The following services are exempt from licensure under this subtitle: Air ambulance services licensed and based outside Maryland which transport patients from or within Maryland less than 26 times per year; or Ambulance services licensed and based outside Maryland which transport patients: Into Maryland; or To and from Maryland for diagnostic or therapeutic services in the same calendar day. An out-of-State ambulance service seeking an exemption from a service license shall submit a completed application on the required form to SOCALR. An exemption is not valid unless issued in writing by SOCALR for a specified period of time. A commercial ambulance service granted an exemption from this subtitle shall reapply for the exemption 30 days before expiration of the exemption. A service granted an exemption from this subtitle shall submit an annual report detailing the number of patients during the previous year who were transported: From the scene of a public safety medical emergency; and From any hospital or health care facility in Maryland. When transporting patients from the scene of a public safety medical emergency, an exempt service shall transport the patient to the closest appropriate facility according to Maryland Medical Protocol for EMS Providers. SOCALR may conduct an investigation to determine if an exemption should be revoked. A service granted on exemption shall notify SOCALR of any disciplinary action taken against the service by the licensing authority in the state in which the service is licensed. An exemption may be revoked if SOCALR finds the party to whom the exemption has been granted has: Obtained or attempted to obtain an exemption by fraud or deceit; Made material omission or misrepresentation of fact on an application for an exemption; Made a material omission or misrepresentation of fact in response to an inquiry or investigation by SOCALR; Defaced, altered, removed, or obliterated any portion of or any official entry on an exemption issued by SOCALR; Interfered with SOCALR in the performance of SOCALR's duties; Failed to reapply for an exemption; Violated any applicable federal, State, or local statute or regulation; Provided patient care which fails to meet the appropriate standard; or Been disciplined by the licensing authority in the state in which the service is licensed.