SB 220: Establish paramedicine programs; require insurance coverage
This bill establishes community paramedicine programs that allow emergency medical technicians (EMTs) to provide non-emergency medical services to community members. The programs must be operated under the direction of a medical director or cooperating physician advisory board, which will establish protocols for services, training requirements, and continuing education needs. The programs can include services such as chronic disease management, health education, medication compliance, and care coordination. The bill also requires health insurance plans to cover these services to the same extent as they cover emergency medical services. Additionally, the Medicaid program will cover services provided under these programs if certain conditions are met, including that the EMTs are certified and the services are provided in accordance with state regulations.
| Jun. 11, 2025 | Referred to committee: Financial Institutions, Insurance and Technology |
| Jun. 10, 2025 | Introduced |
As Introduced
136th General Assembly
Regular Session
S. B. No. 220
2025-2026
Senator Manchester
To enact sections 3902.65, 4765.362, and 5164.11 of the Revised Code to establish community paramedicine programs and to require insurance coverage for services provided under those programs.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:
Section 1.
That sections 3902.65, 4765.362, and 5164.11 of the Revised Code be enacted to read as follows:
Sec. 3902.65.
As used in this section, "emergency medical technician-basic," "emergency medical technician-intermediate," and "emergency medical technician-paramedic" have the same meanings as in section 4765.01 of the Revised Code.
Notwithstanding section 3901.71 of the Revised Code, a health benefit plan issued, delivered, or renewed in this state on or after the effective date of this section that directly or indirectly covers health care services performed by an emergency medical technician-basic, emergency medical technician-intermediate, or emergency medical technician-paramedic shall cover, to the same extent, health care services performed by an emergency medical technician-basic, emergency medical technician-intermediate, or emergency medical technician-paramedic under a community paramedicine program in accordance with section 4765.362 of the Revised Code.
Sec. 4765.362.
(A)
An emergency medical service organization may establish a community paramedicine program in accordance with the requirements of this section, to permit an emergency medical technician-basic, emergency medical technician-intermediate, or emergency medical technician-paramedic to provide nonemergency medical services to members of the community.
(B)
A community paramedicine program established under this section shall operate under the direction of the emergency medical service organization's medical director or cooperating physician advisory board. Both of the following apply regarding a community paramedicine program:
(1)
The medical director or cooperating physician advisory board shall establish all of the following:
(a) Nonemergency medical services that may be provided by an EMT-basic, EMT-intermediate, or paramedic under the community paramedicine program, which may include:
(i) Chronic disease management and prevention:
(ii) Health evaluation and assessment:
(iii) Home safety inspection and fall prevention:
(iv) Health education:
(v) Medication compliance:
(vi) Referral to other community services:
(vii) Enhanced access to other health care services:
(viii) Management of patients following surgery:
(ix) Care coordination.
(b) A protocol to be followed when an EMT-basic, EMT-intermediate, or paramedic provides nonemergency medical services under the community paramedicine program:
(c) Any training requirements that must be satisfied to provide nonemergency medical services under the community paramedicine program:
(d) Any continuing education requirements that must be satisfied to continue providing nonemergency medical services under the community paramedicine program.
(2)
The medical director or cooperating physician advisory board may establish either of the following:
(a) Partnerships with licensed health care professionals, health care facilities, and other nonprofit and for-profit health care entities:
(b) Plans for identifying social determinants of health and providing collaborative health services to at-risk residents living in the community served by the community paramedicine program.
(C)
Nonemergency medical services provided through a community paramedicine program in accordance with this section may be provided through telehealth.
Sec. 5164.11.
(A)
As used in this section, "emergency medical service organization," "emergency medical technician-basic," "emergency medical technician-intermediate," and "emergency medical technician-paramedic" have the same meanings as in section 4765.01 of the Revised Code.
(B)
The medicaid program shall cover services provided under a community paramedicine program established under section 4765.362 of the Revised Code if all of the following conditions are satisfied:
(1)
The emergency medical service organization operating the community paramedicine program holds a valid medicaid provider agreement;
(2)
The community paramedicine program provides services to medicaid recipients;
(3)
The services provided by an emergency medical technician-basic, emergency medical technician-intermediate, or emergency medical technician-paramedic under the community paramedicine program are provided in accordance with section 4765.362 of the Revised Code.