Okaloosa County BOCC — 2013 meeting #1139 (date undetermined) — MEDICAID ORIGINAL 2009 — reading text

lying position but do not require the administration of life support; or, (ii) Medicaid Beneficiaries who have severe mobility disabilities that render them unable to sit in an upright position for prolonged periods of time. (c) In questionable cases, the STP may require a medical professional's verification or documentation of a Medicaid Beneficiary's need for transport by a stretcher vehicle. (4) Public Transportation (where available) - In some areas of Florida, public transportation may be a viable and Cost Effective alternative to more traditional and expensive forms of Non- Emergency Transportation. For purposes of this Agreement, public transportation is any fixed-route transportation service that is available to the general public. (a) Transit companies, county or city governments, or federally funded transportation authorities may provide public transportation. (b) TheSTP_lT1ayus~ public transportation to provide afull Trip, or portion of a Trip, to or from a Medicaid compensable service. (c) The intent of this section is to maximize the use of fixed- route services. (5) Over-the-Road Bus (where available) - An over"the-road bus is traditionally used to traverse long distances such as cross-county and cross-state travel. (6) Private Volunteer Transportation (where available) - Private volunteer transportation is provided by individuals or agencies that receive no compensation or payment other than minimal reimbursement for Mileage for the provision of private volunteer transportation services. (a) The STP shall ensure that Medicaid Beneficiaries receive Transportation Services from a volunteer organization, 2008/2009 Medicaid Non-Emergency Transportation Subcontracted Transportation Provider Contract Page 36 of 117  including, if applicable, scheduling appointments, and notifying Medicaid Beneficiaries of arrangements. (b) The STP is responsible for all necessary payments (excluding co-payments, if any) to the private volunteer Transportation Provider. (c) Use of volunteer transportation does not alleviate the STP's responsibility to assure the safety, comfort, and appropriate mode of Transportation consistent with the Medicaid Beneficiary's health care status. The STP must ensure that all volunteers and vehicles used to provide private volunteer transportation are properly Licensed and insured. (7) Commercial Air Carrier Transportation - The STP may provide, where necessary or appropriate, commercial air carrier transportation to Medicaid Beneficiaries. (a) For in state Commercial Air Carrier Transportation, the Medicaid Beneficiary must provide documented proof to the STP before commercial air carrier transport that necessary medical services are not available within the Medicaid Beneficiary's city/community of residence, or an adjacent city/community, and that commercial air carrier transportation is the only viable option. 7. The STP shall provide Transportation Services and all related travel expenses, in accordance with 42 CFR 440.170, pertaining to related travel expenses (including the. costpfmealsand Jodging) and.. sscjes<:ribed_ il1_ the _Flortc:laMecjic(jid ['Jon- Emergency Transportation Services Coverage and Limitations Handbook. The STP is responsible for coordinating all Transportation Services, lodging, and related travel expenses, for out of state transportation and in state transportation, including: a. The cost of Transportation for the Medicaid Beneficiary by ambulance acting as a stretcher vehicle, taxicab, common carrier, commercial air carrier, or other appropriate means; and, b. The cost of an Attendant/Escort to accompany the Medicaid Beneficiary, if necessary, and the cost of the Attendant's/Escort's transportation, meals, lodging, and, if the Attendant/Escort is not a member of the Medicaid Beneficiary's family, cost of the Attendant's/Escort's services rendered based on the prevailing Medicaid rate. B. Excluded Services 1. The STP is not required to provide the following excluded services: 2008/2009 Medicaid Non-Emergency Transportation Subcontracted Transportation Provider Contract Page 37 of 117  a. Stretcher Vehicle Oxygen Administration - Stretcher van Transportation Providers are not required to be equipped to provide and administer oxygen to a Medicaid Beneficiary during a transport. Oxygen provided and administered by the Medicaid Beneficiary is appropriate for Transportation Services if no other medical equipment or medical care is required en route. (1) Stretcher Vehicle Transportation Providers are not required to be equipped to maintain a ventilator or care for a Medicaid Beneficiary who is ventilator-dependent during a transport. If a Medicaid Beneficiary has a battery-operated ventilator and a properly trained Escort will travel with the Medicaid Beneficiary to provide ventilator care en route to or from a doctor's office or some other Medically Necessary health care service, the Medicaid Beneficiary is eligible for Transportation Services if no other medical equipment or care is required en route. b. Ground Ambulance Transportation - Transportation Services do not include ground ambulance transportation unless the ground ambulance is under contract as a stretcher or wheelchair Transportation Provider as specified in the Wheelchair Vehicle Section, or the Stretcher Vehicle Section. (1) The STP is excluded from providing ground ambulance transportation if a local governmental ordinance mandates non-emergency stretcher transportation services be provided in a ground ambulance vehicle. c. Air Ambulance Transportation - Transportation Services do not include air ambulance transportation. d. Basic Life Support (BLS) and Advance Life Support (ALS) Transportation - For the purpose ,of this Agreement, Transportation Services do. not .include . the arrangement, coordination, or delivery of Transportation Services for Medicaid Beneficiaries who ~equire the administration of any level of life support services (ALS or BLS) during transport. C. Special Exclusions 1. The STP is not responsible for the coverage of: a. The cost of transporting a Medicaid Beneficiary back to Florida when the Medicaid Beneficiary voluntarily traveled outside of Florida and requires hospitalization and/or subsequent Nursing Facility care, unless a Medicaid Beneficiary received prior authorization to travel out of State for the purpose of receiving a Medicaid compensable service; b. Transportation for therapeutic home visits to or from a Hospital, hospice, nursing home, rCF/DD, State, or other private or public institution; 2008/2009 Medicaid Non·Emergency Transportation Subcontracted Transportation Provider Contract Page 38 of 117  c. Transportation of a Medicaid Beneficiary from one Hospital to another, one Nursing Facility to another, or from a Hospital to a Nursing Facility, solely based on the preference of the Medicaid Beneficiary or a member of the Medicaid Beneficiary's family, except as otherwise set forth in this Agreement; d. Transportation of deceased Medicaid Beneficiaries; e. Transportation of family members to visit a hospitalized or institutionalized Medicaid Beneficiary; f. Transportation of a Medicaid BenefiCiary to receive medical training; g. Transportation of Medicaid Beneficiaries to a pharmacy for the purpose of having a prescription filled; h. Transportation of a Medicaid Beneficiary to a medical facility or physician's office for the sole purpose of obtaining a medical recommendation or to pick up Medical Records; i. Transportation of a Medicaid Beneficiary for socialization and/or therapeutic field visits to locations other than the facility where such services are received; j. Transportation Services available to the general public free of charge; k. Transportation Services that are already covered by a per diem rate and