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Dear Provider:
Please see the updated Medicaid requirement by the Department of Transportation in regards to policy and billing.
Attention Ambulette and Taxi/Livery Providers
Record Keeping Requirements Have Been Updated In accordance with Title 18 NYCRR §504.3(a) and 517.3(b), transportation providers will be reimbursed only when contemporaneous, complete, acceptable, verifiable records are available upon request to the State in connection with an audit, investigation or inquiry. The documentation below is required for every leg of a trip, and must be maintained for a period of six years following the date of payment. If any of the required information is incomplete, or deemed unacceptable or false, any relevant paid reimbursement will be recouped and the provider may be subject to other statutory or regulatory liability, financial damages and sanctions.
Ambulette, Taxi/Livery
Providers Effective March 1, 2016, in addition to historically required acceptable trip verification, the Department will now require the full printed name and signature of the driver providing the transport attesting that the referenced trip was completed.
The full list of required trip verification information now includes, at a minimum:
The Medicaid enrollee's name and Medicaid identification number;
The date of the transport;
Both the origination of the trip and time of pickup;
Both the destination of the trip and time of drop off;
The vehicle license plate number;
The driver's license number;
The full printed name and signature of the driver providing the transport; and
An attestation from the driver that the trip was completed. Electronic Records
The use of electronic record-keeping methodology is becoming more prevalent. Transportation vendors using electronic methods to prepare and maintain contemporaneous documentation to support Medicaid claims must produce documentation with an accurate system-generated, unmodifiable date and time stamp for each leg of a billable trip including the pickup and drop-off, as well as driver attestation as required.
Supplemental Documentation
The following items presented as the only evidence of a trip are not considered acceptable documentation. However, these documents may be considered supplemental to additional required documentation and can be presented to supplement required documentation:
A driver/vehicle manifest or dispatch sheet;
Issuance of a prior authorization by an approved official with subsequent checkmarks;
A prior authorization roster; or
An attendance log from a day program.
Reminder - Requirements under 505.10 Transportation for Medical Care and Services Providers must comply with 18 NYCRR § 505.10 in its entirety. |
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