(a) The following terms are defined:

1. (1) "911 call" means a communication indicating that an individual may need emergency medical services;

2. (2) "Alternative destination" means a lower-acuity facility that provides medical services, including without limitation:

   1. (A) A federally-qualified health center;
   2. (B) An urgent care center;
   3. (C) A rural health clinic;
   4. (D) A physician office or medical clinic as selected by the patient; and

   5. (E) A behavioral or mental health care facility including, without limitation, a crisis stabilization unit.

      "Alternative destination" does not include a:

   6. (A) Critical access hospital;
   7. (B) Dialysis center;
   8. (C) Hospital;
   9. (D) Private residence; or
   10. (E) Skilled nursing facility;
3. (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. (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. (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. (1) An emergency medical services agency to:

   1. (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;
   2. (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 health specialist for a behavioral-based complaint; or

   3. (C) An encounter between an ambulance service and enrollee that results in no transport of the enrollee if:

      1. (i) The enrollee declines to be transported against medical advice; and
      2. (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. (1) Only includes emergency medical services transportation to the treatment location;
2. (2) Is subject to the initiation of response, triage, and treatment as a result of a 911 call that is documented in the records of the emergency medical services agency;
3. (3) Is subject to deductibles or copayment requirements of the policy, contract, or plan;
4. (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. (5) Does not include rotary or fixed wing air ambulance services.