New Jersey Administrative Code
Title 10 - HUMAN SERVICES
Chapter 66 - INDEPENDENT CLINIC SERVICES
Subchapter 2 - PROVISION OF SERVICES
Section 10:66-2.17 - Transportation services

Universal Citation: NJ Admin Code 10:66-2.17

Current through Register Vol. 56, No. 18, September 16, 2024

(a) Transportation services shall be covered under the Medicaid and NJ FamilyCare-Plan A, B, C, and D programs and the Alternate Benefit Program (ABP) when the following conditions are met:

1. The clinic is approved to provide transportation service by the Division to partial care programs only.
i. Approval by the Division shall not be granted for the provision of ambulance or mobility assistance vehicle (MAV) service.

2. Transportation service to the partial care programs is provided either:
i. By the clinic, in a clinic owned or leased vehicle; or

ii. By a transportation company under contract to the clinic, which meets the requirements of 10:49-9.8 and (b) below.

3. The purpose of providing transportation, one way or round trip, is to enable a Medicaid/NJ FamilyCare or ABP beneficiary to obtain partial care services.

4. A Medicaid/NJ FamilyCare or ABP beneficiary is transported:
i. To the clinic, from the beneficiary's residence or a designated central point; or

ii. From the clinic, to the beneficiary's residence or a designated central point.

5. The least expensive mode of transportation suitable to the beneficiary's needs shall be used, as indicated at N.J.A.C. 10:50-1.6(a).
i. A clinic shall not seek reimbursement from the Medicaid or NJ FamilyCare programs for the transport of an individual who is capable of utilizing an accessible, alternative mode of transportation at a lesser cost to the Medicaid or NJ FamilyCare programs, such as a bus pass provided by the transportation broker for the beneficiary's use.

ii. Prior to seeking reimbursement from the Medicaid or NJ FamilyCare programs for a clinic-provided or subcontracted transportation service, the patient's medical record shall contain documentation concerning the individual's specific transportation-related needs, including the reason(s) why an accessible, alternative less-expensive mode of service is not appropriate.

iii. Following are examples of factors that may be considered when determining the individual's ability to use an alternative mode of service: walking distance to/from the points of pick up and discharge, weather conditions at the time of transport, time of day or night, safety issues, the patient's need for an escort/attendant, and the patient's inability to access public transportation.

(b) Each vehicle used by a clinic or its subcontractor(s) in providing services to a Medicaid or NJ FamilyCare beneficiary shall be appropriately registered by the New Jersey Motor Vehicle Commission, in accordance with all applicable laws and rules of the New Jersey Motor Vehicle Commission, Title 39 of the Revised Statutes, or the New Jersey Department of Transportation, Title 27 of the Revised Statutes).

1. All applicable Federal and State motor vehicle laws shall be followed, including laws governing seat belts and infant car seats.

(c) Each person (driver) who operates a motor vehicle under the terms of this section shall possess and have readily available for inspection a current and valid New Jersey driver's license, as required by Title 39 of the Revised Statutes of New Jersey.

1. A driver of a commercial motor vehicle that is designed to transport eight to 15 passengers including the driver (Group C), and is used for hire, shall possess a commercial driver's license (CDL) with a passenger endorsement issued by the New Jersey Motor Vehicle Commission, in accordance with 39:3-10.1 1 and 13:21-23.5;

2. Each driver shall be at least 18 years old;

3.

(Reserved)

4. Each driver shall wear an identification badge that includes his or her name and the name of the transportation company or the clinic;

5. Each driver shall maintain an acceptable standard of personal grooming and behavior in order to present a neat, clean and professional appearance while providing services to Medicaid/NJ FamilyCare fee-for-service beneficiaries;

6. Each driver shall assist beneficiaries in entering and leaving the vehicle by using a step stool if necessary, and shall provide door-through-door escort and assistance, if necessary, at the beneficiary's place of departure and destination;

7. Each driver shall supervise the well being of individuals while in the vehicle to ensure their privacy, comfort, and appropriate care;

8. Each driver shall ensure that all vehicle occupants wear automobile safety belts;

9. Each driver shall operate the vehicle in a safe manner, starting and stopping slowly and smoothly, and complying with all applicable motor vehicle laws;

10. Each driver shall ensure that smoking is prohibited within the vehicle at all times;

11. No person shall be allowed to operate a vehicle under the terms of this section:
i. While under the influence of intoxicating liquor or narcotic or habit forming drugs;

ii. In a reckless manner;

iii. At excessive speed; or

iv. While engaging in any illegal conduct.

(d) (Reserved)

Disclaimer: These regulations may not be the most recent version. New Jersey may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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