RSA 153-A:38 · [RSA 153-A:38 repealed by 2025, 262:7, effective June 30, 2030.] 153-A:38 Commission on Improving the Ground Ambulance Services Financing and Delivery System

[RSA 153-A:38 repealed by 2025, 262:7, effective June 30, 2030.] 153-A:38 Commission on Improving the Ground Ambulance Services Financing and Delivery System. – There is established a commission on improving the ground ambulance financing and delivery system.

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I.

The members of the commission shall be as follows:

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(a)

Six members of the house of representatives, appointed by the speaker of the house of representatives, 3 of whom shall be nominated by the leader of the minority party. Two members shall be from the commerce committee, 2 members from the health and human services committee, 1 member from the municipal and county government committee, and 1 member from the criminal justice and public safety committee.

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(b)

Two members of the senate, appointed by the president of the senate, 1 of whom shall be nominated by the leader of the minority party. One member shall be from the health and human services committee, and 1 member shall be from the commerce committee.

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(c)

The commissioner of the department of safety, or designee.

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(d)

The commissioner of the department of insurance, or designee.

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(e)

The commissioner of the department of health and human services, or designee.

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(f)

A representative from the New Hampshire Ambulance Association, nominated by the association and appointed by the governor.

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(g)

A representative from the New Hampshire Association of Fire Chiefs, nominated by the association and appointed by the governor.

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(h)

A representative from the New Hampshire Hospital Association, nominated by the association and appointed by the governor.

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(i)

A representative from America's Health Insurance Plans (AHIP), nominated by the association and appointed by the governor.

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II.

Legislative members of the commission shall receive mileage at the legislative rate when attending to the duties of the commission.

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III.

The commission shall:

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(a)

Review the history and operation of ground ambulance services delivery in New Hampshire and the current financing and delivery models adopted by municipal, hospital-based, and commercial ground ambulance providers in the state.

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(b)

Identify areas in which the ground ambulance financing and delivery system in the state is not meeting the needs of citizens of this state or is in jeopardy of failing to meet the needs of citizens of this state and requires reform.

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(c)

Make recommendations for systemic reforms to support a viable ground ambulance financing and delivery system that will improve sustainability, efficiency, and quality of care while controlling costs.

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IV.

The commission shall determine the feasibility and advisability of applying for a waiver under Section 1115A of the Social Security Act to enter into an all-payer model agreement for ground ambulance services in the state to implement a uniform, cost-based reimbursement schedule for ground ambulance services that includes Medicare, Medicaid, and all commercial payers and that builds upon the mandatory in-network rate schedule and the cost study conducted under RSA 420-J:26. To determine the feasibility and advisability of applying for the federal waiver, the commission shall determine the most appropriate design of an all-payer model program that could form the basis of an application for a federal waiver.

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V.

The proposed all-payer program design shall include measures to align payment policies across public and commercial payers to promote ground ambulance financing and delivery system reforms to improve sustainability, efficiency, and quality of care while controlling costs. The commission shall study the feasibility and advisability of at least the following public policy options for improving the ground ambulance financing and delivery system and such other options as would help meet the requirements for federal approval of the Section 1115A waiver application:

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(a)

Expanding mobile integrated health services in the state as appropriate to improve health system efficiency and quality of care and promote efficiently delivered "treatment in place" where appropriate.

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(b)

Further strengthening regional services coordination systems or regional EMS networks for the rural areas of the state to share the cost of readiness and disperse workloads.

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(c)

Implementing an improved system for delivering and compensating facility-to-facility or scheduled transfers of patients with consideration of supply shortages that have occurred and of the differing nature of emergency and scheduled transports.

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(d)

Implementing a system for compensating care provided in the treat-no-transport context.

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(e)

Developing an improved education program for ambulance providers relating to billing and reimbursement of ambulance services by third-party payers.

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(f)

Evaluating options for improving recruitment and retention of emergency medical services staff.

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VI.

The members of the commission shall elect a chairperson from among the members. The first meeting of the commission shall be called by the first named house member. The first meeting of the commission shall be held within 45 days of the effective date of this section. Eight members of the commission shall constitute a quorum.

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VII.

The commission shall produce a report on November 1 of each year that the commission is in operation detailing the progress made to date carrying out its mandates and including such recommendations for legislative or administrative reforms or initiatives as are timely and appropriate. The commission shall submit its assessment of the feasibility and advisability of applying for a waiver under Section 1115A of the Social Security Act to enter into an all-payer model agreement for ground ambulance services in the state to create a uniform, cost-based reimbursement schedule for ground ambulance services that includes Medicare, Medicaid and all commercial payers no later than its November 1, 2027 report. If this report finds the waiver application not feasible or advisable, then the commission shall continue to report on the feasibility and advisability of at least the public policy options for improving the ground ambulance financing and delivery system listed in RSA 153-A:38, III and V and any other policy options the commission deems would serve the needs of New Hampshire citizens. The commission shall issue its report and any recommendations for proposed legislation or administrative actions to the president of the senate, the speaker of the house of representatives, the chairs of commerce, municipal and county government, health and human services, and criminal justice and public safety in the house of representatives, the chairs of commerce and health and human services in the senate, the president of the senate, the speaker of the house of representatives, the house clerk, the senate clerk, the governor, and the state library. Source. 2025, 262:6, eff. July 31, 2025.

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