SB 1403

Overview

This bill amends Title 35 of the Pennsylvania Consolidated Statutes to update regulations regarding receiving facilities and ambulance transportation coverage within the emergency medical services system. The legislation defines receiving facilities as locations where patients require medical assessment and treatment beyond that provided by the ambulance crew and authorizes the Department of Health to establish protocols for these facilities, including those used for behavioral health or substance use disorder crises. Additionally, the bill mandates that initial patient transports following an emergency response must be directed to a receiving facility unless a medical command physician directs otherwise.

Key Provisions

• Amends Section 8128 to define receiving facilities and requires the Department of Health to authorize facility types, including those for behavioral health and substance use disorders, while establishing procedures for contacting co-responder programs or mobile crisis teams prior to transport.
• Mandates that initial patient transports after an emergency response must be to a receiving facility pursuant to departmental protocol, unless directed otherwise by a medical command physician.
• Establishes Section 8143 to limit Medical Assistance program coverage for ambulance transportation to medically necessary treatment and transport to a patient's home, nearest facility, detoxification/rehabilitation facility, or receiving facility.
• Requires insurers, medical assistance managed care plans, and CHIP managed care plans to pay the emergency services payment amount for treatment and transport provided by an EMS agency in response to an actual or reported emergency, subject to applicable copayments, coinsurances, or deductibles.
• Defines specific terms including "Emergency services payment amount," "HEALTH INSURANCE POLICY" (excluding accident-only, credit-only, long-term care, Medicare supplement, and other limited benefit policies), "INSURER," and "Medical assistance ambulance fee schedule."
• Abrogates 55 Pa. Code § 1245.11 regarding types of services covered.
• Sets the effective date of the act to 180 days from enactment.