Ambulance Tasmania is struggling to meet voluntary national safety and quality standards, a mock assessment showed.
The paramedics' union says the results are alarming.
The Department of Health says Ambulance Tasmania is making improvements to address the issues.
The National Safety and Quality Health Service standards are designed to ensure health services provide nationally consistent, high-quality care.
Ambulance Tasmania engaged the Australian Council on Healthcare Standards to conduct a mock readiness assessment to see how it was performing against the standards.
The Health Department had refused to provide the council's report but the ABC got it under right-to-information provisions.
Across the 138 relevant actions in the standards, Ambulance Tasmania met 23, met 66 with recommendations and did not meet 49.
Accreditation is voluntary for ambulance services, but the report states it could become mandatory in the future.
The only state-based ambulance service now accredited is South Australia's.
The assessors expressed concerns about Ambulance Tasmania's performance, stating it could in future trigger a requirement for them to tell the Australian Commission for Safety and Quality in Health Care — which developed the standards — under the "notification of significant risk" policy.
SAC 1 in a healthcare setting refers to a "severity assessment code one" incident where a patient died or was seriously harmed — or there was a risk of that happening — due to the healthcare provided, or lack thereof.
The Health and Community Services Union described the report as "alarming".
Mr Moore said he understood Ambulance Tasmania had given up on the accreditation process.