§ 26.1-47-09 — Air ambulances

1. A health benefit plan may not be issued in this state unless the plan provides the
reimbursement rate for out-of-network air ambulance provider services is equal to the
average of the insurer's in-network rates for air ambulance providers in the state.
2. An insurer may not use the average of an insurer's in-network rates for air ambulance
providers in the state in order to decrease current or future contractual rates between
an insurer and an air ambulance provider.
3. For purposes of settling a claim made by the insured for air ambulance services, a
payment made by an insurer under the plan in compliance with this section is deemed

to be the same as an in-network payment and is considered a full and final payment by
the insured for out-of-network air ambulance services billed to the insured.
4. This section does not apply to a policy or certificate of insurance, whether written on a
group or individual basis, which provides coverage limited to:
a. A specified disease, a specified accident, or accident-only coverage;
b. Credit;
c. Dental;
d. Disability;
e. Hospital;
f. Long-term care insurance as defined by chapter 26.1-45;
g. Vision care or any other limited supplemental benefit;
h. A Medicare supplement policy of insurance, as defined by the commissioner by
rule or coverage under a plan through Medicare;
i. Medicaid;
j. The federal employees health benefits program and any coverage issued as a
supplement to that coverage;
k. Coverage issued as supplemental to liability insurance, workers' compensation,
or similar insurance; or
l. Automobile medical payment insurance.