Ala. Admin. Code r. 560-X-18-.02

Current through Register Vol. 43, No. 1, October 31, 2024

Section 560-X-18-.02 - Definitions

(1) Recipient - An individual determined to be eligible for Medicaid under the state plan.

(2) Ambulance.

(a) Vehicle specifically designed and equipped for transporting the wounded, injured, ill, or sick. Medicaid recognizes three levels of ambulance services: Basic Life Support (BLS), Advanced Life Support (ALS), and Non-emergency Ambulance Transportation. For a concise definition of these ambulance services refer to the Ambulance (Ground & Air) and/or Non-emergency Transportation (NET) Program chapters of the Alabama Medicaid Provider Manual.

(b) All ambulances licensed and operating in Alabama shall have the essential equipment on board as listed in Rule No. 420-2-1-.04, Ambulance Vehicle Specifications; Emergency Medical Services Rules; Alabama Department of Public Health. Effective date of this publication is January 1991.

(c) Exceptions: The above referred rules, regulations, and standards shall not apply to:

1. Volunteer rescue squads that are members of Alabama Association of Rescue Squads.

2. Ambulances operated by federal agencies.

3. Ambulances which are rendering assistance to licensed ambulances in the case of an emergency in which the licensed ambulances of Alabama are insufficient or unable to provide necessary ambulance services.

4. Ambulances which are operated from a location or headquarters outside Alabama that transport patients from outside the state to locations within the state.

(d) No out-of-state ambulance shall be used to pick up patients for transportation point-to-point within Alabama unless the ambulance operator and ambulance attendant hold current Alabama licenses.

(3) License - No person shall be employed as ambulance attendant, ambulance driver, or ambulance driver-attendant; nor shall any person, firm, or corporation operate an ambulance, or ambulances, on the streets, alleys, or any public way or place in the State of Alabama without having first obtained a valid license from the Emergency Medical Service Division of the Alabama Department of Public Health.

(4) Emergency - Medical conditions of a serious or urgent nature that warrant immediate action to prevent the death or serious impairment of the health of the individual; e.g., accident, heart attack, acute stroke, etc.

(5) Accident - An unexpected happening causing loss or injury to the recipient.

(6) Qualified Provider of Medical Care - The medical source generally available and used by other residents of the community, if that source participates in the Medicaid program.

(7) Evident hardship - May justify an exception from the specific regulation where it is referenced, when the length of the trip, the frequency of the travel or the lack of other practical alternatives makes such an exception reasonable.

Author: Ginger Collum, Program Manager, Clinic/Ancillary Services

Ala. Admin. Code r. 560-X-18-.02

Rule effective October 1, 1982. Emergency rule effective June 28, 1991. Amended effective October 12, 1991. Amended: Filed July 7, 1994; effective August 12, 1994. Amended: Filed February 7, 1996; effective March 14, 1996. Amended: Filed July 12, 2001; effective August 16, 2001.

Statutory Authority: State Plan; 42 C.F.R. §§401etseq.; Title XIX, Social Security Act.