2022 -- H 8282

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LC006016

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2022

____________

A N   A C T

RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES

     Introduced By: Representatives Kislak, Potter, Slater, Diaz, Cassar, Bennett, Caldwell,
Craven, Morales, and Williams

     Date Introduced: May 25, 2022

     Referred To: House Finance

     It is enacted by the General Assembly as follows:

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

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

     27-18-89. Emergency medical services transport to alternate facilities.

     (a) As used in this section, the following terms shall have the following meanings:

     (1) "Advanced life support" or "ALS" means transportation by ground ambulance vehicle,

medically necessary supplies and services and either an ALS assessment by ALS personnel or the

provision of at least one ALS intervention; or the administration of at least three (3) medications

by intravenous push/bolus or by continuous infusion, excluding crystalloid, hypotonic, isotonic,

and hypertonic solutions (dextrose, normal saline, ringer's lactate); or transportation, medically

necessary supplies and services; and the provision of at least one of the following ALS procedures:

     (i) Manual defibrillation/cardioversion;

     (ii) Endotracheal intubation;

     (iii) Central venous line;

     (iv) Cardiac pacing;

     (v) Chest decompression;

     (vi) Surgical airway; or

     (vii) Intraosseous line.

     (2) "Advanced life support assessment" is an assessment performed by ALS personnel as

part of an emergency response that was necessary because the patient's reported condition at the

time of dispatch was such that only ALS personnel is qualified to perform the assessment. An ALS

assessment does not necessarily result in a determination that the patient requires an ALS level of

service.

     (3) "Advanced life support intervention" means a procedure that is required to be furnished

by ALS personnel in accordance with state law and regulation.

     (4) "Advanced life support personnel" means an individual licensed in accordance with

state law and regulation as an advanced emergency medical technician-cardiac or paramedic.

     (5) "Basic life support" or "BLS" means transportation by ground ambulance vehicle and

medically necessary supplies and services, plus the provision of BLS ambulance services. The

ambulance must be staffed by at least two (2) people who meet the requirements of state laws and

regulations where the services are being furnished. Also, at least one of the staff members must be

licensed, at a minimum, as an emergency medical technician by the state or local authority where

the services are furnished and be legally authorized to operate all lifesaving and life-sustaining

equipment on board the vehicle.

     (i) Basic life support shall be deemed non-emergency basic life support at the professional

discretion of the emergency medical services practitioner.

     (6) "Emergency medical services" or "EMS" means the practitioners, ambulance vehicles,

and ambulance service entities licensed in accordance with chapter 4.1 of title 23 to provide

emergency medical care, transportation, and preventive care to mitigate loss of life or exacerbation

of illness or injury, including, but not limited to, EMS responding to the 911 system established

under chapter 21.1 of title 39.

     (7) "Emergency medical services practitioner" means an individual who is licensed in

accordance with state laws and regulations to perform emergency medical care and preventive care

to mitigate loss of life or exacerbation of illness or injury, including emergency medical

technicians, advanced emergency medical technicians, advanced emergency medical technicians-

cardiac, and paramedics.

     (b) This section authorizes emergency medical services in the state to divert non-

emergency basic life service calls from emergency departments. Emergency medical services

practitioners shall assess individuals who are in need of emergency medical services and apply the

correct level of care thereafter, which may include transport to an alternative facility deemed

appropriate by an emergency medical services practitioner. An alternative facility shall include, but

not be limited to:

     (1) An individual’s primary care provider;

     (2) A community health clinic;

LC006016 - Page 2 of 15

     (3) An urgent care facility;

     (4) An emergency room diversion facility, as defined in § 23-17.26-2; and

     (5) A community-based behavioral health facility designed to provide immediate

assistance to a person in crisis.

     (c) Commencing January 1, 2023, every individual or group health insurance contract, plan

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

coverage for emergency medical services shall provide coverage for transport to an alternative

location facility as identified in subsection (b) of this section and shall reimburse the EMS for such

services at the same rate as for a non-emergency basic life support transport to an emergency

department.

     (d) If treatment at an alternative facility is deemed appropriate by the EMS practitioner, the

emergency medical service shall bill at the rate described in subsection (c) of this section, even if

an advanced life support assessment was provided.

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

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

and enforcement of this section.

     27-18-90. Coverage of EMS mental health and substance use disorder treatment.

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

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

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

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

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

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

mental health disorders, including substance use disorders, to accompany EMS. Such providers

shall be permitted to treat EMS patients when medically necessary and appropriate. Such treatment

shall be permitted to occur in the community.

     (c) Commencing January 1, 2023, every individual or group health insurance contract, plan

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

coverage for emergency medical services, shall provide coverage for treatment described in

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

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

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

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

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

LC006016 - Page 3 of 15

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

and enforcement of this section.

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

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

     27-19-81. Emergency medical services transport to alternate facilities.

     (a) As used in this section, the following terms shall have the following meaning:

     (1) "Advanced life support" or "ALS" means transportation by ground ambulance vehicle,

medically necessary supplies and services and either an ALS assessment by ALS personnel or the

provision of at least one ALS intervention; or the administration of at least three (3) medications

by intravenous push/bolus or by continuous infusion, excluding crystalloid, hypotonic, isotonic,

and hypertonic solutions (dextrose, normal saline, ringer's lactate); or transportation, medically

necessary supplies and services; and the provision of at least one of the following ALS procedures:

     (i) Manual defibrillation/cardioversion;

     (ii) Endotracheal intubation;

     (iii) Central venous line;

     (iv) Cardiac pacing;

     (v) Chest decompression;

     (vi) Surgical airway; or

     (vii) Intraosseous line.

     (2) "Advanced life support assessment" is an assessment performed by ALS personnel as

part of an emergency response that was necessary because the patient's reported condition at the

time of dispatch was such that only ALS personnel is qualified to perform the assessment. An ALS

assessment does not necessarily result in a determination that the patient requires an ALS level of

service.

     (3) "Advanced life support intervention" means a procedure that is required to be furnished

by ALS personnel in accordance with state law and regulation.

     (4) "Advanced life support personnel" means an individual licensed in accordance with

state law and regulation as an advanced emergency medical technician-cardiac or paramedic.

     (5) "Basic life support" or "BLS" means transportation by ground ambulance vehicle and

medically necessary supplies and services, plus the provision of BLS ambulance services. The

ambulance must be staffed by at least two (2) people who meet the requirements of state laws and

regulations where the services are being furnished. Also, at least one of the staff members must be

licensed, at a minimum, as an emergency medical technician by the state or local authority where

the services are furnished and be legally authorized to operate all lifesaving and life-sustaining

LC006016 - Page 4 of 15

equipment on board the vehicle.

     (i) Basic life support shall be deemed non-emergency basic life support at the professional

discretion of the emergency medical services practitioner.

     (6) "Emergency medical services" or "EMS" means the practitioners, ambulance vehicles,

and ambulance service entities licensed in accordance with chapter 4.1 of title 23 to provide

emergency medical care, transportation, and preventive care to mitigate loss of life or exacerbation

of illness or injury, including, but not limited to, EMS responding to the 911 system established

under chapter 21.1 of title 39.

     (7) "Emergency medical services practitioner" means an individual who is licensed in

accordance with state laws and regulations to perform emergency medical care and preventive care

to mitigate loss of life or exacerbation of illness or injury, including emergency medical

technicians, advanced emergency medical technicians, advanced emergency medical technicians-

cardiac, and paramedics.

     (b) This section authorizes emergency medical services in the state to divert non-

emergency basic life service calls from emergency departments. Emergency medical services

practitioners shall assess individuals who are in need of emergency medical services and apply the

correct level of care thereafter, which may include transport to an alternative facility deemed

appropriate by an emergency medical services practitioner. An alternative facility shall include, but

not be limited to:

     (1) An individual’s primary care provider;

     (2) A community health clinic;

     (3) An urgent care facility;

     (4) An emergency room diversion facility, as defined in § 23-17.26-2; and

     (5) A community-based behavioral health facility designed to provide immediate

assistance to a person in crisis.

     (c) Commencing January 1, 2023, every individual or group health insurance contract, plan

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

coverage for emergency medical services shall provide coverage for transport to an alternative

location facility as identified in subsection (b) of this section and shall reimburse the EMS for such

services at the same rate as for a non-emergency basic life support transport to an emergency

department.

     (d) If treatment at an alternative facility is deemed appropriate by the EMS practitioner, the

emergency medical service shall bill at the rate described in subsection (c) of this section even if

an advanced life support assessment was provided.

LC006016 - Page 5 of 15

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

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

and enforcement of this section.

     27-19-82. Coverage of EMS mental health and substance use disorder treatment.

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

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

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

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

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

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

mental health disorders, including substance use disorders, to accompany EMS. Such providers

shall be permitted to treat EMS patients when medically necessary and appropriate. Such treatment

shall be permitted to occur in the community.

     (c) Commencing January 1, 2023, every individual or group health insurance contract, plan

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

coverage for emergency medical services, shall provide coverage for treatment described in

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

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

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

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

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

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

and enforcement of this section.

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

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

     27-20-77. Emergency medical services transport to alternate facilities.

     (a) As used in this section, the following terms shall have the following meaning:

     (1) "Advanced life support" or "ALS" means transportation by ground ambulance vehicle,

medically necessary supplies and services and either an ALS assessment by ALS personnel or the

provision of at least one ALS intervention; or the administration of at least three (3) medications

by intravenous push/bolus or by continuous infusion, excluding crystalloid, hypotonic, isotonic,

and hypertonic solutions (dextrose, normal saline, ringer's lactate); or transportation, medically

necessary supplies and services; and the provision of at least one of the following ALS procedures:

     (i) Manual defibrillation/cardioversion;

LC006016 - Page 6 of 15

     (ii) Endotracheal intubation;

     (iii) Central venous line;

     (iv) Cardiac pacing;

     (v) Chest decompression;

     (vi) Surgical airway; or

     (vii) Intraosseous line.

     (2) "Advanced life support assessment" is an assessment performed by ALS personnel as

part of an emergency response that was necessary because the patient's reported condition at the

time of dispatch was such that only ALS personnel is qualified to perform the assessment. An ALS

assessment does not necessarily result in a determination that the patient requires an ALS level of

service.

     (3) "Advanced life support intervention" means a procedure that is required to be furnished

by ALS personnel in accordance with state law and regulation.

     (4) "Advanced life support personnel" means an individual licensed in accordance with

state law and regulation as an advanced emergency medical technician-cardiac or paramedic.

     (5) "Basic life support" or "BLS" means transportation by ground ambulance vehicle and

medically necessary supplies and services, plus the provision of BLS ambulance services. The

ambulance must be staffed by at least two (2) people who meet the requirements of state laws and

regulations where the services are being furnished. Also, at least one of the staff members must be

licensed, at a minimum, as an emergency medical technician by the state or local authority where

the services are furnished and be legally authorized to operate all lifesaving and life-sustaining

equipment on board the vehicle.

     (i) Basic life support shall be deemed non-emergency basic life support at the professional

discretion of the emergency medical services practitioner.

     (6) "Emergency medical services" or "EMS" means the practitioners, ambulance vehicles,

and ambulance service entities licensed in accordance with chapter 4.1 of title 23 to provide

emergency medical care, transportation, and preventive care to mitigate loss of life or exacerbation

of illness or injury including, but not limited to, EMS responding to the 911 system established

under chapter 21.1 of title 39.

     (7) "Emergency medical services practitioner" means an individual who is licensed in

accordance with state laws and regulations to perform emergency medical care and preventive care

to mitigate loss of life or exacerbation of illness or injury, including emergency medical

technicians, advanced emergency medical technicians, advanced emergency medical technicians-

cardiac, and paramedics.

LC006016 - Page 7 of 15

     (b) This section authorizes emergency medical services in the state to divert non-

emergency basic life service calls from emergency departments. Emergency medical services

practitioners shall assess individuals who are in need of emergency medical services and apply the

correct level of care thereafter, which may include transport to an alternative facility deemed

appropriate by an emergency medical services practitioner. An alternative facility shall include, but

not be limited to:

     (1) An individual’s primary care provider;

     (2) A community health clinic;

     (3) An urgent care facility;

     (4) An emergency room diversion facility, as defined in § 23-17.26-2; and

     (5) A community-based behavioral health facility designed to provide immediate

assistance to a person in crisis.

     (c) Commencing January 1, 2023, every individual or group health insurance contract, plan

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

coverage for emergency medical services shall provide coverage for transport to an alternative

location facility as identified in subsection (b) of this section and shall reimburse the EMS for such

services at the same rate as for a non-emergency basic life support transport to an emergency

department.

     (d) If treatment at an alternative facility is deemed appropriate by the EMS practitioner, the

emergency medical service shall bill at the rate described in subsection (c) of this section, even if

an advanced life support assessment was provided.

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

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

and enforcement of this section.

     27-20-78. Coverage of EMS mental health and substance use disorder treatment.

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

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

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

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

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

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

mental health disorders, including substance use disorders, to accompany EMS. Such providers

shall be permitted to treat EMS patients when medically necessary and appropriate. Such treatment

shall be permitted to occur in the community.

LC006016 - Page 8 of 15

     (c) Commencing January 1, 2023, every individual or group health insurance contract, plan

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

coverage for emergency medical services, shall provide coverage for treatment described in

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

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

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

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

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

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

and enforcement of this section.

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

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

     27-41-94. Emergency medical services transport to alternate facilities.

     (a) As used in this section, the following terms shall have the following meaning:

     (1) "Advanced life support" or "ALS" means transportation by ground ambulance vehicle,

medically necessary supplies and services and either an ALS assessment by ALS personnel or the

provision of at least one ALS intervention; or the administration of at least three (3) medications

by intravenous push/bolus or by continuous infusion, excluding crystalloid, hypotonic, isotonic,

and hypertonic solutions (dextrose, normal saline, ringer's lactate); or transportation, medically

necessary supplies and services; and the provision of at least one of the following ALS procedures:

     (i) Manual defibrillation/cardioversion;

     (ii) Endotracheal intubation;

     (iii) Central venous line;

     (iv) Cardiac pacing;

     (v) Chest decompression;

     (vi) Surgical airway; or

     (vii) Intraosseous line.

     (2) "Advanced life support assessment" is an assessment performed by ALS personnel as

part of an emergency response that was necessary because the patient's reported condition at the

time of dispatch was such that only ALS personnel is qualified to perform the assessment. An ALS

assessment does not necessarily result in a determination that the patient requires an ALS level of

service.

     (3) "Advanced life support intervention" means a procedure that is required to be furnished

by ALS personnel in accordance with state law and regulation.

LC006016 - Page 9 of 15

     (4) "Advanced life support personnel" means an individual licensed in accordance with

state law and regulation as an advanced emergency medical technician-cardiac or paramedic.

     (5) "Basic life support" or "BLS" means transportation by ground ambulance vehicle and

medically necessary supplies and services, plus the provision of BLS ambulance services. The

ambulance must be staffed by at least two (2) people who meet the requirements of state laws and

regulations where the services are being furnished. Also, at least one of the staff members must be

licensed, at a minimum, as an emergency medical technician by the state or local authority where

the services are furnished and be legally authorized to operate all lifesaving and life-sustaining

equipment on board the vehicle.

     (i) Basic life support shall be deemed non-emergency basic life support at the professional

discretion of the emergency medical services practitioner.

     (6) "Emergency medical services" or "EMS" means the practitioners, ambulance vehicles,

and ambulance service entities licensed in accordance with chapter 4.1 of title 23 to provide

emergency medical care, transportation, and preventive care to mitigate loss of life or exacerbation

of illness or injury, including, but not limited to, EMS responding to the 911 system established

under chapter 21.1 of title 39.

     (7) "Emergency medical services practitioner" means an individual who is licensed in

accordance with state laws and regulations to perform emergency medical care and preventive care

to mitigate loss of life or exacerbation of illness or injury, including emergency medical

technicians, advanced emergency medical technicians, advanced emergency medical technicians-

cardiac, and paramedics.

     (b) This section authorizes emergency medical services in the state to divert non-

emergency basic life service calls from emergency departments. Emergency medical services

practitioners shall assess individuals who are in need of emergency medical services and apply the

correct level of care thereafter, which may include transport to an alternative facility deemed

appropriate by an emergency medical services practitioner. An alternative facility shall include, but

not be limited to:

     (1) An individual’s primary care provider;

     (2) A community health clinic;

     (3) An urgent care facility;

     (4) An emergency room diversion facility, as defined in § 23-17.26-2; and

     (5) A community-based behavioral health facility designed to provide immediate

assistance to a person in crisis.

     (c) Commencing January 1, 2023, every individual or group health insurance contract, plan

LC006016 - Page 10 of 15

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

coverage for emergency medical services shall provide coverage for transport to an alternative

location facility as identified in subsection (b) of this section and shall reimburse the EMS for such

services at the same rate as for a non-emergency basic life support transport to an emergency

department.

     (d) If treatment at an alternative facility is deemed appropriate by the EMS practitioner, the

emergency medical service shall bill at the rate described in subsection (c) of this section, even if

an advanced life support assessment was provided.

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

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

and enforcement of this section.

     27-41-95. Coverage of EMS mental health and substance use disorder treatment.

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

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

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

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

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

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

mental health disorders, including substance use disorders, to accompany EMS. Such providers

shall be permitted to treat EMS patients when medically necessary and appropriate. Such treatment

shall be permitted to occur in the community.

     (c) Commencing January 1, 2023, every individual or group health insurance contract, plan

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

coverage for emergency medical services, shall provide coverage for treatment described in

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

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

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

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

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

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

and enforcement of this section.

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

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

     42-7.2-21. Emergency medical services transport to alternate facilities.

LC006016 - Page 11 of 15

     (a) As used in this section, the following terms shall have the following meaning:

     (1) "Advanced life support" or "ALS" means transportation by ground ambulance vehicle,

medically necessary supplies and services and either an ALS assessment by ALS personnel or the

provision of at least one ALS intervention; or the administration of at least three (3) medications

by intravenous push/bolus or by continuous infusion, excluding crystalloid, hypotonic, isotonic,

and hypertonic solutions (Dextrose, Normal Saline, Ringer's Lactate); or transportation, medically

necessary supplies and services; and the provision of at least one of the following ALS procedures:

     (i) Manual defibrillation/cardioversion;

     (ii) Endotracheal intubation;

     (iii) Central venous line;

     (iv) Cardiac pacing;

     (v) Chest decompression;

     (vi) Surgical airway; or

     (vii) Intraosseous line.

     (2) "Advanced life support assessment" is an assessment performed by ALS personnel as

part of an emergency response that was necessary because the patient's reported condition at the

time of dispatch was such that only ALS personnel is qualified to perform the assessment. An ALS

assessment does not necessarily result in a determination that the patient requires an ALS level of

service.

     (3) "Advanced life support intervention" means a procedure that is required to be furnished

by ALS personnel in accordance with state law and regulation.

     (4) "Advanced life support personnel" means an individual, licensed in accordance with

state law and regulation, as an advanced emergency medical technician-cardiac or paramedic.

     (5) "Basic life support" or "BLS" means transportation by ground ambulance vehicle and

medically necessary supplies and services, plus the provision of BLS ambulance services. The

ambulance must be staffed by at least two (2) people who meet the requirements of state laws and

regulations where the services are being furnished. Also, at least one of the staff members must be

licensed, at a minimum, as an emergency medical technician by the state or local authority where

the services are furnished and be legally authorized to operate all lifesaving and life-sustaining

equipment on board the vehicle.

     (i) Basic life support shall be deemed non-emergency basic life support at the professional

discretion of the emergency medical services practitioner.

     (6) "Emergency medical services" or "EMS" means the practitioners, ambulance vehicles,

and ambulance service entities licensed in accordance with chapter 4.1 of title 23 to provide

LC006016 - Page 12 of 15

emergency medical care, transportation, and preventive care to mitigate loss of life or exacerbation

of illness or injury, including, but not limited to, EMS responding to the 911 system established

under chapter 21.1 of title 39.

     (7) "Emergency medical services practitioner" means an individual who is licensed in

accordance with state laws and regulations to perform emergency medical care and preventive care

to mitigate loss of life or exacerbation of illness or injury, including emergency medical

technicians, advanced emergency medical technicians, advanced emergency medical technicians-

cardiac, and paramedics.

     (b) This section authorizes emergency medical services in the state to divert non-

emergency basic life service calls from emergency departments. Emergency medical services

practitioners shall assess individuals who are in need of emergency medical services and apply the

correct level of care thereafter, which may include transport to an alternative facility deemed

appropriate by an emergency medical services practitioner. An alternative facility shall include, but

not be limited to:

     (1) An individual’s primary care provider;

     (2) A community health clinic;

     (3) An urgent care facility;

     (4) An emergency room diversion facility, as defined in § 23-17.26-2; and

     (5) A community-based behavioral health facility designed to provide immediate

assistance to a person in crisis.

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

for transport to an alternative facility as identified in subsection (b) of this section and shall

reimburse the EMS for such services at the same rate as for a non-emergency basic life support

transport to an emergency department.

     (d) If treatment at an alternative facility is deemed appropriate by the EMS practitioner, the

emergency medical service shall bill at the rate described in subsection (c) of this section even if

an advanced life support assessment was provided.

     (e) The executive office of health and human services may promulgate such rules and

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

and enforcement of this chapter.

     42-7.2-22. Coverage of EMS mental health and substance use disorder treatment.

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

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

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

LC006016 - Page 13 of 15

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

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

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

mental health disorders, including substance use disorders, to accompany EMS. Such providers

shall be permitted to treat EMS patients when medically necessary and appropriate. Such treatment

shall be permitted to occur in the community.

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

for treatment described in subsection (b) of this section and shall reimburse such services at a rate

not lower than the same service would have been had that service been delivered in a traditional

office setting.

     (d) The executive office of health and human services may promulgate such rules and

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

and enforcement of this chapter.

     SECTION 6. This act shall take effect upon passage.

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LC006016

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LC006016 - Page 14 of 15

EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES

***

     This act would require health insurers, nonprofit hospital service corporations, nonprofit

medical service corporations, health maintenance organizations and Rhode Island Medicaid, to

issue policies that provide coverage for emergency medical services transport to alternate facilities

and coverage of emergency medical services mental health and substance use disorder treatment,

on or after January 1, 2023.

     This act would take effect upon passage.

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LC006016

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LC006016 - Page 15 of 15