On January 20, 2022, MACo President Laura Price and Executive Director Michael Sanderson testified before the House Health and Government Operations Committee in support of HB 44 Maryland Medical Assistance Program – Emergency Service Transporters – Reimbursement with amendments. The bill, with amendments as offered to the Committee by lead sponsor Delegate Kevin Hornberger, is among MACo’s Legislative Initiatives for the 2022 session.
This bill alters the medical services provided by an emergency service transporter for which the Maryland Department of Health is required to reimburse the emergency service transporter who charges for its services and requests reimbursement from the Maryland Medical Assistance Program; and the bill requires the Department to increase the amount of reimbursement by $25 each fiscal year, beginning in fiscal 2023, until the rate is at $300. The sponsor amendments expand reimbursement law to cover treatment delivered onsite, delivery to other appropriate facilities, and health outreach efforts like mobile integrated care.
Frederick County Director of Fire and Rescue Services Thomas Coe explained the antiquated law still governing these efforts, and emphasized the importance of recognizing the more complete range of service delivered – making particular note of “Treat not Transport” as a high volume of work for modern EMS companies. Current Maryland law does not recognize care delivered on-site, without a transport to the hospital, as reimbursable care. Later, committee questions and discussion opened the door for Delegate Hornberger to note that overdose response (including emergency recovery application of naloxone and similar medications) have made on-site care without a subsequent transfer a major component of treatment and emergency call volume during the still-raging opioid epidemic.
From the MACo testimony:
MACo urges that HB 44 be amended to bring Maryland into the modern day, by adding provisions recognizing the following care as delivered through emergency service providers:
- Allow for EMS providers to be reimbursed for transport to facilities other than a hospital when appropriate, (i.e. urgent care facilities).
- Allow EMS providers to provide Mobile Integrated Health services.
- Reimburse EMS providers for the cost of care they provide, not only the cost of transportation. The range of care envisioned in the bill should be pinned to the transport cost already in law (and modified by this bill) for clarity and simplicity.
An amended version of HB 44 can endorse and support Maryland’s best practices, and needed care, delivered by emergency companies across the state.