Current through Register No. 40, October 3, 2024
(a) Except as provided by (c) below, claims
for general medical transportation delivered via private transportation shall
be reimbursed at the lesser amount of:
(1)
Actual number of miles billed multiplied by rate per mile; or
(2) The maximum allowable mileage for the
trip, multiplied by the rate per mile.
(b) All reimbursements shall be made by one
of the following methods:
(1) By direct
deposit to a checking account;
(2)
By direct deposit to a money bank card; or
(3) By paper check.
(c) Public transportation claims shall be
reimbursed in the following manner:
(1) To
either the recipient or to the transportation provider; and
(2) At the usual and customary charge made to
the general public if receipts are attached to the Form 13A.
(d) Reimbursement for tolls and
parking fees shall paid if the total cost is $3.00 or more per trip and
receipts are submitted with the completed Form 13A.
(e) Reimbursement for volunteer drivers when
a trip includes multiple passengers shall be as follows:
(1) For multiple trips in one day this shall
be limited to the submission of one claim per trip regardless of the number of
passengers;
(2) For the total miles
from the volunteer driver's point of origin to the farthest distanced medical
provider and return to the volunteer driver's point of origin; and
(3) For total miles in the claim submission
described in (2) above shall be paid at the actual mileage traveled or the
maximum mileage allowance per trip, in accordance with
He-W
574.10(c) , whichever is
less.
(f) Reimbursement
shall not be made:
(1) For trips provided
prior to the enrollment date of the provider;
(2) For claims submitted 90 days or more from
the date of the trip;
(3) If the
medicaid enrolled provider's signature as described in
He-W
574.06(b) is missing on the Form
13A;
(4) If the signature of the
driver or the recipient, or both, as described in
He-W
574.06(b) , is missing on the Form
13A;
(5) For general medical
transportation provided prior to the enrollment date of the volunteer,
recipient, or transit company driver; or
(6) For waiting time, which is defined as the
total time for which the driver must be in attendance for a recipient while the
recipient is receiving a medicaid covered medical or dental service.
(g) If a recipient is dual
enrolled, transportation of members of his or her assistance group shall
require submission of a claim for the costs of transportation as a recipient
driver only.
(h) Any claims
submitted by a recipient driver which are submitted for payment as a volunteer
driver shall be denied unless:
(1) The
recipient driver is also enrolled as a volunteer driver; and
(2) The recipient driver is providing general
medical transportation for a medicaid recipient who was unable to provide
transportation him/herself.
(See Revision Note at chapter heading He-W 500); ss by
#6163, eff 1-4-96, EXPIRED: 1-4-04
New. #8732, eff
9-30-06
