![]() The request must be made in the manner required by the prior authorization official. Prior authorization generally must be obtained by the medical assistance recipient, his representative, or an ordering practitioner before the transportation expenses are incurred, but such authorization is not required for emergency ambulance transportation or Medicare approved transportation by an ambulance service under certain circumstances. Prior authorization will be granted by the prior authorization official only when payment for transportation expenses is essential in order for an eligible MA recipient to obtain necessary medical care and services which may be paid for under the medical assistance program.” 18 NYCRR §505.10(a). “Generally, payment will be made only upon prior authorization for transportation services provided to an eligible medical assistance recipient. The complete list of contact phone numbers for the transportation vendors in each county is available here: Prior Authorization for Non-Emergency Transportationġ8 NYCRR §505.10 is the regulation governing transportation for medical care and services. LogistiCare continues to be the contractor for Nassau and Suffolk Counties. Medical Answering Services, LLC is handling New York City transportation as of April 23, 2017. State Contractors Handle Transportation for all in Mainstream Managed Care, Fee For Service, and in Feb. The carve out was expected to take place in Oct. HOWEVER, this service will be "carved out" and handled by a State contractor centrally. Transportation has remained a plan benefit for Managed Long Term Care (MLTC), requiring MLTC enrollees to arrange for non-emergency transportation through their plans. Managed Long Term Care ( MLTC) Members - change coming Feb. ![]() Medical Answering Services, LLC, which until recently managed transportation in all counties statewide except Nassau, Suffolk, and New York City, was recently awarded the contract for New York City transportation. Enrollees in mainstream Medicaid managed care plans do not access transportation services through their plans, but directly through private contractors. Non-emergency transportation was carved out of the Medicaid managed care benefit package as part of the 2011 Medicaid Redesign Team's Transportation Reform Initiative. All non-emergency transportation must be authorized prior to payment and only emergency ambulance transportation can be reimbursed without a prior authorization. Medicaid will pay for the most medically appropriate and cost-effective level of transportation to and from services covered by the Medicaid Program. However, for some Medicaid beneficiaries, their medical condition necessitates another form of transportation, such as an ambulette. ![]() Generally, this mode is public transit or a personal vehicle. When travelling to medical appointments, a Medicaid beneficiary is expected to use the same mode of transportation as the beneficiary would use to carry out the activities of daily life. §431.53) to assure necessary transportation to Medicaid beneficiaries to and from medical services. ![]() States are required under federal regulations (42 C.F.R. ![]()
0 Comments
Leave a Reply. |
Details
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |