Minnesota Legislature
HF 380
1st Engrossment - 89th Legislature (2015 - 2016) Posted on 02/09/2015 03:39pm
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A bill for an act
relating to human services; increasing payment rates for rural special
transportation services; amending Minnesota Statutes 2014, section 256B.0625,
subdivision 17.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
Section 1.
Minnesota Statutes 2014, section 256B.0625, subdivision 17, is amended to
read:
Subd. 17.
Transportation costs.
(a) "Nonemergency medical transportation
service" means motor vehicle transportation provided by a public or private person
that serves Minnesota health care program beneficiaries who do not require emergency
ambulance service, as defined in section 144E.001, subdivision 3, to obtain covered
medical services. Nonemergency medical transportation service includes, but is not
limited to, special transportation service, defined in section 174.29, subdivision 1.
(b) Medical assistance covers medical transportation costs incurred solely for
obtaining emergency medical care or transportation costs incurred by eligible persons in
obtaining emergency or nonemergency medical care when paid directly to an ambulance
company, common carrier, or other recognized providers of transportation services.
Medical transportation must be provided by:
(1) nonemergency medical transportation providers who meet the requirements
of this subdivision;
(2) ambulances, as defined in section 144E.001, subdivision 2;
(3) taxicabs and public transit, as defined in section 174.22, subdivision 7; or
(4) not-for-hire vehicles, including volunteer drivers.
(c) Medical assistance covers nonemergency medical transportation provided by
nonemergency medical transportation providers enrolled in the Minnesota health care
programs. All nonemergency medical transportation providers must comply with the
operating standards for special transportation service as defined in sections 174.29 to
174.30 and Minnesota Rules, chapter 8840, and in consultation with the Minnesota
Department of Transportation. All nonemergency medical transportation providers shall
bill for nonemergency medical transportation services in accordance with Minnesota
health care programs criteria. Publicly operated transit systems, volunteers, and
not-for-hire vehicles are exempt from the requirements outlined in this paragraph.
(d) The administrative agency of nonemergency medical transportation must:
(1) adhere to the policies defined by the commissioner in consultation with the
Nonemergency Medical Transportation Advisory Committee;
(2) pay nonemergency medical transportation providers for services provided to
Minnesota health care programs beneficiaries to obtain covered medical services;
(3) provide data monthly to the commissioner on appeals, complaints, no-shows,
canceled trips, and number of trips by mode; and
(4) by July 1, 2016, in accordance with subdivision 18e, utilize a Web-based single
administrative structure assessment tool that meets the technical requirements established
by the commissioner, reconciles trip information with claims being submitted by
providers, and ensures prompt payment for nonemergency medical transportation services.
(e) Until the commissioner implements the single administrative structure and
delivery system under subdivision 18e, clients shall obtain their level-of-service certificate
from the commissioner or an entity approved by the commissioner that does not dispatch
rides for clients using modes under paragraph (h), clauses (4), (5), (6), and (7).
(f) The commissioner may use an order by the recipient's attending physician or a
medical or mental health professional to certify that the recipient requires nonemergency
medical transportation services. Nonemergency medical transportation providers shall
perform driver-assisted services for eligible individuals, when appropriate. Driver-assisted
service includes passenger pickup at and return to the individual's residence or place of
business, assistance with admittance of the individual to the medical facility, and assistance
in passenger securement or in securing of wheelchairs or stretchers in the vehicle.
Nonemergency medical transportation providers must have trip logs, which include pickup
and drop-off times, signed by the medical provider or client attesting mileage traveled to
obtain covered medical services, whichever is deemed most appropriate. Nonemergency
medical transportation providers may not bill for separate base rates for the continuation
of a trip beyond the original destination. Nonemergency medical transportation providers
must take clients to the health care provider, using the most direct route, and must not
exceed 30 miles for a trip to a primary care provider or 60 miles for a trip to a specialty
care provider, unless the client receives authorization from the local agency. The minimum
medical assistance reimbursement rates for special transportation services are:
(1)(i) $17 for the base rate and $1.35 per mile for special transportation services to
eligible persons who need a wheelchair-accessible van;
(ii) $11.50 for the base rate and $1.30 per mile for special transportation services to
eligible persons who do not need a wheelchair-accessible van; and
(iii) $60 for the base rate and $2.40 per mile, and an attendant rate of $9 per trip,
for special transportation services to eligible persons who need a stretcher-accessible
vehicle; and
(2) clients requesting client mileage reimbursement must sign the trip log attesting
mileage traveled to obtain covered medical services.
(g) The covered modes of nonemergency medical transportation include
transportation provided directly by clients or family members of clients with their own
transportation, volunteers using their own vehicles, taxicabs, and public transit, or
provided to a client who needs a stretcher-accessible vehicle, a lift/ramp equipped vehicle,
or a vehicle that is not stretcher-accessible or lift/ramp equipped designed to transport ten
or fewer persons. Upon implementation of a new rate structure, a new covered mode of
nonemergency medical transportation shall include transportation provided to a client who
needs a protected vehicle that is not an ambulance or police car and has safety locks, a
video recorder, and a transparent thermoplastic partition between the passenger and the
vehicle driver.
(h) The administrative agency shall use the level of service process established by the
commissioner in consultation with the Nonemergency Medical Transportation Advisory
Committee to determine the client's most appropriate mode of transportation. If public
transit or a certified transportation provider is not available to provide the appropriate
service mode for the client, the client may receive a onetime service upgrade. The new
modes of transportation, which may not be implemented without a new rate structure, are:
(1) client reimbursement, which includes client mileage reimbursement provided
to clients who have their own transportation or family who provides transportation to
the client;
(2) volunteer transport, which includes transportation by volunteers using their
own vehicle;
(3) unassisted transport, which includes transportation provided to a client by a
taxicab or public transit. If a taxicab or publicly operated transit system is not available,
the client can receive transportation from another nonemergency medical transportation
provider;
(4) assisted transport, which includes transport provided to clients who require
assistance by a nonemergency medical transportation provider;
(5) lift-equipped/ramp transport, which includes transport provided to a client who
is dependent on a device and requires a nonemergency medical transportation provider
with a vehicle containing a lift or ramp;
(6) protected transport, which includes transport to a client who has received a
prescreening that has deemed other forms of transportation inappropriate and who requires
a provider certified as a protected transport provider; and
(7) stretcher transport, which includes transport for a client in a prone or supine
position and requires a nonemergency medical transportation provider with a vehicle that
can transport a client in a prone or supine position.
(i) In accordance with subdivision 18e, by July 1, 2016, the local agency shall be
the single administrative agency and shall administer and reimburse for modes defined in
paragraph (h) according to a new rate structure, once this is adopted.
(j) The commissioner shall:
(1) in consultation with the Nonemergency Medical Transportation Advisory
Committee, verify that the mode and use of nonemergency medical transportation is
appropriate;
(2) verify that the client is going to an approved medical appointment; and
(3) investigate all complaints and appeals.
(k) The administrative agency shall pay for the services provided in this subdivision
and seek reimbursement from the commissioner, if appropriate. As vendors of medical
care, local agencies are subject to the provisions in section 256B.041, the sanctions and
monetary recovery actions in section 256B.064, and Minnesota Rules, parts 9505.2160
to 9505.2245.
(l) The base rates for special transportation services in areas defined under RUCA
to be super rural shall be equal to the reimbursement rate established in paragraph (f),
clause (1), plus deleted text begin 11.3deleted text end new text begin 22.6new text end percent, and for special transportation services in areas defined
under RUCA to be rural or super rural areas:
(1) for a trip equal to 17 miles or less, mileage reimbursement shall be equal to deleted text begin 125deleted text end new text begin
150new text end percent of the respective mileage rate in paragraph (f), clause (1); and
(2) for a trip deleted text begin between 18 and 50deleted text end new text begin over 17new text end miles, mileage reimbursement shall be equal
to deleted text begin 112.5deleted text end new text begin 125new text end percent of the respective mileage rate in paragraph (f), clause (1).
(m) For purposes of reimbursement rates for special transportation services under
paragraph (c), the zip code of the recipient's place of residence shall determine whether
the urban, rural, or super rural reimbursement rate applies.
(n) For purposes of this subdivision, "rural urban commuting area" or "RUCA"
means a census-tract based classification system under which a geographical area is
determined to be urban, rural, or super rural.
(o) Effective for services provided on or after September 1, 2011, nonemergency
transportation rates, including special transportation, taxi, and other commercial carriers,
are reduced 4.5 percent. Payments made to managed care plans and county-based
purchasing plans must be reduced for services provided on or after January 1, 2012,
to reflect this reduction.