The bill amends Chapter 40-8 of the General Laws by adding a new section titled "Community medical services." It mandates the Executive Office of Health and Human Services (EOHHS) to adopt and implement a methodology for medical assistance reimbursement for services provided by licensed medical service providers, including physicians, nurses, physician assistants, paramedics, and emergency medical technicians, when these services are delivered to eligible recipients in accordance with the provisions of 40-8-3.

To qualify for coverage under this section, an individual must have received hospital emergency department services three or more times within a period of four consecutive months in the past twelve months, or have been identified by their primary healthcare provider as needing community medical services to likely prevent admission to or allow discharge from a nursing facility, or to likely prevent readmission to a hospital or nursing facility.

Payments for services provided by community medical service providers must be part of a care plan ordered by a primary healthcare provider and billed by an eligible provider enrolled in medical assistance that employs or contracts with the community medical service provider. The care plan must ensure that the services provided are coordinated with other community health providers and local public health agencies, and that community medical services do not duplicate existing services, including home health care or waiver services. Community medical services will include health assessments, chronic disease monitoring and education, medication compliance, immunizations and vaccinations, laboratory specimen collection, hospital discharge follow-up care, and minor medical procedures approved by the Director of the Department of Health.

Additionally, services provided by a community medical service provider to an eligible recipient who is also receiving care coordination services must be in consultation with the providers of the recipient's care coordination services. The section clarifies that it does not authorize any medical service provider to provide services beyond or outside the scope of their training or license authorization. The Director of the Department of Health may promulgate rules and regulations to implement the method and manner of healthcare services provided under this section. The Department of Human Services or EOHHS is required to seek federal approval to implement the provisions of this section. The act will take effect upon passage.