5-018.02A Medicaid Managed Care Enrollees

If the client is enrolled in one of the Medicaid Managed Care HMO plans, the HMO is responsible for authorizing transportation for the client’s medical services and Department staff must not authorize medical transportation.  Exception:  Department staff may authorize transportation for adult day care or mental health day rehab services and for dental-related appointments and pharmacy services under Medical Transportation codes.  Staff may authorize non-medical transportation for Medicaid Managed Care enrollees if the client meets the SSAD program guidelines.  If the client is enrolled in one of the Medicaid Managed Care “Primary Care” plans,  the responsibility for transportation authorizations remains with the Department worker.

{8/20/07}