(a) In accordance with ambulance service pricing guidelines from the Centers for Medicare and Medicaid Services, or successor organization, the Director may establish fees to be charged for services provided by the emergency ambulance service of the VIFEMS in such amount as may be reasonable in consideration of the interests of the public and the persons required to pay the fees and in consideration of the approximate cost of furnishing such services; but no one shall be denied the services because of his or her inability, and no one may be questioned about the ability to pay at the time the services are requested.
(b) (1) A health care facility shall reimburse the VIFEMS for the cost of emergency ambulance services, as determined under subsection (a) of this section, incurred by a patient resident of the health care facility if the health care facility requests ambulance transport services from the VIFEMS, and the patient’s healthcare insurance denies payment for the ambulance transport after a determination that the transportation did not meet the medical necessity standard as provided in 42 CFR § 410.40(d).(2) For the purposes of this subsection, the term:(A) “Ambulance” means any publicly owned vehicle specially designed, constructed, modified, or equipped for use as a means for transporting patients in a medical emergency or any publicly owned vehicle that is advertised, marked, or in any way held out as a vehicle for the transportation of patients in a medical emergency.(B) The term “health care facility” includes, but is not limited to, hospitals, nursing homes, hospices, health care clinics, health centers, behavioral health facilities, community residence facilities, maternity centers, ambulatory surgical facilities, renal dialysis facilities, intermediate care facilities, rehabilitation facilities, urgent care facilities, and home care agencies.
(1) A health care facility shall reimburse the VIFEMS for the cost of emergency ambulance services, as determined under subsection (a) of this section, incurred by a patient resident of the health care facility if the health care facility requests ambulance transport services from the VIFEMS, and the patient’s healthcare insurance denies payment for the ambulance transport after a determination that the transportation did not meet the medical necessity standard as provided in 42 CFR § 410.40(d).
(2) For the purposes of this subsection, the term:(A) “Ambulance” means any publicly owned vehicle specially designed, constructed, modified, or equipped for use as a means for transporting patients in a medical emergency or any publicly owned vehicle that is advertised, marked, or in any way held out as a vehicle for the transportation of patients in a medical emergency.(B) The term “health care facility” includes, but is not limited to, hospitals, nursing homes, hospices, health care clinics, health centers, behavioral health facilities, community residence facilities, maternity centers, ambulatory surgical facilities, renal dialysis facilities, intermediate care facilities, rehabilitation facilities, urgent care facilities, and home care agencies.
(A) “Ambulance” means any publicly owned vehicle specially designed, constructed, modified, or equipped for use as a means for transporting patients in a medical emergency or any publicly owned vehicle that is advertised, marked, or in any way held out as a vehicle for the transportation of patients in a medical emergency.
(B) The term “health care facility” includes, but is not limited to, hospitals, nursing homes, hospices, health care clinics, health centers, behavioral health facilities, community residence facilities, maternity centers, ambulatory surgical facilities, renal dialysis facilities, intermediate care facilities, rehabilitation facilities, urgent care facilities, and home care agencies.
(c) All health insurers, hospitals or medical services corporations, preferred provider organizations and health maintenance organizations shall reimburse the VIFEMS for emergency services that are due to a medical emergency.
(d) Fees collected by the VIFEMS under this section must be deposited in the Fire and Emergency Medical Services Fund.