Posted inUS_1

Louisiana Healthcare Connections Transportation: Your Guide to Medical Transport Services

No Comments

Navigating healthcare can be complex, especially when transportation to medical appointments becomes a barrier. For Medicaid beneficiaries in Louisiana, particularly those connected with Louisiana Healthcare Connections, understanding the available transportation services is crucial. This guide provides a comprehensive overview of Non-Emergency Medical Transportation (NEMT), Non-Emergency Ambulance Transportation (NEAT), and Emergency Medical Services (EMS) to ensure you can access the medical care you need.

Accessing Non-Emergency Medical Transportation (NEMT)

Non-Emergency Medical Transportation (NEMT) is designed for Medicaid beneficiaries who require assistance getting to and from medical appointments but do not have an emergency medical condition. In Louisiana, accessing NEMT is primarily through your health plan or the Fee-For-Service (FFS) transportation broker, Verida.

How to Access NEMT:

  • Through Your Health Plan: If you are a Medicaid beneficiary enrolled in a health plan, your first step is to contact your health plan’s designated call center to schedule NEMT services. It is recommended to make your transportation request at least 48 hours before your appointment. Below are the contacts for major health plans in Louisiana:

  • Through Verida (FFS Broker): If you are a Medicaid beneficiary not enrolled in a health plan, you should contact Verida, the Fee-For-Service (FFS) transportation broker, directly at (855) 325-7626 to arrange your transportation. Again, a 48-hour advance notice is recommended.

NEMT Eligibility and Covered Services:

To be eligible for Medicaid-covered NEMT services, you must meet the following criteria:

  • Be enrolled in a Medicaid benefit program that explicitly includes transportation services.
  • Declare that you have no other means of transportation available to you.

Covered NEMT services typically include transportation via local transit authorities (local buses) or through NEMT providers contracted with your health plan’s transportation broker. NEMT ensures transportation to and from Medicaid-covered medical services when no alternative transportation options exist. Depending on your specific health plan, transportation to additional services may also be approved. Notably, beneficiaries eligible for physical health services through Legacy Medicaid, both children and adults, are enrolled in a health plan for Medicaid transportation services.

Alt Text: Non-Emergency Medical Transportation (NEMT) services ensure access to healthcare appointments for Medicaid beneficiaries in Louisiana, utilizing various transportation methods including ambulances for those with specific needs.

Attendant Requirements for NEMT:

For beneficiaries under 17 years of age, an attendant is required. This attendant must be:

  • A parent, legal guardian, or a responsible adult designated by the parent or legal guardian.
  • Capable of authorizing medical treatment and care for the beneficiary.

Attendants cannot be:

  • Under 17 years of age.
  • A Medicaid provider or employee of a Medicaid provider offering services to the beneficiary, with exceptions for mental health facility employees in specific situations.
  • A transportation provider or employee of a transportation provider.

It is important to note that parents or guardians are responsible for providing appropriate child passenger restraint systems for children being transported, in compliance with Louisiana state law (La. R.S. 32:295). An exception exists for females of any age seeking prenatal or postpartum care, who are not required to have an attendant.

Meals and Lodging Coverage:

In situations requiring long-distance travel (defined as trips exceeding 12 hours, including appointment duration and travel time), Medicaid may cover eligible expenses such as:

  • Transportation for the beneficiary and one attendant.
  • Meals, lodging, and other related travel expenses for both the beneficiary and one attendant.

This coverage applies when these expenses are necessary to receive medically necessary services and are not covered by inpatient per diem, primary insurance, or other payer sources.

Important Comments Regarding NEMT:

If your scheduled NEMT transportation is delayed or canceled, immediately contact your MCO or transportation broker. This allows them to promptly reassign your transport to another available NEMT provider. While prior approval is generally not required for standard NEMT services (ambulatory or wheelchair level), it is necessary for out-of-state destinations. Unless it’s an urgent request or discharge from an inpatient facility, schedule NEMT services at least 48 hours in advance, excluding non-business days. Out-of-state medical care transportation may be approved if the beneficiary has pre-authorization to receive treatment out of state when it is the nearest available option, but coordination may take longer than 48 hours.

Accessing Non-Emergency Ambulance Transportation (NEAT)

Non-Emergency Ambulance Transportation (NEAT) is for Medicaid beneficiaries who, while not in an emergency, require ambulance transportation due to their medical condition. Similar to NEMT, access is through your health plan or Verida for FFS Medicaid.

How to Access NEAT:

  • Through Your Health Plan: Contact your health plan’s call center to schedule NEAT services, ideally 48 hours in advance. Contact information for health plans includes:

  • Through Verida (FFS Broker): For beneficiaries not in a health plan, contact Verida at (225) 726-2800 for non-emergency ambulance services, with a 48-hour advance notice.

NEAT Eligibility and Covered Services:

Eligibility for NEAT mirrors NEMT, requiring enrollment in a Medicaid program that covers transportation and a declaration of no other transportation means. NEAT is provided when a beneficiary’s condition contraindicates other transport methods or would make them susceptible to injury.

Gas Reimbursement Program:

Louisiana Medicaid offers a Gas Reimbursement Program allowing family members or friends to transport beneficiaries and receive mileage reimbursement. To participate, the gas reimbursement provider must be 18 or older and not reside with the beneficiary. Beneficiaries cannot act as their own gas reimbursement providers, nor for their children. Contact your health plan or transportation broker for program details.

Ground Ambulance Covered Services and Certification:

NEAT services require a completed and valid Certification of Ambulance Transportation (CAT) form. This form must be certified by the beneficiary’s physician, registered nurse, nurse practitioner, physician assistant, or clinical nurse specialist, confirming the medical necessity of ambulance transport and describing the medical condition necessitating it. The CAT form must be completed before scheduling NEAT.

Attendant Requirements for NEAT:

Attendant requirements for NEAT are the same as for NEMT, particularly for beneficiaries under 17, with identical stipulations and exceptions for prenatal and postpartum care. Child passenger restraint system responsibilities also apply in ambulances as per La. R.S. 32:295.

Comments Regarding NEAT:

Prior approval is mandatory for all NEAT services, including out-of-state transport. Similar to NEMT, aim to schedule NEAT 48 hours in advance (excluding non-business days), except for urgent situations or hospital discharges. Out-of-state NEAT requires pre-approval for out-of-state medical treatment, which may extend coordination times beyond 48 hours. Contact your MCO or transportation broker if scheduled NEAT is disrupted for reassignment.

Nursing Facility Ambulance Transportation

Nursing facilities bear the responsibility for providing and covering medically necessary transportation for Medicaid beneficiaries residing within their facilities, specifically for non-emergency, non-ambulance transportation needs.

Emergency Medical Services – Ambulance Transportation (EMS)

How to Access EMS:

For all emergency medical situations requiring immediate ambulance services, dial 911.

EMS Eligibility:

Medicaid covers emergency transportation for beneficiaries enrolled in a Medicaid program that explicitly includes emergency transportation services.

Contact for Transportation Inquiries (NEMT, NEAT, and EMS):

For general transportation inquiries related to NEMT, NEAT, and EMS, you can contact Louisiana Medicaid directly:

Email: [email protected]

Contact Persons:

This guide aims to clarify the processes and contacts for medical transportation in Louisiana, especially for those utilizing Louisiana Healthcare Connections and other Medicaid programs. By understanding these services, beneficiaries can ensure they have reliable access to necessary medical care.

Comments

No comments yet. Why don’t you start the discussion?

Leave a Reply

Your email address will not be published. Required fields are marked *