An Act to Expand Reimbursement for Treatment in Place,
Maine Legislature, Session 132, LD 2119
Committee: Health and Human Services
Sponsors: DEBRITO, FECTEAU
Amends: 22 MRSA §3174-Q, 24-A MRSA §4303-F

Legislative Document
No. 2119
H.P. 1434
House of Representatives, January 7, 2026
An Act to Expand Reimbursement for Treatment in Place, 
Community Paramedicine and Alternate Destination Transport
Approved for introduction by a majority of the Legislative Council pursuant to Joint Rule 
203.
Reference to the Committee on Health and Human Services suggested and ordered printed.
ROBERT B. HUNT
Clerk
Presented by Representative DEBRITO of Waterville.
Cosponsored by Representatives: ARATA of New Gloucester, DUCHARME of Madison, 
Speaker FECTEAU of Biddeford, ROEDER of Bangor, SALISBURY of Westbrook, Senators: 
CURRY of Waldo, MOORE of Washington.
Be it enacted by the People of the State of Maine as follows:
Sec. 1.  22 MRSA §3174-QQQ is enacted to read:
§3174-QQQ.  Reimbursement for ambulance services
1.  Reimbursement for ambulance services.  The department shall provide 
reimbursement under the MaineCare program for ambulance services, including:
A.  Emergency transport to a hospital;
B.  Treatment provided on the scene in response to an emergency call, regardless of 
transport;
C.  Care provided by an emergency medical services provider through community 
paramedicine as defined in Title 32, section 84, subsection 4 through approved 
community paramedicine services as described in Title 32, section 84, subsection 4; 
and
D.  Transport of a patient to an alternate destination.  As used in this paragraph, 
"alternate destination" means a facility other than a hospital emergency department that 
is clinically appropriate for the patient's condition, including, but not limited to, an 
urgent care center, federally qualified health center, primary care practice, behavioral 
health crisis center, substance use treatment facility or other clinically appropriate site, 
as permitted by the Department of Defense, Veterans and Emergency Management, 
Maine Emergency Medical Services.
2.  Rules.  The department shall adopt rules to implement this section. Rules adopted 
pursuant to this subsection are routine technical rules as defined in Title 5, chapter 375, 
subchapter 2-A.
Sec. 2.  24-A MRSA §4303-F, sub-§1, as amended by PL 2025, c. 34, §1 and 
affected by §2, is further amended by repealing the first blocked paragraph.
Sec. 3.  24-A MRSA §4303-F, sub-§5 is enacted to read:
5.  Required reimbursement for ambulance services.  A carrier that provides 
coverage for emergency medical services shall reimburse for ambulance services, 
including:
A.  Emergency transport to a hospital;
B.  Treatment provided on the scene in response to an emergency call, regardless of 
transport;
C.  Care provided by an emergency medical services provider through community 
paramedicine as defined in Title 32, section 84, subsection 4 through approved 
community paramedicine services as described in Title 32, section 84, subsection 4; 
and
D.  Transport of a patient to an alternate destination.  As used in this paragraph, 
"alternate destination" means a facility other than a hospital emergency department that 
is clinically appropriate for the patient's condition, including, but not limited to, an 
urgent care center, federally qualified health center, primary care practice, behavioral 
health crisis center, substance use treatment facility or other clinically appropriate site, 
as permitted by the Department of Defense, Veterans and Emergency Management, 
Maine Emergency Medical Services.
Sec. 4.  Rulemaking.  The Department of Health and Human Services, in 
consultation with the Department of Defense, Veterans and Emergency Management, 
Maine Emergency Medical Services, shall adopt rules to implement this Act, including, but 
not limited to:
1.  Establishing clinical and documentation standards for treatment provided on the 
scene in response to an emergency call, care provided by an emergency medical services 
provider through community paramedicine and alternate destination transport;
2.  Establishing billing and coding procedures; and
3.  Establishing quality assurance and patient safety requirements.
Rules adopted under this section are routine technical rules as defined in the Maine 
Revised Statutes, Title 5, chapter 375, subchapter 2-A.
SUMMARY
This bill expands existing requirements for insurance carriers and the MaineCare 
program to provide reimbursement for ambulance services to include:
1.  Treatment provided on the scene in response to an emergency call, regardless of 
transport;
2.  Care provided by an emergency medical services provider through community 
paramedicine; and
3.  Alternate destination transport to clinically appropriate facilities other than hospital 
emergency departments.
The bill requires the Department of Health and Human Services and the Department of 
Defense, Veterans and Emergency Management, Maine Emergency Medical Services to 
adopt rules to implement reimbursement standards.