Current through Register Vol. 50, No. 9, September 20, 2024
A.
Transportation-community access services are provided to assist the beneficiary
in becoming involved in his or her community. The service encourages and
fosters the developmental of meaningful relationships in the community which
reflects the beneficiary's choice and values. This service provides the
beneficiary with a means of access to community activities and resources. The
goal is to increase the beneficiary's independence, productivity, and community
inclusion and to support self-directed employees benefits as outlined in the
beneficiary's POC.
1. Transportation-community
access services are to be included in the beneficiary's plan of care.
2. The beneficiary must be present for the
service to be billed.
3. Prior to
accessing transportation-community access services, the beneficiary is to
utilize free transportation provided by family, friends, and community
agencies.
4. When appropriate, the
beneficiary should access public transportation or the most cost-effective
method of transportation prior to accessing transportation-community access
services.
B. Service
Limits
1. Community access trips are limited
to no more than three round trips per day and must be arranged for geographic
efficiency.
2. Greater than three
trips per day require approval from the department or its designee.
a. Repealed.
C. Service Exclusions
1. Transportation-community access services
shall not replace the following services:
a.
transportation services to medically necessary services under the Medicaid
State Plan;
b. transportation
services provided as a means to get to and from school; or
c. transportation services to or from day
habilitation, prevocational services, or supported employment
services.
2.Transportation-community access services
are not available to beneficiaries receiving the following services:
a. shared living;
b. host home; or
c. companion care.
d. - e. Repealed.
3. Transportation-community access will not
be used to transport beneficiaries to day habilitation, pre-vocational, or
supported employment services.
4.
Transportation-community access services may not be billed for the same day at
the same time as community living supports.
D. Provider Qualifications. Friends and
family members who furnish transportation-community access services to waiver
beneficiaries must be enrolled as Medicaid nonemergency medical transportation
(NEMT) family and friends providers with the Department of Health (Bureau of
Health Services Financing).
1. In order to
receive reimbursement for transporting Medicaid recipients to waiver services,
family and friends must maintain compliance with the following:
a. state minimum automobile liability
insurance coverage;
b. possess a
current state inspection sticker; and
c. possess a current valid driver's
license.
2. No special
inspection by the Medicaid agency will be conducted.
3. Documentation of compliance with the three
listed requirements for this class of provider must be submitted when
enrollment in the Medicaid agency is sought. Acceptable documentation shall be
the signed statement of the individual enrolling for payment that all three
requirements are met.
a. The statement must
also have the signature of two witnesses.
4. NEMT (family and friends transportation)
providers may provide for up to three identified waiver
beneficiaries.
E.
Vehicle Requirements. All vehicles utilized by for profit and non-profit
transportation services providers for transporting waiver beneficiaries must
comply with all of the applicable state laws and regulations and are subject to
inspection by the department or its designee.
AUTHORITY
NOTE: Promulgated in accordance with
R.S.
36:254 and Title XIX of the Social Security
Act.
