Ala. Admin. Code r. 560-X-18-.19

Current through Register Vol. 42, No. 12, September 30, 2024

Section 560-X-18-.19 - Administration Of The NET Program

(1) The Alabama Medicaid Agency staff, including Regional NET Coordinators and Central Office staff, serve as the point of contact and assist with scheduling the least expensive appropriate NET on a statewide basis. Recipients must contact the Agency to request transportation assistance five days prior to the needed transportation or within 24 hours after urgent care appointments. The Alabama Medicaid Agency arranges necessary non-emergency transportation services for Medicaid recipients. The responsibilities of the NET Program include, but are not limited to, the following:

(a) Determine availability of free transportation; this includes recipient's vehicle, transportation by relative or friend or volunteer services. Medicaid reimbursements are not awarded if recipient has access to free transportation, except in the case of evident hardship.

(b) Determine mileage reimbursement for recipient's vehicle or friend, relative or volunteer driver.

(c) Determine evident hardship.

(d) Verify eligibility; no reimbursement is available for transportation to/from non-covered medical services.

(e) Verify scheduled medical appointment.

(f) Determine the least costly appropriate means of transportation services.

(g) Assign prior authorization number

(h) Coordinate in-state and out-of-state commercial bus, train, or air transportation; Approve the use of commercial buses, trains or airplanes for in-state and out-of-state use for Medicaid recipients.

(i) The Alabama Medicaid Agency may issue a travel reimbursement through Electronic Benefit Transfer (EBT) for the cost of fare for recipients who are able to ride public transportation to medical services; public transportation should be utilized whenever possible; before other modes of more expensive transportation are authorized, there should be a determination that public transportation cannot meet the recipient's needs.

(j) Issue reimbursements to the recipient or redirect the reimbursement on behalf of the recipient to an address determined to be more appropriate than the address on file

(k) Compile information on all certified and licensed transporters.

(l) Complete retrospective utilization review of transportation reimbursements issued.

(2) Alabama NET Program is operated by Agency staff as an administrative service. Alabama provides for methods of administration that are necessary for the proper and efficient operation of the program.

Ala. Admin. Code r. 560-X-18-.19

New Rule: Filed February 7, 1996; effective March 14, 1996. Amended: Filed August 11, 2010; effective September 15, 2010.

Author: Dorothy Powell, Associate Director, Non-Emergency Transportation Program

Statutory Authority: State Plan; 42 C.F.R. § 431.53; Title XIX, Social Security Act.