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<law><site_title>Virginia Decoded</site_title><site_url>https://vacode.org</site_url><law_id>72540</law_id><section_number>38.2-3407.9</section_number><catch_line>Reimbursement for emergency medical services vehicle transportation services</catch_line><edition url="https://vacode.org/2025/" slug="2025" current="TRUE" last_updated="">2025</edition><referred_to_by><reference>32.1-111.14</reference><reference>38.2-4214</reference><reference>38.2-4319</reference></referred_to_by><structure><unit label="title" level="1" order_by="1" identifier="38.2">Insurance</unit><unit label="chapter" level="2" order_by="1" identifier="34">Provisions Relating to Accident and Sickness Insurance</unit><unit label="article" level="3" order_by="1" identifier="1">General Provisions</unit></structure><text>
						<section id="A"><p><span class="prefix-number">A.</span> If an accident and sickness <span class="dictionary">insurance</span> policy provides coverage for <span class="dictionary">services provided by an emergency medical services vehicle</span>, any <span class="dictionary">person</span> providing such services to a <span class="dictionary">person</span> covered under such policy shall receive reimbursement for such services directly from the issuer of such policy, when the issuer of such policy is presented with an assignment of benefits by the <span class="dictionary">person</span> providing such services. <a id="paragraph-261187" class="section-permalink" href="https://vacode.org/38.2-3407.9/#A"><i class="fa fa-link"/></a></p></section>
						<section id="B"><p><span class="prefix-number">B.</span> No (i) <span class="dictionary">insurer</span> proposing to <span class="dictionary">issue</span> individual or group accident and sickness <span class="dictionary">insurance policies</span> providing hospital, medical and surgical or major medical coverage on an expense-incurred basis, (ii) corporation providing individual or group accident and sickness subscription <span class="dictionary">contracts</span>, or (iii) health maintenance organization providing a health care plan for health care services shall establish or promote an emergency medical response and transportation system that encourages or directs access by a <span class="dictionary">person</span> covered under such policy, <span class="dictionary">contract</span> or plan in competition with or in substitution of an emergency 911 system or other <span class="dictionary">state</span>, county or municipal emergency medical system for <span class="dictionary">services provided by an emergency medical services vehicle</span>. An entity subject to this subsection may use transportation outside an emergency 911 system or other <span class="dictionary">state</span>, county or municipal emergency medical system for services that are not <span class="dictionary">services provided by an emergency medical services vehicle</span>. <a id="paragraph-261188" class="section-permalink" href="https://vacode.org/38.2-3407.9/#B"><i class="fa fa-link"/></a></p></section>
						<section id="C"><p><span class="prefix-number">C.</span> For the purposes of this section, &#x201C;<span class="dictionary">services provided by an emergency medical services vehicle</span>&#x201D; means the transportation of any <span class="dictionary">person</span> requiring resuscitation or emergency relief or where human life is endangered, by means of any emergency medical services vehicle designed or used principally for such purposes. No (i) <span class="dictionary">insurer</span> proposing to <span class="dictionary">issue</span> individual or group accident and sickness <span class="dictionary">insurance policies</span> providing hospital, medical and surgical or major medical coverage on an expense-incurred basis, (ii) corporation providing individual or group accident and sickness subscription <span class="dictionary">contracts</span>, or (iii) health maintenance organization providing a health care plan for health care services shall require a <span class="dictionary">person</span> covered under such policy, <span class="dictionary">contract</span> or plan to obtain prior authorization before accessing an emergency 911 system or other <span class="dictionary">state</span>, county or municipal emergency medical system for <span class="dictionary">services provided by an emergency medical services vehicle</span>. <a id="paragraph-261189" class="section-permalink" href="https://vacode.org/38.2-3407.9/#C"><i class="fa fa-link"/></a></p></section></text><history>1995, c. 420; 2000, c. 630; 2015, cc. 502, 503.</history><metadata></metadata></law>
