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Local County or Tribal Agency Nonemergency Medical Transportation (NEMT) Services

Revised: 06-19-2017

  • Overview
  • Eligible Providers
  • Eligible Recipients
  • Covered Services
  • Noncovered Services
  • Authorization Requirements
  • Billing
  • Legal References
  • Overview

    Local county or tribal agency nonemergency medical transportation (NEMT) service is transportation provided for eligible Minnesota Health Care Programs (MHCP) recipients by local county and tribal agencies to allow the recipients access to receive covered medical services or to attend MHCP service-related appeal hearings. Eligible fee-for-service (FFS) recipients do not need to be certified for state-administered NEMT services to receive local agency NEMT transport services.

    The local county or tribal agency must inform the recipients of their transportation options and requirements to correctly access those services. Information to recipients must include but is not be limited to the following:

  • • Scheduling process
  • • Types of transports available
  • • Reimbursements including the rural urban commuting area (RUCA), documentation, and billing for reimbursement within the timeframes for the recipients or the transportation providers to bill the local agency for reimbursement.
  • • How long it takes the local agency to reimburse the recipient or the transportation providers.
  • Minnesota Nonemergency Transportation (MNET) coordinates local agency NEMT for some counties through a host county contract. Hennepin County is the host county for the contract for local agency NEMT coordination in these counties: Anoka, Benton, Chisago, Dakota, Hennepin, Isanti, Mille Lacs (added April 1, 2017), Ramsey, Sherburne, Stearns, Washington and Wright. Contact for these counties continues to be Medical Transportation Management’s Minnesota Nonemergency Transportation (MTM-MNET). FFS recipients who live in these counties must contact MTM MNET at 866-467-1724 for local agency NEMT services.

    For all other counties, contact the local county or tribal agency for NEMT transport processes and procedures.

    Note: Although assisted transport (Mode 4) is listed as a state-administered NEMT service, the local county or tribal agency is responsible for arranging the ride with a qualified provider, reimbursing the provider for the transport, and billing MHCP for reimbursement paid to the transportation provider. If a transportation provider is providing services within the counties contracted with MNET, they must be enrolled as a transportation provider with MNET before they can receive reimbursement for services they provide.

    Local agency NEMT transport services are sometimes referred to as “common carrier.” This includes the following:

  • • Taxi, bus, light rail, other commercial carriers (unassisted transport)
  • • Volunteer driver (volunteer mileage)
  • • Personal mileage
  • • Airfare
  • Local agency NEMT transportation services provided by the NEMT provider include the following:

  • • Helping the recipient to and from the vehicle when necessary
  • • Helping the recipient to safely enter and exit the vehicle when needed
  • • Verifying the recipient is safely secured in the vehicle
  • • Helping to secure the recipient when necessary
  • Ancillary Access Services
    Local county and tribal agencies administer reimbursement of related travel expenses when necessary to allow recipients to obtain a covered health service.

    Ancillary access services available include:

  • • Lodging
  • • Meals
  • • Parking and tolls
  • Refer to the Access Services Ancillary to Transportation page for more information.

    Eligible Providers

    The county or tribal agency uses transportation providers or private automobile to provide transportation services to FFS recipients. Contact the local county or tribal agency for their transportation service enrollment or contracting information and requirements.

    Examples of local agency NEMT providers include the following:

  • • Personal vehicle
  • • Volunteer drivers
  • • Bus, light rail
  • • Taxi and dial-a-ride services
  • • Airplane
  • County and Tribal Agencies
    Effective July 1, 2016, all NEMT providers must comply with the operating standards for vehicles and drivers according to Minnesota Statutes 174.29 and 174.30. NEMT providers that are not certified by the Minnesota Department of Transportation (MnDOT) by July 1, 2016, must request a variance from these operating standards. Publicly operated transit systems, volunteers, and not-for-hire vehicles are exempt from the requirement.

    Provider Type Home Page Links
    Review related Web pages for the latest news and additions, forms, and quick links.

    Eligible Recipients

    Fee-for-service MHCP recipients enrolled in the following programs are eligible to receive transportation services:

  • Emergency Medical Assistance (EMA)
  • Medical Assistance (MA)
  • • State-only funded MA benefits due to residing in an Institution for Mental Disease (IMD)
  • MinnesotaCare for recipients under the age of 21 or pregnant woman
  • Minnesota Family Planning Program (MFPP)
  • • Refugee Medical Assistance (RMA)
  • For recipients enrolled in a managed care organization (MCO), or transportation services provided through a waiver program, refer to Eligible Recipients in the Nonemergency Medical Transportation (NEMT) Services (Overview) section.

    MinnesotaCare members enrolled in a managed care plan with dates of service on and after January 1, 2017, will only receive or be reimbursed for personal mileage (mode 1), unassisted transport—air fare only (mode 3), and out-of-state transport and ancillary services (lodging, meals, parking or tolls) through the local county or tribal agencies. All other NEMT transports are accessed through the health plan.

    Recipients must contact MNET or their local county or tribal agency for policies and procedures for scheduling or obtaining local agency NEMT-related ancillary services or reimbursements.

    Covered Services

    Refer to Covered Services in the Nonemergency Medical Transportation (NEMT) Services (Overview) section for general service coverage requirements.

    Refer to Multiple Riders in the Transportation Overview section for information on transporting multiple MHCP recipients at the same time from a single pick-up (origination) location for dates of service on or prior to June 30, 2017. Effective with dates of service on and after July 1, 2017, the proration of multiple rider NEMT transports no longer applies.

    Also see One-time Transport Assessments and Upgrades in the Transportation Overview section.

    Local agency NEMT is a covered service when nonemergency transportation services are provided for the following:

  • • To enable a recipient to obtain a covered health service. Transport is limited to a provider within 30 miles of the recipient’s home or residence for primary care and 60 miles from the home or residence for specialty care. (Refer to the NEMT Authorization Requirements table for mileage exceeding the 30-mile and 60-mile limits.)
  • • To enable eligible MHCP recipients to attend MHCP-related appeal hearings
  • • To help a recipient who needs assistance
  • • To provide a ride from origination (pick-up) location to destination (drop-off) location by the most direct route
  • • The most appropriate and cost-effective level of transport to meet the needs of the recipient
  • • The recipient and, when necessary, one responsible person who is needed to make medical decisions, learn about the recipient’s medical care services, or is otherwise necessary to allow the recipient to get to or receive a covered medically necessary service. This includes, but is not limited to, a family member, relative, authorized representative or legal guardian
  • • When transporting one responsible person or one or more siblings from a single location separately from the recipient is necessary to enable family therapy services established in the recipient’s plan of care to be completed. This includes when a child or parent is in a residential facility and a responsible person, sibling(s) or spouse is required to attend to complete therapy service. The recipient receiving care does not need to be included in the transport.
  • • When an additional attendant is needed to enable the transport of a recipient
  • Electroconvulsive Therapy, Dialysis and Outpatient Procedures with Sedation
    Recipients who receive electroconvulsive therapy (ECT), dialysis, or outpatient procedures with sedation are eligible for local agency NEMT to and from the service. Recipients may require state-administered NEMT transport for the return trip. Refer to the State-Administered NEMT Transportation Services section for Authorization Requirements. Refer to Transportation Upgrade in the State-Administered NEMT Transportation Services section for covered services.

    Personal Mileage Reimbursement
    Personal mileage is the least costly method of transport and is reimbursed by the local county or tribal agency. Recipients who have a vehicle must use personal mileage and are not eligible for other modes of transport.

    Personal mileage reimbursement cannot be denied based on a minimal distance driven to obtain the MHCP covered medical service. The mileage to and from the eligible service by the most direct route is reimbursable. The local agency may hold personal mileage reimbursement until a reasonable amount has been accrued before generating a payment. The local county or tribal agency may deny personal mileage that exceeds the 30 or 60 mile limits when not authorized, coordinated or delivered according to local agency policies and procedures.

    Refer to the following exceptions from the use of the personal mileage requirement:

  • • Recipient has a medical condition that prevents the safe operation of a motor vehicle
  • • A qualified medical professional must provide documentation
  • • Exclusion may be time limited
  • • The transportation coordinator (county or tribal local agency, or entity hired to act on behalf of the county or tribe) may consider other reasonable exclusions for a vehicle being unavailable for use
  • • Recipient must provide supporting documentation
  • • Exclusion may be time limited
  • Personal mileage reimbursement requirements include, but may not be limited to the following:

  • • Personal mileage requirements apply to the client and people who have a relationship (vested interest) to the recipient. This includes, but is not limited to family, friends, relatives, neighbors, personal care assistants (PCA), home health aides (HHA), other personal attendants, corporate foster care staff or county social worker.
  • • The recipient must complete and submit personal mileage trip-log sheets for reimbursement. The local agency establishes trip-log submission deadlines. Trip logs must include the following:
  • • Recipient name and MHCP ID number
  • • Date of service
  • • Name of medical provider or facility
  • • Address of residence (trip origination location) and medical provider or facility (destination location)
  • • Verification of medical appointment. Acceptable verification may include a signature from the medical provider or facility or copy of the medical appointment explanation of benefits
  • MHCP covers corporate or business foster care provider mileage reimbursement when:

  • • Transportation reimbursement is not part of the per diem or negotiated rate paid to the corporate foster care provider
  • • The foster care provider has a vested interest to the recipient unless enrolled as an NEMT provider with the county or tribal agency. If enrolled with the local agency as an NEMT provider, the transport rate is negotiated by the county or tribal agency
  • Local agency-recognized volunteer drivers must meet both of the following:

  • • Recognized as a volunteer driver by the county or tribal agency
  • • Available to transport all members of the community
  • Refer the volunteer driver or volunteer driver organization to the Minnesota Department of Revenue’s website and their Volunteer Mileage Reimbursement page for information related to volunteer driver reimbursement, possible tax implications and requirements for issuing Form 1099.

    For reimbursement of parking, meals and lodging, refer to the Access Services Ancillary to Transportation page.

    Noncovered Services

    Refer to Noncovered Services in the Nonemergency Medical Transportation (NEMT) Services (Overview) section.

    Transport provided by a PCA, HHA, corporate foster care, county social worker or case worker, etc., is not reimbursable if transportation is reimbursed by other program funds.

    Transport of an Emergency Medical Assistance (EMA) recipient for the purpose of obtaining routine or preventative medical care or services is not covered.

    Authorization Requirements

    Refer to Authorization for general authorization requirements. Refer to the Authorization section in the Nonemergency Medical Transportation (NEMT) Services (Overview) for more specific information. Local county or tribal agencies may require authorization for the transportation services they provide or reimburse.

    Out-of-State Medical Services

    Refer to the Nonemergency Medical Transportation (NEMT) Services (Overview) section for out-of-state medical services.

    Billing

    Refer to Billing in the Nonemergency Medical Transportation (NEMT) Services (Overview) section for billing policy information. Refer to the MN–ITS User Guide for specific billing instructions.

    Local agency administered NEMT providers do not bill MHCP for service reimbursements. Contact the local county or tribal agency for reimbursement processes.

    County or Tribal Agencies
    Local county and tribal agencies may reimburse the recipient or the provider directly for costs incurred. Reimbursement is the lesser of the recipient’s or provider’s submitted charge and the MHCP calculated allowable. The calculated allowable is the maximum amount MHCP will reimburse the local agency.

    Personal Mileage Reimbursement Rate
    Personal mileage is reimbursed as follows:

  • • Paid to the owner of the vehicle providing the transport at:
  • • Dates of service on and before June 30, 2016, is 20 cents per loaded mile
  • • Dates of service on and after July 1, 2016, is 22 cents per loaded mile
  • • Paid to corporate or business foster care provider at the IRS business mileage deduction rate in effect on the date of transport
  • IRS Business Mileage Deduction Rate
    Reimbursement is paid at the IRS business mileage deduction rate in effect on the date of transport. The IRS rate is paid only to the following:

  • • Licensed foster parent (individual listed on the foster parent license)
  • • Volunteer drivers recognized by the local agency
  • See the Minnesota Department of Revenue’s website and their Volunteer Mileage Reimbursement information page for additional information on volunteer driver reimbursement, possible tax implications and issuing of Form 1099.

    For the NEMT billing process, refer to the Procedure Codes, Modifiers and Payment Rates web page.

    For the ancillary access services billing process, refer to the Ancillary Access Service Procedure Codes, Modifiers and Payment Rates web page.

    Legal References

    Laws of Minnesota 2014, chapter 312, article 24, section 28 NEMT provider requirement
    Laws of Minnesota 2014, chapter 312, article 24, section 45
    Waiver Applications for Nonemergency Medical Transportation Service Providers
    Minnesota Statutes 174
    (Department of Transportation)
    Minnesota Statutes 174.29-174.30
    (Coordination of Special Transportation Service)
    Minnesota Statutes 256B.0625
    , subd.17(Transportation costs)
    Minnesota Statutes 256B.0625
    , subd.17a (Payment for ambulance services)
    Minnesota Statutes 256B.0625
    , subd.18 (Bus or taxicab transportation)
    Minnesota Statutes 256B.0625
    , subd.18a (Access to medical services)
    Minnesota Rules 8840.5925
    (Vehicle Equipment)
    Minnesota Rules 9505.0315
    (Medical Transportation)
    Minnesota Rules 9505.0445
    (Payment Rates)

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