Current through Register Vol. 18, September 20, 2024
(1) "Air ambulance services" means ambulance
services provided by aircraft. There are two categories of air ambulance
services, namely, fixed wing (airplane) and rotary wing (helicopter) aircraft.
(a) Fixed wing air ambulance services are
furnished when the recipient's medical condition is such that transport by
ground ambulance, in whole or in part, is not appropriate. Generally, transport
by fixed wing air ambulance may be necessary because the recipient's condition
requires rapid transport to a treatment facility, and either great distances or
other obstacles, for example, heavy traffic, preclude such rapid delivery.
Transport by fixed wing air ambulance may also be necessary because the
recipient is inaccessible by land or water ambulance vehicle.
(b) Rotary wing air ambulance services are
furnished when the recipient's medical condition is such that transport by
ground ambulance, in whole or in part, is not appropriate. Generally, transport
by rotary wing air ambulance may be necessary because the recipient's condition
requires rapid transport to a treatment facility, and either great distances or
other obstacles, for example, heavy traffic, preclude such rapid delivery.
Transport by rotary wing air ambulance may also be necessary because the
recipient is inaccessible by land or water ambulance vehicle.
(2) "Ambulance" means a vehicle
that:
(a) is specifically designed for
transporting the sick or injured;
(b) contains a stretcher, linens, first aid
supplies, oxygen equipment, and other lifesaving equipment required by state or
local laws; and
(c) is staffed with
personnel trained to provide first aid treatment.
(3) "Ambulance services" means services
provided by a licensed ambulance provider in the ground or air transportation
of a sick or injured person in a specially designed and equipped vehicle as
defined above, which includes a trained ambulance attendant who is licensed or
certified as required by state law.
(4) "Appropriate facility" means an
institution equipped to provide the required hospital or nursing care for the
illness or injury involved. In the case of a hospital, it also means that a
physician or a physician specialist is available to provide the necessary care
required to treat the patient's condition. However, the fact that the patient's
personal physician does not have staff privileges in a hospital is not a
consideration in determining whether the hospital is an appropriate
facility.
(5) "Emergency services"
means services provided after the sudden onset of a medical condition
manifesting itself by acute symptoms of such severity (including severe pain)
that the absence of immediate medical attention could reasonably be expected to
result in placing the patient's health in serious jeopardy, serious impairment
to bodily functions, or serious dysfunction of any bodily organ or
part.
(6) "Ground ambulance
services" means ambulance services provided by a vehicle designed to operate on
the ground, including both water and land. Ground ambulance services include:
(a) Basic life support (BLS), which includes,
when medically necessary, the provision of BLS services as defined in the
national EMS education and practice blueprint for the EMT-basic, including
other basic life support services, or the ambulance must be staffed by an
individual who is qualified in accordance with state and local laws as an
emergency medical technician-basic (EMT-basic);
(b) Basic life support emergency, which is
furnished, when medically necessary, as specified above in (6)(a), in response
to an emergency as defined in this rule;
(c) Advanced life support, level 1 (ALS1),
which includes, when medically necessary, provision of an assessment by an ALS
provider trained to the level of the emergency medical technician-intermediate
or paramedic as defined in the national EMS education and practice blueprint or
in accordance with state and local laws or the provision of one or more ALS
interventions, that is, a procedure beyond the scope of an EMT-basic as defined
in (6)(a). An ALS assessment does not necessarily result in a determination
that the patient requires an ALS level of service.
(d) Advanced life support, level 1 (ALS1)
emergency, which includes, when medically necessary, the provision of ALS1
services specified in (6)(c) above, in response to an emergency as defined in
this rule;
(e) Advanced life
support, level 2 (ALS2), which includes, when medically necessary, supplies and
services including the administration of at least three separate
administrations of one or more different medications or the provision of at
least one of the following ALS procedures:
(i) manual
defibrillation/cardioversion;
(ii)
endotracheal intubation;
(iii)
central venous line;
(iv) cardiac
pacing;
(v) chest
decompression;
(vi) surgical
airway;
(vii) intraosseous
line;
(f) Specialty care
transport (SCT), which includes, when medically necessary, for a
critically-injured or ill recipient, a level of interfacility service provided
beyond the scope of the paramedic. SCT is necessary when a recipient's
condition requires ongoing care that must be provided by one of more health
professionals in an appropriate specialty area such as nursing, medicine,
respiratory care, cardiovascular care or paramedic with additional
training.
(7)
"Nonemergency" means all scheduled transportation, regardless of origin and
destination, that does not meet the above criteria for emergency. By
definition, hospital discharge trips, trips to and from end stage renal disease
(ESRD) facilities for maintenance dialysis, trips to and from other outpatient
facilities for chemotherapy or radiation therapy, and other diagnostic and
therapeutic services are scheduled runs and, therefore, are considered to be
"nonemergency" services.
53-6-113,
MCA; IMP,
53-6-101,
53-6-113,
53-6-141,
MCA;
