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H 4118

An Act to establish an emergency medical services treatment-in-place (TIP) pilot program

194th Legislature (2025-2026) Introduced by Leigh Davis and 7 co-sponsors

Establishes a 3-year TIP pilot to treat non-emergent cases on scene or via telehealth, reducing ED visits and shifting EMS reimbursement toward TIP services.

Accompanied a study order, see H5234
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Bill Summary · H 4118

Summary: H 4118 — An Act to Establish an Emergency Medical Services Treatment-in-Place (TIP) Pilot Program

Overview

H 4118 proposes a three-year pilot program to test “treat-in-place” (TIP) models within Massachusetts Emergency Medical Services (EMS). The bill designates emergency clause status to address urgent public-convenience concerns. It directs the Department of Public Health (DPH) to collaborate with the EMS System Advisory Board and to develop financing and evaluation mechanisms for TIP, including alternative payment structures that reimburse non-transport EMS care.

Purpose and Goals

  • Improve access to EMS for aging residents.
  • Enhance the quality of patient care.
  • Reduce unnecessary emergency department (ED) visits.
  • Develop innovative financial models to sustain EMS systems.

Key Provisions

Definitions (Section 1)

  • Clarifies terms: Board (EMS system advisory board), Department (DPH), emergent vs non-emergent conditions, EMS providers (licensed EMS organizations, including municipal fire departments and private ambulances), and “treat-in-place” (on-scene treatment or telehealth without hospital transport for non-emergent conditions).

Pilot Program (Section 2)

  • Establishes a 3-year TIP pilot to test, evaluate, and advance TIP models across the Commonwealth.
  • Activities supported include on-scene treatment, telehealth consultations for non-emergent cases, coordination with primary care or urgent care, and referrals to community resources.
  • Prioritizes EMS providers serving populations with high Medicare/Medicaid beneficiaries or limited ED access.

Participation and Operations

  • Providers may participate at no additional cost.
  • The program may include alternative payment models and reimbursement for TIP services (not limited to transport-based payments).
  • Department to align reimbursement with federal programs (CMS) and provide financial incentives to implement/evaluate TIP.

Data, Evaluation, and Stakeholders

  • Providers must collect data on patient outcomes, cost savings, patient satisfaction, and other metrics for annual reporting.
  • The department will engage EMS organizations, health systems, insurers, and patient advocacy groups to ensure program relevance.

Funding and Reporting (Sections 2 and 3)

  • Implementation and evaluation funding is subject to appropriation.
  • Annual reports due by December 31 each year, detailing effectiveness, cost savings, data collected, and recommendations for expansion or adjustments. Reports go to the Governor and legislative chairs.

Who Is Affected

  • Emergency medical service providers (public and private EMS organizations, including municipal fire departments and ambulance services).
  • Patients who experience non-emergent conditions that could be treated on-site or via telehealth.
  • Health systems, insurers, and patient advocacy groups involved in EMS and community health.

Timeline and Status

  • Introduced: May 12, 2025.
  • Hearing: June 25, 2025.
  • Senate concurrence: May 15, 2025 (per actions).
  • Reporting date extended: October 21, 2025.
  • Related bill: HD 2224 (replaces).

Potential Impact

  • Could reduce ED crowding and healthcare costs by treating non-emergent conditions at the scene or through telehealth.
  • May shift some EMS reimbursement away from transport-based payments toward value-based TIP services.
  • Depends on appropriation and successful execution of data collection and interagency coordination.

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

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