Purpose

Medical Assistance consumers residing in Pennsylvania are entitled to transportation services necessary to secure medical care provided under the Medical Assistance program. Counties that accept the program must comply with the conditions set forth in this document and its attachments. The County assures that medical transportation services are provided to eligible County residents.

Medical transportation services are defined as non-emergency transportation of Medical Assistance (MA) recipients to any MA compensable service for the purpose of receiving treatment, medical evaluation or purchasing prescription drugs or medical equipment. Medical transportation does not include transportation that would normally be provided by an ambulance.

The County is not an agent of the Department and is solely responsible for assuring the safety of consumers whenever consumers receive these services.

The County shall undertake the responsibility to:

1. Inform and educate consumers about the program

2. MATP telephone line

3. Manage the program to ensure cost-effective, appropriate transportation services are     provided

4. Verify consumer eligibility for Medicaid and assess transportation need

5. Authorize transportation services, schedule and dispatch trips

6. Recruit, maintain and monitor an adequate transportation provider network

7. Ensure quality of services through a complaint tracking system

8. Maintain consumer confidentiality.

9. Failure to comply with any term of this Grant Agreement may result in the Department's imposition of the following sanctions: the County’s submission of a corrective action plan to correct areas of non-compliance; suspension of payments; or termination of this Grant Agreement.

Target Population

Medical assistance-eligible persons who require transportation services in order to meet the need for non-emergency medical care and treatment.

Eligibility

To be eligible for the MATP services, the following eligibility requirements must be met:

1. Applicant’s name appears on a valid Medical Assistance card, or is determined to be eligible through the Electronic Verification System (EVS) maintained by the Department of Public Welfare.

2. Be a permanent or temporary resident of the County in which the service is requested.

3. Be determined to need a particular type, mode and frequency of service.

4. Service is for non-emergency medical treatment, evaluation or to purchase prescription drugs.

5. Pursuant to an agreement between the Commonwealth’s Deputy Secretaries for Aging and Transportation referenced in correspondence dated August 23, 1996, transportation services for persons aged 60-64 is to be provided by the Area Agency on Aging.  Implemented as a part of the 1996 agreement was the following:

• Persons aged 60-64 who are currently being served via MATP will continue under this funding.
• Persons aged 60-64 who are new applicants for MATP services are not funded under this program, but are to be referred to the Area Agency on Aging for transportation service

Program Services

The program provides medical transportation services to any approved listed medical facility, physician office, dentist, hospital, clinic, or pharmacy for the purpose of medical evaluation, treatment, or to purchase prescription drugs.  Provision for the use of vehicles equipped to accommodate handicapped passengers is required.  Transportation costs for an escort service for a non-eligible person may be paid if the consumer can not travel independently and the provider cannot furnish suitable escort services.  The service modes include: fixed route, share ride service (via minibus, van, public bus, taxi or volunteer driver) and mileage reimbursement.

Program regulations have changed throughout the year and may continue to change, with new areas of eligibility for specialized population groups.  In all cases, however, the MATP provides the most cost efficient service available that meets the consumers’ needs for transportation to medical providers.  Some examples of medical providers are physicians, dentists, hospitals (non-emergency), surgical centers, pharmacies and psychologists/psychiatrists.

Restrictions

Funds may not be used:

1. To transport for other than non-emergency medical reasons.

2. To transport by ambulance or to sheltered workshops, day care programs, or mental health social rehabilitation services or to non-compensable Medicaid programs.

3. To fund trips where the distance from the origin to destination does not exceed ¼ mile unless the mental and/or physical capacity of the recipient is such that services would not be obtained if transportation were not provided.

Service Providers

Call A Ride Service

Phone: (717) 242-2277

249 West Third Street

Lewistown, PA 17044