AN ACT RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES (Permits licensed providers to accompany emergency medical services and treat patients within the community for mental health disorders, including substance use disorders.)

S2560

2026 -- S 2560
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LC004840
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STATE OF RHODE ISLAND
IN GENERAL ASSEMBLY
JANUARY SESSION, A.D. 2026
____________
A N A C T
RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES

Introduced By:
Senators DiMario, Murray, Britto, Mack, DiPalma, Lauria, Vargas,
Thompson, Dimitri, and Kallman

Date Introduced:
February 13, 2026

Referred To:
Senate Health & Human Services
It is enacted by the General Assembly as follows:
1
SECTION 1. Chapter 27-18 of the General Laws entitled "Accident and Sickness Insurance
2
Policies" is hereby amended by adding thereto the following section:
3

27-18-96. Coverage of emergency medical services mental health and substance use
4
disorder treatment.

5

(a) As used in this section, "emergency medical services" or "EMS" means the
6
practitioners, ambulance vehicles, and ambulance service entities licensed in accordance with
7
chapter 4.1 of title 23 to provide emergency medical care, transportation, and preventive care to
8
mitigate loss of life or exacerbation of illness or injury, including, but not limited to, EMS
9
responding to the 911 system established under chapter 21.1 of title 39.
10

(b) Emergency medical services shall be permitted to allow licensed providers who
11
evaluate and treat mental health disorders, including substance use disorders, to accompany EMS.
12
Such providers shall be permitted to evaluate and treat EMS patients when medically necessary
13
and appropriate. Such evaluation and treatment shall be permitted to occur in the community.
14

(c) Emergency medical services shall be permitted to transport to the following facilities
15
designated by the director of the department of health:
16

(1) Emergency room diversion facilities, as defined in § 23-17.26-2; and
17

(2) Community-based behavioral health facilities designed to provide immediate assistance
18
to a person in crisis.
19

(d) Commencing January 1, 2027, every individual or group health insurance contract, plan

1
or policy issued for delivery or renewed in this state that provides medical coverage that includes
2
coverage for emergency medical services, shall provide coverage for evaluation and treatment
3
described in subsection (b) of this section and shall reimburse such services at a rate not lower than
4
the same service would have been had that service been delivered in a traditional office setting.
5

(e) Commencing January 1, 2027, every individual or group health insurance contract, plan
6
or policy issued for delivery or renewed in this state that provides medical coverage that includes
7
coverage for emergency medical services, shall provide coverage for transportation and described
8
in subsection (c) of this section and shall reimburse such services at a rate not lower than the same
9
rate as for transport to an emergency department.
10

(f) Treatment and coverage for mental health disorders, including substance use disorders,
11
as described in this section shall be provided in accordance with chapter 38.2 of title 27.
12

(g) The department of health with the collaboration of the ambulance service coordinating
13
advisory board shall promulgate any rules, regulations, standing orders, protocols, and procedures
14
necessary and proper for the efficient administration and enforcement of this section.
15

(h) The office of the health insurance commissioner may promulgate such rules and
16
regulations as are necessary and proper to effectuate the purpose and for the efficient administration
17
and enforcement of this section.
18
SECTION 2. Chapter 27-19 of the General Laws entitled "Nonprofit Hospital Service
19
Corporations" is hereby amended by adding thereto the following section:
20

27-19-88. Coverage of emergency medical services mental health and substance use
21
disorder treatment.
22

(a) As used in this section, "emergency medical services" or "EMS" means the
23
practitioners, ambulance vehicles, and ambulance service entities licensed in accordance with
24
chapter 4.1 of title 23 to provide emergency medical care, transportation, and preventive care to
25
mitigate loss of life or exacerbation of illness or injury, including, but not limited to, EMS
26
responding to the 911 system established under chapter 21.1 of title 39.
27

(b) Emergency medical services shall be permitted to allow licensed providers who
28
evaluate and treat mental health disorders, including substance use disorders, to accompany EMS.
29
Such providers shall be permitted to evaluate and treat EMS patients when medically necessary
30
and appropriate. Such evaluation and treatment shall be permitted to occur in the community.
31

(c) Emergency medical services shall be permitted to transport to the following facilities
32
designated by the director of the department of health:
33

(1) Emergency room diversion facilities, as defined in § 23-17.26-2; and
34

(2) Community-based behavioral health facilities designed to provide immediate assistance

LC004840 - Page 2 of 7
1
to a person in crisis.
2

(d) Commencing January 1, 2027, every individual or group health insurance contract, plan
3
or policy issued for delivery or renewed in this state that provides medical coverage that includes
4
coverage for emergency medical services, shall provide coverage for evaluation and treatment
5
described in subsection (b) of this section and shall reimburse such services at a rate not lower than
6
the same service would have been had that service been delivered in a traditional office setting.
7

(e) Commencing January 1, 2027, every individual or group health insurance contract, plan
8
or policy issued for delivery or renewed in this state that provides medical coverage that includes
9
coverage for emergency medical services, shall provide coverage for transportation and described
10
in subsection (c) of this section and shall reimburse such services at a rate not lower than the same
11
rate as for transport to an emergency department.
12

(f) Treatment and coverage for mental health disorders, including substance use disorders,
13
as described in this section shall be provided in accordance with chapter 38.2 of title 27.
14

(g) The department of health with the collaboration of the ambulance service coordinating
15
advisory board shall promulgate any rules, regulations, standing orders, protocols, and procedures
16
necessary and proper for the efficient administration and enforcement of this section.
17

(h) The office of the health insurance commissioner may promulgate such rules and
18
regulations as are necessary and proper to effectuate the purpose and for the efficient administration
19
and enforcement of this section.
20
SECTION 3. Chapter 27-20 of the General Laws entitled "Nonprofit Medical Service
21
Corporations" is hereby amended by adding thereto the following section:
22

27-20-84. Coverage of emergency medical services mental health and substance use
23
disorder treatment.

24

(a) As used in this section, "emergency medical services" or "EMS" means the
25
practitioners, ambulance vehicles, and ambulance service entities licensed in accordance with
26
chapter 4.1 of title 23 to provide emergency medical care, transportation, and preventive care to
27
mitigate loss of life or exacerbation of illness or injury, including, but not limited to, EMS
28
responding to the 911 system established under chapter 21.1 of title 39.
29

(b) Emergency medical services shall be permitted to allow licensed providers who
30
evaluate and treat mental health disorders, including substance use disorders, to accompany EMS.
31
Such providers shall be permitted to evaluate and treat EMS patients when medically necessary
32
and appropriate. Such evaluation and treatment shall be permitted to occur in the community.
33

(c) Emergency medical services shall be permitted to transport to the following facilities
34
designated by the director of the department of health:

LC004840 - Page 3 of 7
1

(1) Emergency room diversion facilities, as defined in § 23-17.26-2; and
2

(2) Community-based behavioral health facilities designed to provide immediate assistance
3
to a person in crisis.
4

(d) Commencing January 1, 2027, every individual or group health insurance contract, plan
5
or policy issued for delivery or renewed in this state that provides medical coverage that includes
6
coverage for emergency medical services, shall provide coverage for evaluation and treatment
7
described in subsection (b) of this section and shall reimburse such services at a rate not lower than
8
the same service would have been had that service been delivered in a traditional office setting.
9

(e) Commencing January 1, 2027, every individual or group health insurance contract, plan
10
or policy issued for delivery or renewed in this state that provides medical coverage that includes
11
coverage for emergency medical services, shall provide coverage for transportation and described
12
in subsection (c) of this section and shall reimburse such services at a rate not lower than the same
13
rate as for transport to an emergency department.
14

(f) Treatment and coverage for mental health disorders, including substance use disorders,
15
as described in this section shall be provided in accordance with chapter 38.2 of title 27.
16

(g) The department of health with the collaboration of the ambulance service coordinating
17
advisory board shall promulgate any rules, regulations, standing orders, protocols, and procedures
18
necessary and proper for the efficient administration and enforcement of this section.
19

(h) The office of the health insurance commissioner may promulgate such rules and
20
regulations as are necessary and proper to effectuate the purpose and for the efficient administration
21
and enforcement of this section.
22
SECTION 4. Chapter 27-41 of the General Laws entitled "Health Maintenance
23
Organizations" is hereby amended by adding thereto the following section:
24

27-41-101. Coverage of emergency medical services mental health and substance use
25
disorder treatment.

26

(a) As used in this section, "emergency medical services" or "EMS" means the
27
practitioners, ambulance vehicles, and ambulance service entities licensed in accordance with
28
chapter 4.1 of title 23 to provide emergency medical care, transportation, and preventive care to
29
mitigate loss of life or exacerbation of illness or injury, including, but not limited to, EMS
30
responding to the 911 system established under chapter 21.1 of title 39.
31

(b) Emergency medical services shall be permitted to allow licensed providers who
32
evaluate and treat mental health disorders, including substance use disorders, to accompany EMS.
33
Such providers shall be permitted to evaluate and treat EMS patients when medically necessary
34
and appropriate. Such evaluation and treatment shall be permitted to occur in the community.

LC004840 - Page 4 of 7
1

(c) Emergency medical services shall be permitted to transport to the following facilities
2
designated by the director of the department of health:
3

(1) Emergency room diversion facilities, as defined in § 23-17.26-2; and
4

(2) Community-based behavioral health facilities designed to provide immediate assistance
5
to a person in crisis.
6

(d) Commencing January 1, 2027, every individual or group health insurance contract, plan
7
or policy issued for delivery or renewed in this state that provides medical coverage that includes
8
coverage for emergency medical services, shall provide coverage for evaluation and treatment
9
described in subsection (b) of this section and shall reimburse such services at a rate not lower than
10
the same service would have been had that service been delivered in a traditional office setting.
11

(e) Commencing January 1, 2027, every individual or group health insurance contract, plan
12
or policy issued for delivery or renewed in this state that provides medical coverage that includes
13
coverage for emergency medical services, shall provide coverage for transportation and described
14
in subsection (c) of this section and shall reimburse such services at a rate not lower than the same
15
rate as for transport to an emergency department.
16

(f) Treatment and coverage for mental health disorders, including substance use disorders,
17
as described in this section shall be provided in accordance with chapter 38.2 of title 27.
18

(g) The department of health with the collaboration of the ambulance service coordinating
19
advisory board shall promulgate any rules, regulations, standing orders, protocols, and procedures
20
necessary and proper for the efficient administration and enforcement of this section.
21

(h) The office of the health insurance commissioner may promulgate such rules and
22
regulations as are necessary and proper to effectuate the purpose and for the efficient administration
23
and enforcement of this section.
24
SECTION 5. Chapter 42-7.2 of the General Laws entitled "Office of Health and Human
25
Services" is hereby amended by adding thereto the following section:
26

42-7.2-21. Coverage for emergency medical services mental health and substance use
27
disorder.

28

(a) As used in this section, "emergency medical services" or "EMS" means the
29
practitioners, ambulance vehicles, and ambulance service entities licensed in accordance with
30
chapter 4.1 of title 23 to provide emergency medical care, transportation, and preventive care to
31
mitigate loss of life or exacerbation of illness or injury, including, but not limited to, EMS
32
responding to the 911 system established under chapter 21.1 of title 39.
33

(b) Emergency medical services shall be permitted to allow licensed providers who
34
evaluate and treat mental health disorders, including substance use disorders, to accompany EMS.

LC004840 - Page 5 of 7
1
Such providers shall be permitted to evaluate and treat EMS patients when medically necessary
2
and appropriate. Such evaluation and treatment shall be permitted to occur in the community.
3

(c) Emergency medical services shall be permitted to transport to the following facilities
4
designated by the director of the department of health:
5

(1) Emergency room diversion facilities, as defined in § 23-17.26-2; and
6

(2) Community-based behavioral health facilities designed to provide immediate assistance
7
to a person in crisis.
8

(d) Rhode Island Medicaid and its contracted managed care entities shall provide coverage
9
for transportation, evaluation, and treatment described in subsections (c) and (d) of this section and
10
shall reimburse such services at a rate not lower than the same service would have been had that
11
service been delivered in a traditional office setting or for transport to an emergency department.
12

(e) The executive office of health and human services shall set the reimbursement rates for
13
the services described in this section.
14
SECTION 6. This act shall take effect upon passage.
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LC004840
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LC004840 - Page 6 of 7
EXPLANATION
BY THE LEGISLATIVE COUNCIL
OF
A N A C T
RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES
***
1
This act would permit licensed providers to accompany emergency medical services and
2
treat patients within the community for mental health disorders, including substance use disorders.
3
This act would take effect upon passage.
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LC004840
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LC004840 - Page 7 of 7