Bill
SB 221
Louisiana Medicaid would cover and reimburse on-site, non-transport TIP (treatment-in-place) ambulance services with standard EMS base rates.
Purpose
- The bill, SB 221 (Senator Boudreaux), would require Medicaid to cover a new category of ambulance services called “treatment-in-place” services. These are on-scene interventions provided by ambulance providers in response to 911 calls where the patient is not transported to a facility.
Key Definitions
- 911 call: A communication indicating a beneficiary may need emergency medical services.
- Ambulance provider: As defined in existing law (R.S. 40:1131); excludes air ambulance providers for the purposes of this section.
- Beneficiary: A recipient entitled to covered healthcare services under Louisiana’s Medicaid program.
- Treatment-in-place service: An encounter where an ambulance provider assesses or treats a beneficiary on scene without transporting them.
- Medical assistance program: Louisiana’s Medicaid program, administered by the Louisiana Department of Health (LDH).
- Qualified medical practitioner: Licensed physician, nurse practitioner, or physician’s assistant.
- The service must align with the ambulance provider’s medical direction and protocols, and with the practitioner’s scope of practice.
Main Provisions
- Coverage: Treatment-in-place (TIP) services are to be a covered service under Medicaid.
- On-scene nature: TIP services occur on-site in response to a 911 call and do not involve transporting the beneficiary.
- Payment/reimbursement: TIP services must be reimbursed under the standard Medicaid fee schedule, using the appropriate base rate based on the level of response and services rendered:
- Basic Life Support (BLS) base rate
- Emergency Base Rate
- Advanced Life Support (ALS), Level 1 Emergency Base Rate
- On-site facilitation: Ambulance providers may initiate and facilitate TIP on site and may use real-time audio/video telecommunication with a qualified medical practitioner. However, such telecommunication is not a prerequisite for reimbursement.
- Compliance: TIP must be performed in accordance with the ambulance provider’s medical direction and established protocols; EMS assessments/services must stay within the EMS scope of practice.
- Rulemaking: LDH is required to promulgate rules necessary to implement the TIP provisions.
Effective Date
- August 1, 2026.
Administrative/Procedural Elements
- Adds new statutory provision: R.S. 40:1132.
- Senate amendments: Minor technical changes; no substantive policy changes beyond clarifications.
- Implementation: Requires regulatory rules by LDH to operationalize the new coverage and procedures.
Impact and Beneficiaries
- Beneficiaries: Medicaid recipients who require on-scene medical assessment or treatment without transport after a 911 response.
- Ambulance providers: Expanded reimbursement pathway for TIP services, aligning payments with existing EMS fee schedule categories.
- Payers: Medicaid program would bear costs for TIP services under existing base rates corresponding to the EMS level of response.
Notes
- The bill explicitly excludes air ambulance providers from TIP definitions for this provision.
- The measure includes no mandated telecommunication requirement for payment, beyond allowing it as a possible facilitation method.
Overall, SB 221 aims to formalize and reimburse on-site, non-transport EMS interventions under Louisiana’s Medicaid program, potentially improving patient outcomes by delivering timely on-scene care while controlling costs through established EMS reimbursement rates.
Compiled from official sources — confirm details with the bill’s official record.
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