62J.48 CRITERIA FOR REIMBURSEMENT.
All ambulance services licensed under section
are eligible for reimbursement
under health plan companies. The commissioner shall require health plan companies to adopt the
following reimbursement policies.
(1) All scheduled or prearranged air and ground ambulance transports must be reimbursed
if requested by an attending physician or nurse, and, if the person is an enrollee in a health
plan company, if approved by a designated representative of a health plan company who is
immediately available on a 24-hour basis. The designated representative must be a registered
nurse or a physician assistant with at least three years of critical care or trauma experience, or
a licensed physician.
(2) Reimbursement must be provided for all emergency ambulance calls in which a patient
is transported or medical treatment rendered.
(3) Special transportation services must not be billed or reimbursed if the patient needs
medical attention immediately before transportation.
History: 1994 c 625 art 4 s 1; 1995 c 234 art 8 s 11; 1997 c 199 s 14