1. “Air ambulance” means ambulance services provided by fixed or rotor wing ambulance services;

2. “Alliance” means the Oklahoma Ambulance Alliance or its successor association;

3. “Ambulance” means a motor vehicle that is primarily used or designated as available to provide transportation and basic life support or advanced life support;

4. “Ambulance service” or “ambulance service provider” means any private firm or governmental agency which is or should be licensed by the State Department of Health to provide levels of medical care based on certification rules or standards promulgated by the State Commissioner of Health;

5. “Department” means the State Department of Health;

6. “Emergency” or “emergent” means a serious situation or occurrence that happens unexpectedly and demands immediate action, such as a medical condition manifesting itself by acute symptoms of sufficient severity including severe pain such that the absence of immediate medical attention could reasonably be expected, by a reasonable and prudent layperson, to result in placing the patient's health in serious jeopardy, serious impairment to bodily function or serious dysfunction of any bodily organ or part;

7. “Emergency transport” means the movement of an acutely ill or injured patient from the scene to a health care facility or the movement of an acutely ill or injured patient from one health care facility to another health care facility;

8. “Licensure” means the licensing of emergency ambulance services pursuant to rules and standards promulgated by the State Commissioner of Health;

9. “Net operating revenue” means the gross revenues earned for providing emergency and nonemergency transports in Oklahoma excluding revenues earned for providing air ambulance services and amounts refunded to or recouped, offset or otherwise deducted by a patient or payer for ground medical transportation;

10. “Nonemergency transport” means the movement of any patient in an ambulance other than an emergency transport;

11. “Upper payment limit” means the lesser of the customary charges of the ambulance service provider or the prevailing charges in the locality of the ambulance service provider for comparable services under comparable circumstances, calculated according to methodology in an approved state plan amendment for the state Medicaid program; and

12. “Upper payment limit gap” means the difference between the upper payment limit of the ambulance service provider and the Medicaid payments not financed using the ambulance service provider assessments made to all ambulance service providers, provided that the upper payment limit gap shall not include air ambulance services.