Committee advances bill to let EMS bill Medicaid for on-scene treatment when patient declines transport

Senate Bill 221, presented to the House Health and Welfare Committee on April 28, would allow ambulance providers to obtain Medicaid reimbursement for responses where EMS provides treatment on scene and the patient is not transported.

Senator Boudreaux and representatives of the Louisiana Ambulance Alliance described the proposal as filling a gap in current law that does not reimburse for non-transport on-scene care. Curry Landry of the Louisiana Ambulance Alliance called the measure a "baby step" that could demonstrate cost savings to Medicaid and pave the way for commercial or Medicare coverage later.

Committee members asked technical questions about billing codes, credentialing and whether helicopters or high-acuity transports would be included. Witnesses said existing CPT codes (cited as A0427 and A0429 for ALS/BLS) can be used in some states, and that LDH rulemaking and possible CMS approvals may be required before implementation.

Supporters noted potential savings from avoiding unnecessary emergency-department visits and from mileage reductions. The committee received roughly 30 green cards in support and reported SB 221 favorably by voice vote.

What happens next: SB 221 was reported favorably to the full House; proponents said LDH rulemaking and coordination with payers will be required before billing can begin.