SF 1543, paragraph (a), provides medical assistance coverage for services provided by community paramedics who are certified by the Board of Emergency Medical Services Regulatory Board as a EMT-CP to eligible recipients if the services are provided in accordance with this subdivision.
Paragraph (b) defines an eligible recipient as an individual who has received hospital emergency department services three or more times within four consecutive months in the past 12 months, or an individual who has been identified by their primary health care provider as benefiting from community paramedic services since the services are likely to prevent admission to or would allow discharge from a nursing facility or would likely prevent readmission to a hospital or nursing facility.
Paragraph (c) requires the services to be part of a care plan ordered by a primary health care provider in consultation with the medical director of an ambulance service and must be billed by an eligible provider that employs or contracts with the community paramedic. This paragraph also lists the community paramedic services.
Paragraph (d) requires services that are provided to a recipient who is also receiving care coordination services to be provided in consultation with the providers of the care coordination services.
Paragraph (e) requires the commissioner to seek any necessary federal approval.
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