North Dakota Code § 23-27-04.10

Air ambulance services
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1. The department shall create and maintain a primary call list and a secondary call list of 
air ambulance service providers operating in this state.
2. To qualify to be listed on the primary call list, an air ambulance service provider shall 
submit to the department attested documentation indicating the air ambulance service 
provider is a participating provider of the health insurance carriers in the state which 
collectively hold at least seventy -five percent of the health insurance coverage in the 
state as determined by annual market share reports.

3. The department shall provide the primary call list and the secondary call list for air 
ambulance service providers operating in this state to all emergency medical services 
personnel, each hospital licensed under chapter 23 -16, each 911 coordinator in this 
state, and each public safety answering point operating in this state.
4. The department shall establish air ambulance service response zones for rotary wing 
aircraft which are based on response times and patient health and safety.
a. Upon receipt of a request for air ambulance services, emergency medical 
services personnel, a hospital licensed under chapter 23 -16, or a public safety 
answering point operating in this state, shall make a reasonable effort to inform 
the requesting party of the estimated response time for the requested air 
transport versus the ground transport for that designated response zone. If at any 
point during the request for air ambulance services the requester withdraws the 
request, the receiving party is not required to complete that call for air ambulance 
services.
b. If emergency medical services personnel, a hospital licensed under 
chapter 23-16, or a public safety answering point operating in this state receives 
a request from emergency medical services personnel for air ambulance 
services, the recipient of the request shall comply with the call priority under this 
subdivision in responding to the request.
(1) First, the recipient of the request shall call an air ambulance service provider 
listed on the primary call list which is within the designated response zone.
(2) Second, if each of the air ambulance service providers listed on the primary 
list is not available or is not able and willing to respond to the call, the 
recipient of the request shall notify the requester of this fact and shall call an 
air ambulance provider listed on the secondary call list within the designated 
response zone.
(3) Third, if each of the air ambulance service providers listed on the secondary 
list is not available or is not able and willing to respond to the call, the 
recipient of the request shall notify the requester of this fact and shall inform 
the requester of primary and secondary air ambulance service provider 
options outside the designated response zone.
5. Upon request of the department, a potential patient, or a potential patient's legal 
guardian, an air ambulance service provider shall provide that provider's fee schedule, 
including the base rate, per loaded mile rate, and any usual and customary charges.
a. The department shall compile and distribute this fee information to each hospital 
licensed under chapter 23 -16, each hospital emergency department in the state, 
each physician the department determines is likely to generate an air ambulance 
transport, each emergency medical services operation, each emergency medical 
services professional, each emergency medical services personnel, each public 
safety answering point in this state, and each 911 coordinator in this state.
b. Before a hospital refers a patient to an air ambulance service provider, the 
hospital shall make a reasonable effort to inform the patient or the patient's legal 
guardian of the fees for the air ambulance service providers licensed under this 
chapter, for the purpose of allowing the patient or legal guardian to make an 
informed decision on choosing an air ambulance service provider. A hospital is 
exempt from complying with this subdivision if the hospital determines 
compliance might jeopardize the health or safety of the patient.
6. The department of health and human services shall adopt rules establishing air 
ambulance service provider requirements that must address transport plans, including 
auto launch protocol and auto launch cancellation protocol; transporting to the nearest 
appropriate medical facility; medical necessity; and informed consent. As necessary, 
the department of health and human services shall adopt rules relating to quality of 
care standards and other appropriate requirements regarding air ambulance service 
providers.

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