An Act to Improve the
Maine Legislature, Session 132, LD 1530
Committee Amendment CA_B_S596 (Senate)
Amends: 24-A MRSA §4303-F

COMMITTEE AMENDMENT "J^ » to S.P. 614, L.D. 1530, "An Act to Improve the
Sustainability of Emergency Medical Services in Maine"
Amend the bill by striking out everything after the enacting clause and inserting the
following;
'See. 1. 24-A MRSA §4303-F, as amended by PL 2025,c. 34, §1 and affected by
§2, is further amended by amending the section headnote to read:
§4303-F. Reimbursement for ambulance services and nontransportine emereencv
medical services: particioation of ambulance and nontransportine emereencv
medical service providers in carrier nehvorks
See. 2. 24-A MRSA §4303-F, sub-§l, as amended by PL 2025, c. 34, §1 and
affected by §2, is further amended to read:
1. Reimbursement for ambulance and nontransoortineemereenc^ medical
services. With respect to a bill for covered services rendered by an ambulance service Q£.
nontransportmg emergency medical service provider, a carrier shall reimburse the
ambulance service or nontransporting emergency medical service provider or enrollee, as
applicable, as follows.
A. If the ambulance service or notitransportme emergency medical sen'ice provider
participates in the carrier's network, the carrier shall reimburse at the ambulance service
provider's or nontransportine emereencv medical service provider's rate or 308% 300%
of the Medicare rate for that service, whichever is less, plus any adjustment required
by paragraph C.
B, If the ambulance service or nontransporting emergency medical service provider is
an out-of-network provider, the carrier shall reimburse at the ambulance ser/ice
provider's or nontransportina emergency medical service provider's rate or -1-80% 280'%
of the Medicare rate for that service, whichever is less, plus any adjustment required
by paragraph C.
COMMITTEE AMENDMENT
^
COMMITTEE AMENDMENT"/^" (o S.P. 614, L,D. 1530 C5 'S^'<&
p~-
C. If the ambulance service or nontransporting emergency medical service provider is
located in a mt'al or super rural area as designated by the federal Department of Health
and Human Services, Centers for Medicare and Medicaid Services and eligible for
additional Medicare reimbursement for services that were provided to a Medicare
enrollee, the carrier shall increase the reimbursement to that ambulance service
provider or nontransporting emergency medical service provider in the same amount
as the additional Medicare reimbursement,
D. If, on the effective date of this subsection in the case of an ambulance service
provider or. on or after January 1. 2027 injhe case^ofajlontransDortmg emereencv
medical service provider, an ambulance service provider's or a nontransportine
emergency medical service provider's charge for ambulance services is below 300%
300% of the Medicare rate for that service, the ambulance service provider or
nontoansportitiB emergency medical service provider may not increase the charge for
that service by more than 5 % annually.
E. A carrier may not require a ground ambulance service provider to obtain prior
authorization before transporting an enrollee to a hospital, between hospitals or from a
hospital to a nursing home, hospice care facility or other health care facility, as defined
in Title 22, section 328, subsection 8. A carrier may not require an air ambulance
service provider that is a nonprofit organization to obtain prior authorization before
transporting an eurollee to a hospital or between hospitals for urgent care.
P. Notwithstanding this subsection, a carrier shall reimburse an ambulance service
Emvider or nontransportine emergency medical service provider for the administration
and disoensine of naloxone hvdrochloride or another ooioid overdose-reversine
medication as authorized under Title 32. section 86. subsection 4,
G, A carrier may not be required to reimburse twice for covered services when both
an ambulance service provider and a nontransDortinB emergency medical service
oroyiderresDondto the same reouest for emereencv services.
Notwithstanding this subsection, a carrier is not required to reimburse an ambulance service
provider at the reimbursement rates required in this subsection for covered services
delivered through community paramedicine in accordance with Title 32, section 84,
subsection 4 and a carrier may require an ambulance service provider to obtain prior
authorization before providing services through community paramedicine.
As used in this subsection, "nontransportine emergency medical service" has the same
meanine as in Title 32. section 83. subsection 14.
See. 3. Application. This Act applies to all policies, contracts and certificates
executed, delivered, issued for delivery, continued or renewed in this State on or after
January 1,2027. For purposes of this Act, all contracts are deemed to be renewed no later
8 than the next yearly anniversary of the contract date.'
Amend the bill by relettering or renumbering any nonconsecutive Part letter or section
number to read consecutively.
SUMMARY
This amendment replaces the bill. The amendment provides that care that is provided
at the scene of an emergency medical services event by an ambulance service or
COMMITTEE AMENDMENT
COMMITTEE AMENDMENT " ^)" to S,P. 614, L.D. 1530 (G>-(.
nontransporting emergency medical service is reimbursable care regardless of whether a
patient is transported to another facility, including the administration ofoverdose-reversing
medications that do not result in patient transport to a facility. The amendment specifies
that a carrier is not required to reimburse twice for the same request for emergency services.
The amendment also increases the reimbursement rate paid to ambulance service
providers and nontransporting emergency medical service providers from 200% of the
Medicare rate to 300% of the Medicare rate for covered services,
The amendment applies to health plans issued on or after January 1,2027,
FISCAL NOTE REQUIRED
(See attached)
COMMITTEE AMENDMENT
Revised: 03/26/26 t^RL
LD 1530 LR 1615(03)
An Act to Improve the Sustainability of Emergency Medical Services in Maine
Fiscal Note for Bill as Amended by Committee Amendment '^' (3076t
Committee: Health Coverage, Insurance and Financial Servi%s
Fiscal Note Required: Yes
Fiscal Note
FY 2025-26-
$0
$0
$0
$0
FY 2026-27
$0
$0
$0
$0
Projections
FY 2027-28
$31,020
$10,790
$31,020
$10,790
Projections
FY 2028-29
$31,020
$10,7^'
$31,020
$10,790
Net Cost (Savings)
General Fund
Highway Fund
Appropriatlons/AlIocations
General Fund
Highway Fund
Fiscal Detail and Notes
This bill expands the coverage of services for emergency medical services provided by an ambulance or
nontransporting emergency service, and requires health insurance carriers to reimburse nontransporting emergency
service providers at 300% of the Medicare rate for covered services. The requirements of this bill apply to health
plans issued or renewed on or after January 1,2027.
The State Employee Health Plan annual impact will be $67,435 beginning in fiscal year 2027-28, The annual costs are
split across General Fund ($3 1,020), Highway Fund ($10,790), and all other ($25,625).
LR1615(03)- Fiscal Note -Page 1 of 1