Nevada Receives Approval from Centers for Medicare and Medicaid to Reimburse for Paramedicine

Richard Whitley, Director of the Nevada Department of Health and Human Services (DHHS), today announced that the federal Department of Health and Human Services, Centers for Medicare & Medicaid (CMS) has approved a Division of Health Care Financing Policy (DHCFP) Nevada Medicaid State Plan Amendment (SPA) that updates coverage and reimbursement to include Community Paramedicine services. “This is a tremendous opportunity for Nevada to fill the gaps in health care in both rural and urban locations around the state,” DHCFP Acting Administrator Marta Jensen said. “Over time, this should reduce costly hospital re-admissions and free up physicians’ time to see more critical cases as well as provide wellness interventions to the citizens of Nevada.”

In the final days of the 2015 Nevada legislative session, Assembly Bill (AB) 305, sponsored by Assemblyman James Oscarson, was signed into law by Governor Brain Sandoval and Community Paramedicine was added to Nevada Revised Statutes (NRS) 450B. With CMS’ approval for reimbursement of the services, Nevada is poised to become a national leader in a promising model for integrating emergency and primary care. “Community paramedics offer extensive background experience and will provide for better access to health care,” Oscarson said. “Nevada now has an opportunity to fill unmet or unrealized community primary care and health needs. Using EMS providers in an expanded role will increase patient access to primary and preventive care, save healthcare dollars and improve patient outcomes.”

The Division of Public and Behavioral Health (DPBH) has partnered with the EMS industry and the EMS Advisory Committee to craft appropriate regulatory language for this new provision of health care and with the Southern Nevada Health District (SNHD). The regulations are scheduled to be adopted at the Nevada State Board of Health during the December 2016 meeting.

Currently, four EMS services are now fully certified by DPBH to perform Community Paramedicine. These services include REMSA, Humboldt General Hospital EMS, East Fork Fire Protection District, and North Lake Tahoe Fire Protection District. In addition, four other EMS organizations will receive DPBH certification to perform Community Paramedicine pending the receipt of documentation. SNHD has approximately 30 EMS services eligible to provide Community Paramedicine in Clark County.

Coverage for medically necessary Community Paramedicine service through DHCFP’s approved SPA is designed to provide health care services to the medically underserved. Community Paramedicine services (provided by an Emergency Medical Technician, Advanced Emergency Medical Technician, or Paramedic) fill patient gaps in a local health care system and prevent duplication of services while improving the health care services of the recipient. Prevention of unnecessary ambulance responses, emergency room visits and hospital admissions can result in cost reductions for the state. Services must be part of the care plan ordered by the recipient’s primary care provider and may include: evaluation/health assessments; chronic disease prevention, monitoring and education; medication compliance, and immunizations and vaccinations.

For additional information on AB 305, link to:
https://www.leg.state.nv.us/Session/78th2015/Bills/AB/AB305_EN.pdf
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Nevada Department of Health and Human Services
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