Treat-in-place model passes House with amendments, now back to Senate

The West Virginia House of Delegates adopted a bill to allow EMS workers to utilize a “treat-in-place” model, which would ensure they are paid for services even if a patient is not admitted to a hospital. (Getty Images)

The West Virginia House of Delegates on Thursday adopted a bill to allow EMS responding to patients covered by private insurance in West Virginia to utilize a “treat-in-place” model, which would ensure they are paid for services rendered even if a patient is not admitted to a hospital for care.

Senate Bill 533 previously passed the Senate unanimously . On Thursday, House members suspended the constitutional rule that a bill be read on three separate days and passed the legislation unanimously , with eight members absent and not voting.

Del. Amy Summer, R-Taylor, offered an amendment on the floor to include language from Senate Bill 444 , a bill that has been pending in the House Judiciary Committee since Feb. 19.

The amendment — adopted via a voice vote — ensures that private insurers issue coverage for patients and reimbursement when EMS providers offer “prehospital screening and stabilization of an emergency medical condition,” even if a patient refuses transport against medical advice.

SB 533 was introduced in the Legislature several months after West Virginia’s congressional delegation called on the national Centers for Medicare & Medicaid services to implement a similar treatment model for their patients.

Under the model proposed, after making a call to 911, a consenting patient could be diverted to a “lower-acuity” facility outside of hospitals and emergency rooms for treatment. This includes federally qualified health care centers, a doctor’s office, an urgent care center and mental and behavioral health facilities. First responders would also have the option to triage and treat patients on the scene when possible and coordinate with telehealth providers on how best to serve the patient.

Proponents for the treat-in-place model include the West Virginia EMS Coalition and the state Hospital Association, where leaders believe it could reduce crowding in understaffed hospitals as well as allow underfunded EMS to collect more insurance payments for services rendered.

“This is something EMS has been looking for, for years,” said Del. D. Rolland Jennings, R-Preston, who was the only member to speak on the bill Thursday.

Jennings said EMS have long-standing issues where a patient may not need emergency care, but could benefit from other services. He gave the example of when someone who is diabetic forgets to take their insulin or experiences increased glucose levels.

“They’ll get up and they want us to disconnect them from the IV, they don’t go to the hospital, and [their insurance doesn’t] get charged,” Jennings said. “This will let us charge for those three or four different things that we do, and it’s always in contact with a doctor and medical command. We’re not allowed to do this on our own.”

As it currently stands, EMS can only receive payments through insurance if a patient is taken and admitted to a hospital for care. The proposed bill would require private insurers to reimburse EMS agencies treating, triaging or transporting patients to alternative care centers at the same rate they would if a patient was transported to an emergency room.

A majority of West Virginians — about 75% of those with insurance — are governmental payers, meaning they are insured through Medicaid, Medicare or the Public Employees Insurance Agency. The proposed law would not apply to these residents.

SB 533, as amended, will now go back to the Senate, where lawmakers will either approve the changes or reject them. The bill that was amended into SB 533 previously passed the Senate unanimously .

GET THE MORNING HEADLINES DELIVERED TO YOUR INBOX

The post Treat-in-place model passes House with amendments, now back to Senate appeared first on West Virginia Watch .