H.B. No. 197 Summary

• Allows emergency medical technicians (basic, intermediate, and paramedic) to provide nonemergency medical services to individuals under a care plan established by the individual's primary care physician in consultation with the technician's medical director or physician advisory board.

• Requires health insurance policies to cover nonemergency EMT services provided in accordance with established care plans, including health assessments, chronic disease monitoring, medication compliance, immunizations, laboratory specimen collection, hospital discharge follow-up care, and other approved minor medical procedures.

• Health plan issuers must provide EMTs with written explanation of benefits specifying reimbursement amounts and any applicable deductibles, copayments, or coinsurance owed by covered individuals.

• EMTs may bill health plan issuers for services rendered and shall be reimbursed the greatest of: the billed amount, the usual and customary reasonable rate, or the Medicare reimbursement rate for the service.

• Medicaid program must cover nonemergency medical services performed by EMTs in accordance with care plan requirements, with violations considered a breach of relevant licensing or certification laws.