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SB 1403

An Act amending Title 35 (Health and Safety) of the Pennsylvania Consolidated Statutes, in emergency medical services system, further providing for receiving facilities and providing for transportation coverage; and abrogating a regulation.

2025-2026 Regular Session Introduced by Camera Bartolotta and 4 co-sponsors

Expands EMS receiving facilities and crisis-response links, aligns ambulance payment with MA/CHIP, and removes a prior regulation to broaden covered services.

Referred to Institutional Sustainability & Innovation
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WeVote Research Nonpartisan
Bill Summary · SB 1403

Overview

SB 1403 (2025-2026, Pennsylvania) amends Title 35 (Health and Safety) to reform emergency medical services (EMS) receiving facilities and transportation coverage. The bill introduces a new framework for receiving facilities, expands coordination with crisis response services for behavioral health and substance use disorders, updates ambulance transportation coverage through the Medical Assistance program, and abrogates a current regulation related to services covered. The act would take effect 180 days after enactment.

Purpose and intent

  • Clarify and standardize the role of receiving facilities in the EMS system.
  • Improve crisis response and de-escalation options for patients with behavioral health or substance use issues by enabling contact with co-responder/mobile crisis teams.
  • Align ambulance transportation payments with a defined emergency services payment structure under Medicaid/MA and CHIP plans.
  • Streamline the types of services covered under current regulations and remove an existing regulatory provision (Section abrogation).

Key provisions

Receiving facilities (Section 8128)

  • Defines the purpose of a receiving facility as a place to which an ambulance may transport a patient who needs additional medical assessment and treatment beyond what the EMS crew provides.
  • Expands the concept beyond traditional fixed ED facilities to include other facility types as authorized by regulation, especially for patients with special medical needs.
  • Regulations and protocol requirements (by the Department) to:
    • Authorize facility types that can serve as receiving facilities.
    • Include facilities able to handle suspected behavioral health crises or substance use disorder issues.
    • Establish procedures for EMS responders to contact local co-responder programs, mobile crisis teams, or medical mobile crisis teams to assist with crisis de-escalation, assessment, and referral before transport.
  • Transport rules: Unless a medical command physician directs otherwise, the initial transport after an EMS response should be to a receiving facility per the regulations or as designated by protocol.

Transportation coverage (New Section 8143)

  • Ambulance transportation under the Medical Assistance (MA) program is limited to medically necessary treatment and, if needed, transport to:
    • Recipient’s home
    • Nearest facility
    • Nonhospital drug/alcohol detox or rehabilitation facility
    • Receiving facility under 8128
  • Emergency services payment: If EMS provides treatment in response to an actual or reported emergency and, if necessary, transports to a receiving facility per 8128, insurers/MA managed care plans (including CHIP plans) must pay the emergency services payment amount. This payment is subject to copays, coinsurance, or deductibles.
  • Definitions:
    • “Emergency services payment amount”: The amount payable under the MA ambulance fee schedule for treatment and transport provided by an EMS agency in response to an actual or reported emergency.
    • “Medical assistance ambulance fee schedule”: The MA ambulance fees updated by DHS (including updates from MA Bulletin 26-24-01, effective Jan 1, 2024) and any subsequent updates.

Abrogation (Section 3)

  • Abrogates 55 Pa. Code § 1245.11 (types of services covered), removing a specific regulatory constraint that previously governed covered services.

Effective date

  • The act takes effect 180 days after enactment.

Who or what is affected

  • Emergency medical service providers (ambulance services) and their operations, including transport decisions and protocols.
  • Receiving facilities (existing EDs and eligible alternative facilities) and the processes by which they receive EMS transports.
  • Local co-responder programs, mobile crisis teams, and medical mobile crisis teams involved in crisis de-escalation and referral.
  • Medical Assistance (MA) program beneficiaries and plans, including CHIP managed care plans, through updated ambulance payment reimbursement.
  • Pennsylvania Department of Health/EMS regulators responsible for establishing regulations and protocols governing receiving facilities and crisis-response coordination.

Procedural and timeline aspects

  • Regulatory framework: Departmental regulations and regional council protocols will define eligible receiving facilities and crisis-response collaboration.
  • Transport protocol: Initial EMS transport to a receiving facility per protocol unless overridden by medical command.
  • Payment framework: Emergency services payments tied to MA/MA-determined ambulance fee schedules with updates as defined by state statute and regulatory updates.
  • Effective date: 180 days after enactment, allowing time for regulatory development and system adaptation.
  • Abrogation: Removal of a prior regulatory provision (55 Pa. Code § 1245.11) related to covered services, which may modify what is presently reimbursed or required.

Potential impact and considerations

  • May broaden access to appropriate receiving facilities beyond traditional EDs, including facilities better suited for behavioral health or substance use crises.
  • Could improve crisis intervention by enabling rapid linkage to co-responder/mobile crisis resources prior to or in lieu of hospital transport.
  • Aligns ambulance payment with MA/CHIP reimbursement for emergency EMS services, potentially simplifying payer processes and reducing under- or over-payment.
  • Regulatory development will be critical to define eligible facilities and ensure consistency across regions.
  • Abrogation of existing regulation may alter covered services and reimbursement, requiring stakeholders to adjust billing and compliance practices.

Compiled from official sources — confirm details with the bill’s official record.

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