An Act to Improve the
Maine Legislature, Session 132, LD 1530
Committee Amendment CA_A_S595 (Senate)
Amends: 24-A MRSA §4303-F, 24-A MRSA §4303

COMMITTEE AMENDMENT "/-I " 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 nontransoorfine emereencv
medical services: oarticioation of ambulance and nontransportine emereencv
medical service providers in carrier nehvorks
Sec. 2. 24-A MRSA §4303-F, sub-§l-A, 1(D, as enacted by PL 2023,c. 468, §2,
is amended to read:
D. If, on the effective date of this subsection, an ambulance service provider's rate for
ambulance services is below 200% of the average of the Medicare rate for basic life
support services and the Medicare rate for advanced life support services, the
ambulance service provider may not increase the rate for that service by more than 5%
annually.
Sec. 3. 24-A MRSA §4303-F, sub-§l-B is eaacted to read:
1-B. Reimbursement for nontransDorrtne emereencv medical services. With
respect to a health plan with an effective date on or after January 1. 2027. when a
nontraQSDortine emereencv medical service provider responds to a call for emergency
services, a carrier shall reimburse the nontransportine emereencv medical service provider
for any covered services as follows.
A. If the nontransoortina emeraencv medical sei-vice provider participates in the
carrier's network, the carrier shall reimburse the nontransporting emereencv medical
servicenrovider at the nontransportine emereencv medical service provider's rate or
160% of the average of the Medicare rate for basic life support services and the
COMMITTEE AMENDMENT
COMMm-EE AMENDMENT " l\ " to S.P. 614, L.D. 1530 f^)\
^~>I Medicare rate for advanced life support services, whichever is less. plus any adjustment
required by oaraeraph C.
B. If the nontransoortine emereencv medical service provider is an out-of-network
provider, the carrier shall reimburse the nontransDortine emereencv medical service
provider at the ambulance service provider's rate or 140% of the averaae of the
Medicare rate for basic life support services and the Medicare rate for advanced life
support services, whichever is less. plus any adjustment required bv oaraeraoh C,
C, If the nontransportine emereencv medical service Drovider islocatedin_a nu'al or
super rural area as designated bv the federal Department of Health and Human
Services. Centers for Medicare and Medicaid Services and elieible for additional
Medicare reimbursement for services that were m'ovided to a Medicare enrollee. the
carrier shall increase the reimbursement to that noQtransDortine emergency medical
service provider in the same amount as the additional Medicare reimbursement.
D, If. on the effective date of this subsection, a nontransportuiR emeraencv medical
service provider's rate for nontransoorting emereencv medical services is below 160%
of the averaee of the Medicare rate for basic life support services and die Medicare rate
for^dvanced life^ suDBort services, the nontransportine emergency medical service
Bfovider may not increase the rate for that service by more than 5% annually.
Notwithstandine this subsection, a carrier is not required to reimburse a nontransoortine
emergency medical service provider at the reimbursement rates required in this subsection
for covered services delivered throueh community paramedicine in accordance with Title
32. section 84. subsection 4. and a carrier may require a nontransportine emcreencv
medical service provider to obtain orior authorization before proyidine services throueh
community Daramedicine.
See. 4. 24-A MRSA §4303-F, sub-§2, as amended by PL 2023, c. 468, §2, is
further amended to read:
2. Network participation; standard contract A carrier shall offer a standard
contract to all ambulance service providers and nonft'ansportina emergency medical service
providers willing to participate in the carrier's provider network with the following
provisions:
A. The reimbursement rate paid for ambulance services or nontransportine emergency
medical services conforms to the requirements of subseotion subsections 1. 1-A and
1JB;
B. The contract term is for a minimum of 24 months;
C. The contract may be terminated as long as the party seeking to terminate the contract
provides at least 180 days' prior notice; and
D. The contract provides that an ambulance service provider or nonh-ansportine
emereencv medical service provider has a minimum of 120 days to submit a claim.
See. 5. 24-A MRSA §4303-F, sub"§5 is enacted to read:
5. Reimbursement for administration and disoensine of naloxone hvdrochloride.
Notwithstandinfi this section, a earner shall reimburse an ambulance service orovider or
nontransDortmg^emergencv medical service provider for the administration and dispensing
Page2-132LR1615(02)
COMMITTEE AMENDMENT
COMMm-EE AMENDMENT "/^ " to S,P, 614, L,D. 1530
ofnaloxone hvdrochloride or another opioid overdose-reversine medication as authorized
under Title 32. section 86. subsection 4.
\
See. 6. 24-A MRSA §4303-F, sub-§6 is enacted to read:
6. Dual response to request for emereencv services. A carrier mav not be required
to reimburse twice for covered services under this section when both an ambulance service
provider and a nontransportinB emereencv medical service provider respond to the same
request for emereencyservices.
Sec. 7. 24-A MRSA §4303"F, sub-§7 is enacted to read:
7. NontransDortine emereencv medical service;definition. As_used in this sectjon,
"nontransoortine emereencv medical service" has the same meanine as in Title 32. section
83. subsection 14.
Sec. 8. Application. This Act applies to all policies, contracts and certificates
executed, delivered, issued for delivery, continued or renewed m this State on or after
January 1,2027. For purposes of this Act, all contracts are deemed to be renewed no later
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 requires that, begmning with health
plans issued or renewed on or after January 1, 2027, health insurance carriers reimburse
nontransporting emergency medical service providers at 160% of the Medicare rate for
I 22 covered services,
The amendment also provides that care that is provided at the scene of an emergency
medical services event by an ambulance service or nontransporting emergency medical
service is reimbursable care regardless of whether a patient is transported to another
facility, including the administration of overdose-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 service when both an ambulance service provider and a
nontransporting emergency medical service provider respond to the same request for
emergency services.
The amendment applies to health plans issued on or after January 1, 2027.
FISCAL NOTE REQUIRED
(See attached)
COMMITTEE AMENDMENT
Approved: 03/24/26 LRL
LD 1530 LR 1615(02)
An Act to Improve the Sustainability of Emergency Medical Services in Maine
Fiscal Note for Bill as Amended by Committee Amendment ^'^S'i
Committee; Health Coverage, Insurance and Financial Services
Fiscal Note Required: Yes
Fiscal Note
FY 2025-26
$0
$0
$0
$0
FY 2026-27
$0
$0
$0
$0
Projections
FY 2027-28
$22,157
$7,707
$22,157
$7,707
Projections
FY 2028-29
$22,157
$7,70
$22,157
$7,707
Net Cost (Savings)
General Fund
Highway Fund
Appropnations/AUocations
General Fund
Highway Fund
Fiscal Detail and Notes
This bill expands the coverage of services for emergency medical services provided by an ambulance or
tiontransporting emergency service, and requires health insurance earners to reimburse nonfransporting emergency
service providers at 160% 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 $48,168 beginning in fiscal year 2027-28. The annual costs are
split across General Fund ($22,157), Highway Fund ($7,707), and all other ($18,304).
LR1615(02) - Fiscal Note - Page 1 of I