SB 221: HEALTH SERVICES: Provides relative to ambulance providers. (8/1/26) (EN NO IMPACT See Note) - Louisiana

Senate Floor Bureau Note, #1223, Boudreaux, Gerald, Adopted → SB221 Act 370 · 6 edits

MODERATE

This bill enacts a new section into the Louisiana Medicaid statute to cover 'treatment-in-place' services provided by ground ambulance providers. It allows ambulances to treat patients at the scene of a 911 call without transporting them to a hospital, provided a qualified medical practitioner directs the care. The change matters because it expands Medicaid coverage to include these on-site emergency encounters and establishes a specific reimbursement rate for them.

Scope change

The bill expands the scope of covered services under the Louisiana Medicaid program to include ground ambulance treatment-in-place services, excluding air ambulances.

SCOPE

Added coverage for 'treatment-in-place' services, defined as emergency encounters where an ambulance provider assesses or treats a patient at the scene without transporting them.

DEFINITION

Created new definitions for '911 call', 'ambulance provider' (excluding air ambulances), 'beneficiary', 'qualified medical practitioner', and 'treatment-in-place service'.

FISCAL

Established that these services are covered at the associated basic life support, emergency base rate, or advanced life support, Level 1 emergency base rate in the Medicaid fee schedule.

REQUIREMENT

Required that treatment-in-place services follow the ambulance provider's medical direction and established protocols, consistent with the practitioner's scope of practice.

Authorized the use of audio and video telecommunication systems to facilitate real-time communication between ambulance providers and medical practitioners, though such technology is not strictly required for reimbursement.

ENFORCEMENT

Mandated that the Louisiana Department of Health promulgate rules and regulations to implement these new provisions.

SB221 Original → Senate Floor Bureau Note, #1223, Boudreaux, Gerald, Adopted · 2 edits

MINOR

The bill was amended to give the Department of Health flexibility in deciding whether to cover treatment-in-place services, rather than mandating coverage. Additionally, the rule requiring these services to be paid for at specific Medicaid rates was changed to allow the department to determine the reimbursement method.

Scope change

The bill's scope was narrowed from a mandatory coverage requirement to a discretionary one, allowing the state to opt out of funding these services if deemed unnecessary.

REQUIREMENT

Changed the requirement for Medicaid to cover treatment-in-place services from mandatory ('are') to discretionary ('may be').

FISCAL

Changed the requirement for reimbursement rates from mandatory ('are') to discretionary ('shall be' used in context of setting rates, but the underlying obligation to pay was removed in the first amendment).

SB221 Enrolled → SB221 Original · 4 edits

MODERATE

The bill was reclassified from an 'Enrolled' version to an 'Original' version, indicating a procedural reset where the bill is being reintroduced or amended for the 2026 Regular Session. The substantive policy text regarding Medicaid coverage for 'treatment-in-place services' by ambulance providers appears unchanged in content, though the formatting and header information have been updated to reflect the new session status and sponsor list.

Scope change

The bill's scope remains focused on ambulance providers and Medicaid coverage for treatment-in-place services; however, the procedural status changed from a final 'Enrolled' bill to an 'Original' bill, suggesting it is now subject to further legislative review or amendment.

TECHNICAL

The bill header was changed from 'ENROLLED' to 'ORIGINAL', and the session identifier was updated to 'SLS 26RS-561', indicating a procedural reset rather than a policy change.

The list of sponsors was updated to include only 'SENATOR BOUDREAUX', removing 'REPRESENTATIVE CHASSION' who was listed in the previous version.

A summary digest was added to the original version, outlining the bill's purpose and effective date (August 1, 2026), which was not present in the enrolled version's footer.

The signature block for the Governor and the 'APPROVED' stamp were removed, consistent with the bill no longer being in its final enrolled state.

SB221 Reengrossed → SB221 Enrolled · 4 edits · May 19, 2026

MODERATE

The bill was finalized as an enrolled version, adding a Representative as a co-sponsor and updating the page count from three to two. The substantive policy content regarding Medicaid coverage for ambulance 'treatment-in-place' services remains identical to the previous version.

Scope change

The bill's scope and applicability are unchanged; it continues to apply to ambulance providers and the Louisiana Department of Health.

TECHNICAL

The bill title was updated from 'REENGROSSED' to 'ENROLLED', indicating the final version passed both legislative chambers and signed by the Governor.

Representative Chassion was added as a co-sponsor alongside Senator Boudreaux.

The footer page count was reduced from 'Page 1 of 3' to 'Page 1 of 2', reflecting the removal of the separate digest section.

The standalone digest section and signatures of the Senate President, House Speaker, and Governor were removed from the main text body, as they are no longer needed in the enrolled final text.

SB221 Engrossed → SB221 Reengrossed · 3 edits · Mar 25, 2026

MINOR

The bill was reengrossed to incorporate technical corrections and clarifications from the Senate floor. The most significant substantive change is the addition of the word 'may' to clarify that ambulance providers have the option, rather than a mandatory requirement, to initiate and facilitate treatment-in-place services. A related change ensures that any services provided during this optional encounter are explicitly covered by the existing emergency base rates.

Scope change

The scope of the bill's requirements was narrowed slightly by clarifying that the initiation of treatment-in-place services is optional for ambulance providers, whereas the coverage of services performed during such encounters remains mandatory.

REQUIREMENT

Changed the requirement for ambulance providers to 'Initiation and facilitation of treatment-in-place services' to 'Initiation and facilitation of treatment-in-place services may be performed,' clarifying that this action is optional for providers.

Updated the coverage language to state that services provided during the encounter 'shall be covered,' ensuring explicit confirmation that these services are paid for under the medical assistance program.

TECHNICAL

Added a summary of Senate amendments noting that the changes are primarily technical in nature.

HEALTH SERVICES: Provides relative to ambulance providers. (8/1/26) (EN NO IMPACT See Note)

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