Provides relative to ambulance providers. (8/1/26)

Senate Bill 221 creates a new statute, R.S. 40:1132, that establishes Medicaid coverage for treatment-in-place services provided by ambulance providers. The bill defines treatment-in-place services as encounters between an ambulance provider and a Medicaid beneficiary in response to a 911 call where the ambulance provider delivers assessment or treatment but does not transport the beneficiary. The legislation mandates that the Louisiana Department of Health cover these services under the medical assistance program using the existing Medicaid fee schedule rates for either basic life support emergency services or advanced life support Level 1 emergency services, depending on the level of response and services provided. The statute permits but does not require ambulance providers to use audio and video telecommunications with qualified medical practitioners, meaning reimbursement is available regardless of whether real-time physician consultation occurs. Treatment-in-place services must be consistent with the ambulance provider's established medical protocols and the scope of practice of the EMS practitioners involved.

Ambulance providers offering ground emergency medical services to Medicaid beneficiaries will gain a new revenue stream through reimbursement for encounters where they respond to 911 calls but do not transport patients. Medicaid beneficiaries receive expanded access to emergency medical assessment and treatment in their current location, potentially reducing unnecessary hospital transports and emergency department visits. The Louisiana Department of Health assumes responsibility for processing and paying claims for these services at rates already established in the existing Medicaid fee schedule, eliminating the need to negotiate new reimbursement amounts. Air ambulance providers are explicitly excluded from the coverage requirement. The practical effect creates financial incentives for ambulance providers to implement treatment-in-place programs while ensuring that Medicaid beneficiaries have access to non-transport emergency medical care when appropriate.

The new statute operates within Louisiana's existing regulatory framework for ambulance providers under R.S. 40:1131 and the medical assistance program established under Title XIX of the federal Social Security Act. The bill references the current Medicaid fee schedule for reimbursement amounts, integrating treatment-in-place services into the existing payment structure rather than creating separate rates. The statute requires compliance with ambulance providers' medical direction protocols and EMS scope of practice limitations, anchoring the clinical operation to established professional standards. Authority to implement the statute rests with the Louisiana Department of Health, which must promulgate implementing rules and regulations. The effective date is August 1, 2026, providing adequate time for the Department of Health to develop regulations and ambulance providers to establish necessary protocols.