West Virginia Code § 33-25-8v

Coverage of emergency medical services to triage and transport to
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alternative destination or treat in place.
(a) The following terms are defined:
(1) "911 call" means a communication indicating that an individual may need emergency
medical services;
(2) "Alternative destination" means a lower-acuity facility that provides medical services,
including without limitation:
(A) A federally-qualified health center;
(B) An urgent care center;
(C) A rural health clinic;
(D) A physician office or medical clinic as selected by the patient; and
(E) A behavioral or mental health care facility including, without limitation, a crisis
stabilization unit.
"Alternative destination" does not include a:
(A) Critical access hospital;
(B) Dialysis center;
(C) Hospital;
(D) Private residence; or
(E) Skilled nursing facility;
(3) "Emergency medical services agency" means any agency licensed under §16-4C-6a of this
code to provide emergency medical services: Provided, That rotary and fixed wing air
ambulances are specifically excluded from the definition of an emergency medical services
agency;
(4) "Medical command" means the issuing of orders by a physician from a medical facility to
emergency medical services personnel for the purpose of providing appropriate patient care;
and
(5) "Telehealth services" means the use of synchronous or asynchronous telecommunications
technology or audio-only telephone calls by a health care practitioner to provide health care
services, including, but not limited to, assessment, diagnosis, consultation, treatment, and
monitoring of a patient; transfer of medical data; patient and professional health-related
education; public health services; and health administration. The term does not include e-
mail messages or facsimile transmissions.
(b) An insurer which issues or renews a health insurance policy on or after January 1, 2025,
shall provide coverage for:
(1) An emergency medical services agency to:
(A) Treat an enrollee in place if the ambulance service is coordinating the care of the
enrollee through telehealth services with a physician for a medical-based complaint or with a
behavioral health specialist for a behavioral-based complaint; u
(B) Triage or triage and transport an enrollee to an alternative destination if the ambulance
service is coordinating the care of the enrollee through telehealth services with a physician
for a medical-based complaint or with a behavioral heaalth specialist for a behavioral-based
complaint; or
(C) An encounter between an ambulance service and enrollee that results in no transport of
the enrollee if:
(i) The enrollee declines to be transported against medical advice; and
(ii) The emergency medical services agency is coordinating the care of the enrollee through
telehealth services or medical command with a physician for a medical-based complaint or
with a behavioral health specialist for a behavioral-based complaint.
(c) The coverage under this section:
(1) Only includes emergency medical services transportation to the treatment location;
(2) Is subject to the initiation of response, triage, and treatment as a result of a 911 call that
is dWocumented in the records of the emergency medical services agency;
(3) Is subject to deductibles or copayment requirements of the policy, contract, or plan;
(4) Does not diminish or limit benefits otherwise allowable under a health benefit plan, even
if the billing claims for medical or behavioral health services overlap in time that is billed by
the ambulance service also providing care; and
(5) Does not include rotary or fixed wing air ambulance services.
(d) The reimbursement rate for an emergency medical services agency that triages, treats,
and transports a patient to an alternative destination, or triages, treats, and does not
transport a patient, if the patient declines to be transported against medical advice, if the
ambulance service is coordinating the care of the enrollee through medical command or
telemedicine with a physician for a medical-based complaint, or with a behavioral health
specialist for a behavioral-based complaint under this section, shall be reimbursed at the
same rate as if the patient were transported to an emergency room of a facility provider.

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