Letter to CMS - Medicaid Managed Care Policies - Agency for ...

Vendor Name:
Review Period:
Date of Review:
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Participating Vendor Staff Member:
Agency For Health Care Administration
Managed Care Organizations
Transportation Audit Tool
Transportation Review Tool
Item Number Standard Found in Handbook Reference Comments
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NON-REFORM COVERING TRANSPORTATION AND REFORM PLANS
The health plan provides transportation services, including emergency
transportation, for its enrollees who have no other means of transportation
available to any Medicaid-compensable, medically necessary service,
including Medicaid services not covered by this Contract such as
prescribed pediatric extender care (this example does not apply to the
specialty plan for children with chronic conditions).
The health plan complies with provisions of the Medicaid Transportation
Services Coverage and Limitations Handbooks. In any instance when
compliance conflicts with the terms of this Contract, the Contract prevails.
In no instance may the limitations or exclusions imposed by the health
plan be more stringent than those in the Medicaid Transportation Services
Coverage and Limitations Handbooks.
The health plan is not obligated to follow the requirements of the
Commission for the Transportation Disadvantaged (CTD) or the
Transportation Coordinating Boards as set forth in Chapter 427, F. S.,
unless the health plan has chosen to coordinate services with the CTD.
The health plan may provide transportation services directly through its
own network of transportation providers or through a provider contract
relationship, which may include the Commission for the Transportation
Disadvantaged. In either case, the health plan is responsible for
monitoring provisions of services to its enrollees.
The health plan ensures that all transportation providers comply with
standards set forth in Chapter 427, F. S., and Rules 41-2 and 14-90, FAC.
These standards include drug and alcohol testing, safety standards, driver
accountability, and driver conduct.
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Managed Care Organizations Page 1
Transportation Audit Tool F1_03_10
Florida Medicaid
Exhibit 5
Y N N/A Exhibit 5
Y N N/A Exhibit 5
Y N N/A Exhibit 5
Y N N/A Exhibit 5