MTM is here to take on your biggest challenges in healthcare and public transit. From statewide non-emergency medical transportation (NEMT) brokerage to scheduling. Medi-Cal Ground Emergency Medical Transportation Supplemental Reimbursement Program GEMT Program Overview. California Welfare and Institutions (W&I) Code Non-Emergency Medical Transportation Consultant The only NEMT consultant in California approved by DHCS. NEMT Solutions assists small and medium sized non-emergency. Veterans Transportation Program assist veterans who require travel assistance to and from VA health care facilities. VTP offers these services at little or no costs. Ground Emergency Medical Transportation. GEMT Program Overview. California Welfare and Institutions(W& I) Code . This voluntary Certified Public Expenditure (CPE) based program provides additional funding to eligible governmental entities that provide GEMT services to Medi- Cal beneficiaries. The Centers for Medicare and Medicaid Services (CMS) approved State Plan Amendment (SPA) 0. September 4, 2. 01. Medi- Cal fee- for- service transports, effective January 3. GEMT Program Eligibility. For a publicly owned GEMT service provider to be eligible for the program, the following requirements must be met, as specified in Welfare and Institutions (W& I) Code . The supplemental reimbursement payment is based on claiming federal financial participation on CPEs that have already been incurred by the public provider. The supplemental reimbursement amount is determined by the methodology approved by CMS in. SPA 0. 9- 0. 24. Subscribe To Our Email Service (LISTSERV)Subscribe/Unsubscribe here if you wish to be added or removed from our e- mail service. How To Contact Us. If your organization would like to participate in this program, or if you have any further questions, send inquiries to: GEMT@dhcs. Family Caregiver Support Program. The California Department of Aging. ACE is a non-emergency medical transportation provider, committed to providing the highest quality service to our clients throughout the Southern California and Texas. Non- Emergency Medical Transportation . The purpose of the NEMT program is to ensure transportation to eligible MO Health. Net Division (MHD) fee- for- service and managed care health plan participants who do not have access to free appropriate transportation to and from scheduled - MHD covered services. The NEMT program may use public transportation or bus tokens, vans, taxi, ambulance, or even an airplane if necessary to get you to your health care appointment. You may also be able to get help with gas costs if you have a car, or have a friend or a neighbor who can take you. The NEMT program must approve this before your appointment. Tips about getting a ride before using NEMTIf your city has public transportation, ask if you can ride the bus to your health care appointment at no cost to you. Call your Local Community Organizations. If you can get a ride from another agency, please call them before you call NEMT. Who can get NEMT services? You must be on MO Health. Net or MO Health. Medical Appointments Transportation programs County of San Diego, California. Medical Appointments Transportation. More Services Special Services. Deaf Access Program This website provides basic information about California's public programs for. Net Managed Care on the day of your appointment. People in a MO Health. Net Managed Care Health Plan get their NEMT services from the health plan. Some people on MO Health. Net or MO Health. Net Managed Care do not get NEMT services as part of their benefits. The NEMT program will let you know if your benefits do not cover NEMT. If you need to be away from home overnight, the NEMT program may be able to help with meals and lodging. If a child under the age of 2. NEMT will only pay for the child and one parent or guardian. NEMT will only pay for other children or adults to ride along for specific circumstances on a case by case basis. Participants under the age of 1. What health care services can I get NEMT to take me to? An appointment with a health care provider that takes MO Health. Net or MO Health. Net Managed Care. An appointment for a service covered by MO Health. Net or MO Health. Net Managed Care. An appointment with a health care provider near where you live. If the provider is far away, you may need to say why and get a note from your doctor. There are rules about how far you can travel to a health care appointment and get a ride from the NEMT program. NEMT will not give you a ride to these services: Pharmacy, certain Durable Medical Equipment services, some Comprehensive Substance Treatment Abuse and Rehabilitation (CSTAR) services, Developmental Disability (DD) Waiver Services, some Community Psychiatric Rehabilitation (CPR) services, adult day care services, and services provided in your home. School districts must supply a ride to a child's individual education plan (IEP) services and IEP medical related services. How do I use the NEMT program? Call 1- 8. 66- 2. You must call at least 5 calendar days before the day of the appointment or you may not get NEMT. You may call this number Monday through Friday, 8: 0. A. M. You may be able to get a ride sooner if a medical problem comes up and your doctor says you can be seen. If you have an emergency, dial 9. Participants with MO Health. Net Managed Care need to call the number on your health plan card to set up transportation. What do I need when I call 1- 8. The caller will need the following information when requesting a ride: The patient's name, date of birth, address, phone number, and the MO Health. Net or MO Health. Net managed care ID number; The name, address, and phone number of where you are going; The date and time of the appointment; The medical reason for your transportation request; The type of MO Health. Net covered service (doctor, dentist, therapy, etc.); Special needs of the patient, such as the patient uses a walker, cane, or wheelchair; and. Tell the NEMT program if you need someone to go along if the patient is under the age of 2. If the patient is under the age of 1. What do I do if my ride is late? If your ride is more than 1. Participants with managed care need to call the number on your health plan card. Do I have to pay for this service? Yes. You must pay $2 for each trip. This $2 will be charged for trips that are one- way or round trip. If your trip requires more than one stop, you still only pay $2. Your ride cannot be denied if you cannot pay $2. You do not have to pay the $2 for trips if you are in a Managed Care Health Plan. You do not pay $2 if you are under age 1. You do not pay $2 if you use public transportation, bus tokens, or if you receive help to pay for gas. What else do I need to know about the NEMT program? Call the NEMT program to cancel the ride if you cannot go to your appointment or need to change the date. The NEMT program will give you a ride that meets your needs. You do not get to choose what kind of car or van or the company that will give you the ride. Missouri law requires the following. You can file a grievance with the NEMT program. All you need to do is call 1- 8. You can also write Logisti. Care, 1. 80. 7 Park 2. Drive, Suite 5. 18, Saint Louis, MO 6. If you have a Managed Care Health Plan, you need to call your Managed Care Health Plan to file a complaint. What can I do if a NEMT service is denied? The NEMT program will send you a letter if they do any of the following: deny or give a limited approval of service; suspend or end a service already approved; or deny payment for a service. You have the right to ask for a State Fair Hearing within 9. You may ask anyone such as a family member, your minister, a friend, or an attorney to help you. A decision will be made within 9. State Fair Hearing unless it was an expedited request. For information on a State Fair Hearing, call the Participant Services Unit at 1- 8. Toll Free) or 1- 5.
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December 2016
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