued for delivery or renewed in this state that provides medical coverage that includes 15
coverage for emergency medical services, shall provide coverage for transportation and described 16
in subsection (c) of this section and shall reimburse such services at a rate not lower than the same 17
rate as for transport to an emergency department. 18
(f) Treatment and coverage for mental health disorders, including substance use disorders, 19
as described in this section shall be provided in accordance with chapter 38.2 of title 27. 20
(g) The department of health with the collaboration of the ambulance service coordinating 21
advisory board shall promulgate any rules, regulations, standing orders, protocols, and procedures 22
necessary and proper for the efficient administration and enforcement of this section. 23
(h) The office of the health insurance commissioner may promulgate such rules and 24
regulations as are necessary and proper to effectuate the purpose and for the efficient administration 25
and enforcement of this section. 26
SECTION 5. Chapter 42-7.2 of the General Laws entitled "Office of Health and Human 27
Services" is hereby amended by adding thereto the following sections: 28
42-7.2-21. Emergency medical services transport to alternate facilities. 29
(a) As used in this section, the following terms shall have the following meaning: 30
(1) "Emergency medical services" or "EMS" means the practitioners, ambulance vehicles, 31
and ambulance service entities licensed in accordance with chapter 4.1 of title 23 to provide 32
emergency medical care, transportation, and preventive care to mitigate loss of life or exacerbation 33
of illness or injury, including, but not limited to, EMS responding to the 911 system established 34
LC001167 - Page 12 of 15
under chapter 21.1 of title 39. 1
(2) "Emergency medical services practitioner" means an individual who is licensed in 2
accordance with state laws and regulations to perform emergency medical care and preventive care 3
to mitigate loss of life or exacerbation of illness or injury, including emergency medical 4
technicians, advanced emergency medical technicians, advanced emergency medical technicians-5
cardiac, and paramedics. 6
(3) “Mobile integrated healthcare community paramedicine” means the provision of 7
healthcare using patient-centered, mobile resources in the out-of-hospital environment pursuant to 8
an EMS agency’s plan approved by the department of health utilizing licensed paramedic and 9
advanced emergency medical technician-cardiac practitioners working in collaboration with 10
physicians, nurses, mid-level practitioners, community health teams and social, behavioral and 11
substance use disorder specialists to address the unmet needs of individuals experiencing 12
intermittent health care issues. 13
(b) Only those emergency medical services (EMS) agencies who submit plans that meet 14
the minimum requirements for participation set and approved by the department of health shall be 15
eligible to participate in a mobile integrated healthcare/community paramedicine program. 16
(c) This section authorizes emergency medical services in the state that are approved by 17
the department of health to participate in a mobile integrated healthcare/community paramedicine 18
program to divert non-emergency basic life service calls from emergency departments within their 19
service area as provided by department of health regulations. Pursuant to an EMS agency’s 20
approved plan, emergency medical services practitioners shall assess individuals who are in need 21
of emergency medical services and apply the correct level of care thereafter, which may include 22
transport to an alternative facility deemed appropriate by the emergency medical services 23
practitioner. An alternative facility shall include, but not be limited to: 24
(1) An individual’s primary care provider; 25
(2) A community health clinic; 26
(3) An urgent care facility; 27
(4) An emergency room diversion facility, as defined in § 23-17.26-2; and 28
(5) A community-based behavioral health facility designed to provide immediate 29
assistance to a person in crisis. 30
(d) The department of health with the collaboration of the ambulance service coordinating 31
advisory board shall administer the mobile integrated healthcare/community paramedicine program 32
and shall promulgate any rules, regulations, standing orders, protocols, and procedures necessary 33
and proper for the efficient administration and enforcement of this section. The requirements of 34
LC001167 - Page 13 of 15
this chapter shall only apply to EMS agencies who apply for and receive approval from the 1
department of health to provide such services. 2
(e) Rhode Island Medicaid and its contracted managed care entities shall provide coverage 3
for transport to an alternative facility as identified in subsection (c) of this section and shall 4
reimburse the EMS for such services at the same rate as for a transport to an emergency department. 5
(f) If treatment at an alternative facility is deemed appropriate by the EMS practitioner, the 6
emergency medical service shall bill at the rate described in subsection (e) of this section, even if 7
an advanced life support assessment was provided. 8
(g) The executive office of health and human services shall set the reimbursement rates for 9
the services described in this section. 10
42-7.2-22. Coverage for emergency medical services mental health and substance use 11
disorder. 12
(a) As used in this section, "emergency medical services" or "EMS" means the 13
practitioners, ambulance vehicles, and ambulance service entities licensed in accordance with 14
chapter 4.1 of title 23 to provide emergency medical care, transportation, and preventive care to 15
mitigate loss of life or exacerbation of illness or injury, including, but not limited to, EMS 16
responding to the 911 system established under chapter 21.1 of title 39. 17
(b) Emergency medical services shall be permitted to allow licensed providers who 18
evaluate and treat mental health disorders, including substance use disorders, to accompany EMS. 19
Such providers shall be permitted to evaluate and treat EMS patients when medically necessary 20
and appropriate. Such evaluation and treatment shall be permitted to occur in the community. 21
(c) Emergency medical services shall be permitted to transport to the following facilities 22
designated by the director of the department of health: 23
(1) Emergency room diversion facilities, as defined in § 23-17.26-2; and 24
(2) Community-based behavioral health facilities designed to provide immediate assistance 25
to a person in crisis. 26
(d) Rhode Island Medicaid and its contracted managed care entities shall provide coverage 27
for transportation, evaluation, and treatment described in subsections (c) and (d) of this section and 28
shall reimburse such services at a rate not lower than the same service would have been had that 29
service been delivered in a traditional office setting or for transport to an emergency department. 30
(e) The executive office of health and human services shall set the reimbursement rates for 31
the services described in this section. 32
LC001167 - Page 14 of 15
SECTION 6. This act shall take effect upon passage. 1
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LC001167
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LC001167 - Page 15 of 15
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 individual’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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LC001167
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