Current through Register Vol. 24-18, September 15, 2024
(1) The medicaid
agency requires:
(a) Brokers and
subcontracted transportation providers to be licensed, equipped, and operated
in accordance with applicable federal, state, and local laws, and the terms
specified in their contracts;
(b)
Brokers to:
(i) Screen their employees and
subcontracted transportation providers and employees prior to hiring or
contracting, and on an ongoing basis thereafter, to assure that employees and
contractors are not excluded from receiving federal funds as required by
42 U.S.C.
1320a-7 and
42 U.S.C.
1320c-5; and
(ii) Report immediately to the agency any
information discovered regarding an employee's or contractor's exclusion from
receiving federal funds in accordance with
42 U.S.C.
1320a-7 and
42 U.S.C.
1320c-5.
(c) Drivers and passengers to comply with all
applicable federal, state, and local laws and regulations during
transport.
(2) Brokers:
(a) Must determine the level of assistance
needed by the client (e.g., curb-to-curb, door-to-door, door-through-door,
hand-to-hand) and the mode of transportation to be used for each authorized
trip;
(b) Must select the lowest
cost available mode or alternative that is both accessible to the client and
appropriate to the client's medical condition and personal
capabilities;
(c) Must have
subcontracts with transportation providers in order for the providers to be
paid by the broker;
(d) Must
provide transportation services comparable to those available to the general
public in the local community;
(e)
May subcontract with licensed ambulance providers for nonemergency trips in
licensed ground ambulance vehicles; and
(f) Must negotiate in good faith a contract
with a federally recognized tribe that has all or part of its contract health
service delivery area, as established by 42 C.F.R. Sec. 136.22, within the
broker's service region, to provide transportation services when requested by
that tribe. The contract must comply with federal and state requirements for
contracts with tribes. When the agency approves the request of a tribe or a
tribal agency to administer or provide transportation services under WAC
182-546-5100 through
182-546-6200, tribal members may
obtain their transportation services from the tribe or tribal agency with
coordination from and payment through the transportation broker.
(3) If the broker is not open for
business and is unavailable to give advance approval for transportation to an
urgent care appointment or after a hospital discharge, the subcontracted
transportation provider must either:
(a)
Provide the transportation in accordance with the broker's after-hours
instructions and request a retroactive authorization from the broker within two
business days of the transport; or
(b) Deny the transportation, if the
requirements of this section cannot be met.
(4) If the subcontracted transportation
provider provides transportation as described in subsection (3)(a) of this
section, the broker may grant retroactive authorization and must document the
reason in the client's trip record.
11-17-032, recodified as WAC 182-546-5200, filed 8/9/11,
effective 8/9/11. Statutory Authority:
RCW
74.04.057,
74.08.090, and
74.09.500. 11-15-029, §
388-546-5200, filed 7/12/11, effective 8/12/11. Statutory Authority:
RCW
74.08.090,
74.09.500,
74.04.050,
74.04.055, and
74.04.057. 01-06-029, §
388-546-5200, filed 3/2/01, effective
4/2/01.
