Regulation .05 Limitations.

Services not rendered in response to a 911 call unless delivered as part of a mobile integrated health visit;

Services performed or billed by an emergency services transporter that is not enrolled in the Program;

Services rendered by an emergency services transporter in response to a 911 call when the participant refuses medical services and transport of the participant does not occur;

Services rendered to anyone other than an eligible participant;

Services for which proper documentation, including but not limited to run sheets, cannot be provided on request of the Department or its designee;

Services not indicated by the medical protocols adopted by the EMS Board;

Mobile integrated health services delivered to participants younger than 18 years old; and

Services delivered in any setting other than the eligible participant’s home or any community-based site permitted under the medical protocols adopted by the EMS Board.