RELATING TO HEALTH AND SAFETY -- EMERGENCY MEDICAL TRANSPORTATION, SERVICES
S2685 would require the Rhode Island Department of Health, working with the ambulance service coordinating advisory board, to administer a mobile integrated healthcare/community paramedicine program. The bill defines that program in state law and limits participation to emergency medical services agencies that submit department-approved plans. It also authorizes the department to adopt rules, protocols, standing orders, and procedures for the program’s administration.
The bill further amends the state’s insurance laws governing accident and sickness insurers, nonprofit hospital service corporations, nonprofit medical service corporations, and health maintenance organizations. For individual and group health insurance policies issued or renewed on or after January 1, 2027, it requires coverage and reimbursement for Rhode Island ground ambulance services at Medicare-equivalent rates, including payment for the level of care provided even when the patient is not transported. It also extends coverage to community-based healthcare services and department-approved mobile integrated healthcare/community paramedicine services, and it preserves existing limits on ambulance copays for policies issued or renewed on or after January 1, 2009.
The bill would amend multiple chapters of the General Laws—chapters 23-4.1, 27-18, 27-19, 27-20, and 27-41—by adding definitions for emergency medical services, ground ambulance services, and mobile integrated healthcare/community paramedicine programs, and by revising insurer reimbursement obligations. It would require covered health plans to reimburse ground ambulance providers at Medicare rates and to pay for care delivered by EMS practitioners regardless of transport, while also applying those rules to in-network and out-of-network ambulance and community paramedicine services. The measure would affect health insurers, nonprofit hospital and medical service corporations, HMOs, EMS agencies, and the Department of Health, and it would take effect upon passage, with the reimbursement mandate beginning for policies issued or renewed on or after January 1, 2027.
Based on the bill text and the absence of recorded committee testimony or votes in the provided materials, the overall sentiment appears supportive of expanding ambulance and EMS reimbursement and formalizing community paramedicine within the state health system. The bill’s caption and explanatory note frame it as a coverage and reimbursement expansion intended to support emergency medical service providers. No contrary positions, amendments, or recorded roll-call votes are included in the available context.
The main policy issue embedded in the bill is cost and payment methodology: insurers would be required to reimburse ground ambulance services at Medicare-equivalent rates and to pay for non-transport care, which could increase insurer spending and potentially affect premiums. Another point of potential contention is the inclusion of out-of-network ambulance services and mobile integrated healthcare/community paramedicine in the reimbursement mandate, since these provisions limit insurer discretion over payment levels. The bill also requires the Department of Health to approve participating EMS agency plans, which could raise questions about administrative standards, provider eligibility, and implementation timing.