Committee advances bill directing DHHS and insurance bureau to review treatment-in-place reimbursement

The Health and Human Services Committee advanced LD2119 as amended, a bill that asks the Department of Health and Human Services to review reimbursement for ‘treatment in place’ (care provided that does not result in transport) and directs the state Bureau of Insurance to conduct the statutorily required review that would precede any mandated commercial coverage.

“ This is the second work session for LD2119, enact to expand reimbursement for treatment in place, community paramedicine, and alternate destination transport,” the committee analyst summarized, explaining the amendment is a strike-and-replace that would require DHHS to examine a single MaineCare code currently reimbursed at a flat $95 and report findings to this committee by 01/01/2027.

The analyst told members that the Bureau of Insurance review is necessary before the Legislature can require commercial carriers to cover a new mandated category. The bureau’s formal report would be submitted to both this committee and the Insurance and Financial Services committee to give either committee authority to report legislation based on the review.

A committee member moved that LD2119 pass as amended and another member seconded; the chair called the question and the committee moved forward with the amended bill on the record.

Why it matters: Witnesses at the public hearing and members said the $95 flat reimbursement has not changed in some time and was described as insufficient by service providers. The bill creates a structured review process rather than setting a new reimbursement rate in statute; it also ensures the Bureau of Insurance evaluates commercial-coverage impacts before the Legislature mandates coverage.

Next steps: The bureau’s report and DHHS findings, due January 1, 2027, would inform whether the committee or its counterparts choose to report legislation changing reimbursement or mandating coverage.