Section 170.255 - Out-of-state Ambulance Services(A) Ambulance services located in and licensed in another state are not required to be licensed in accordance with 105 CMR 170.000 if they are transporting patients from locations outside of Massachusetts to locations within Massachusetts.(B) No ambulance service shall regularly operate in Massachusetts unless the ambulance service is licensed in accordance with the provisions set forth in 105 CMR 170.000. An out-of-state ambulance service shall be deemed to be regularly operating in Massachusetts if: (1) the service advertises in Massachusetts, or otherwise solicits business in Massachusetts;(2) the service has a contractual agreement to provide ambulance service in Massachusetts; or(3) the service transports persons from locations within Massachusetts on a routine or frequent basis.(C) Out-of-state ambulance services which provide only backup service to Massachusetts ambulance services are exempt from the requirements of 105 CMR 170.255(B). However, such a service must be in compliance with all applicable licensing laws and regulations in the state in which the backup ambulance service is based.(D) If an out-of-state ambulance service regularly operates in Massachusetts, within the meaning of 105 CMR 170.255(B), that service shall either maintain a place of business within Massachusetts or make acceptable provisions for Department inspection of the service's vehicles and records. Such service shall meet all requirements imposed by M.G.L. c. 111C and 105 CMR 170.000 including being subject to enforcement and penalties for failure to comply, pursuant to 105 CMR 170.710 through 170.730, unless such requirements are waived by the Department.Amended by Mass Register Issue 1486, eff. 1/6/2023.