                                 CODE OF VIRGINIA

REIMBURSEMENT FOR EMERGENCY MEDICAL SERVICES VEHICLE TRANSPORTATION SERVICES (§
38.2-3407.9)

A. If an accident and sickness insurance policy provides coverage for services
provided by an emergency medical services vehicle, any person providing such
services to a person 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 person providing such
services.

B. No (i) insurer proposing to issue individual or group accident and sickness
insurance policies providing hospital, medical and surgical or major medical
coverage on an expense-incurred basis, (ii) corporation providing individual or
group accident and sickness subscription contracts, 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 person covered under such policy,
contract or plan in competition with or in substitution of an emergency 911
system or other state, county or municipal emergency medical system for services
provided by an emergency medical services vehicle. An entity subject to this
subsection may use transportation outside an emergency 911 system or other
state, county or municipal emergency medical system for services that are not
services provided by an emergency medical services vehicle.

C. For the purposes of this section, &#8220;services provided by an emergency
medical services vehicle&#8221; means the transportation of any person 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) insurer proposing to issue individual or group accident and
sickness insurance policies providing hospital, medical and surgical or major
medical coverage on an expense-incurred basis, (ii) corporation providing
individual or group accident and sickness subscription contracts, or (iii)
health maintenance organization providing a health care plan for health care
services shall require a person covered under such policy, contract or plan to
obtain prior authorization before accessing an emergency 911 system or other
state, county or municipal emergency medical system for services provided by an
emergency medical services vehicle.

HISTORY: 1995, c. 420; 2000, c. 630; 2015, cc. 502, 503.