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DOH Clarifies MLTC Transportation Benefit

In policy guidance issued this week, the Department of Health (DOH) reminds Managed Long Term Care (MLTC) plans to have policies and procedures in place to monitor the effectiveness of covered transportation. Plans must ensure that the appropriate level of service is being provided to meet the enrollee's condition and conform to the Person Centered Service Plan (PCSP).  

Plans are required to use only approved Medicaid ambulette vendors to provide ambulette transportation services to MLTC plan members, while other modes of transportation may be provided by non-Medicaid enrolled providers, as long as appropriate licensure is in place. Transportation may be provided by means of a wheelchair van, ambulance, ambulette, taxi or livery service, or public transportation.

Plans should have a formal process for credentialing subcontracted providers on a periodic basis (initially and not less than once every three years) and for monitoring provider performance. DOH also expects plans to conduct periodic contract monitoring to ensure that insurance coverage is in place and recommends that plans review their existing policies and procedures to ensure all the requirements are addressed. The guidance document is available here.

Contact: Darius Kirstein, dkirstein@leadingageny.org, 518-867-8841