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2000 SESSION

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CHAPTER 630 An Act to amend and reenact § 38.2-3407.9 of the Code of Virginia, relating to health insurance; access to ambulance services. [H 660] Approved April 8, 2000

Be it enacted by the General Assembly of Virginia:

1. That § 38.2-3407.9 of the Code of Virginia is amended and reenacted as follows:

§ 38.2-3407.9. Reimbursement for ambulance services.

A. If an accident and sickness insurance policy provides coverage for ambulance services, 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 ambulance services. 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 ambulance services.

B. C. For the purposes of this section, "ambulance services" means the transportation of any person requiring resuscitation or emergency relief or where human life is endangered, by means of any ambulance, rescue or life-saving vehicle designed or used principally for such purposes. Such term includes emergency medical services ambulances and mobile intensive care units. 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 ambulance services.