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Minnesota Legislature

Office of the Revisor of Statutes

SF 1157

as introduced - 90th Legislature (2017 - 2018) Posted on 08/09/2017 10:08am

KEY: stricken = removed, old language.
underscored = added, new language.

Current Version - as introduced

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A bill for an act
relating to human services; creating provider and driver standards for the provision
of nonemergency medical transportation services to children; amending Minnesota
Statutes 2016, section 256B.0625, subdivision 17.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

Minnesota Statutes 2016, 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.

(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;

(4) public transit, as defined in section 174.22, subdivision 7; or

(5) 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) An organization may be terminated, denied, or suspended from enrollment if:

(1) the provider has not initiated background studies on the individuals specified in
section 174.30, subdivision 10, paragraph (a), clauses (1) to (3); or

(2) the provider has initiated background studies on the individuals specified in section
174.30, subdivision 10, paragraph (a), clauses (1) to (3), and:

(i) the commissioner has sent the provider a notice that the individual has been
disqualified under section 245C.14; and

(ii) the individual has not received a disqualification set-aside specific to the special
transportation services provider under sections 245C.22 and 245C.23.

(e) 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.

(f) 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 of transportation under paragraph (i), clauses (4), (5), (6), and (7).

(g) 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 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.

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 maintain trip logs, which include pickup and drop-off times,
signed by the medical provider or client, whichever is deemed most appropriate, attesting
to mileage traveled to obtain covered medical services. Clients requesting client mileage
reimbursement must sign the trip log attesting mileage traveled to obtain covered medical
services.

(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.

(i) The covered 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 to family or an acquaintance 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 public transit 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 provided to a client who has received
a prescreening that has deemed other forms of transportation inappropriate and who requires
a provider: (i) with 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; and (ii) who is 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.

(j) The local agency shall be the single administrative agency and shall administer and
reimburse for modes defined in paragraph (i) according to paragraphs (m) and (n) when the
commissioner has developed, made available, and funded the Web-based single
administrative structure, assessment tool, and level of need assessment under subdivision
18e. The local agency's financial obligation is limited to funds provided by the state or
federal government.

(k) 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.

(l) 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.

(m) Payments for nonemergency medical transportation must be paid based on the client's
assessed mode under paragraph (h), not the type of vehicle used to provide the service. The
medical assistance reimbursement rates for nonemergency medical transportation services
that are payable by or on behalf of the commissioner for nonemergency medical
transportation services are:

(1) $0.22 per mile for client reimbursement;

(2) up to 100 percent of the Internal Revenue Service business deduction rate for volunteer
transport;

(3) equivalent to the standard fare for unassisted transport when provided by public
transit, and $11 for the base rate and $1.30 per mile when provided by a nonemergency
medical transportation provider;

(4) $13 for the base rate and $1.30 per mile for assisted transport;

(5) new text begin$16 for the base rate and $1.30 per mile for transport of unaccompanied children 17
years of age or younger;
new text end

new text begin (6) new text end$18 for the base rate and $1.55 per mile for lift-equipped/ramp transport;

deleted text begin (6)deleted text end new text begin(7) new text end$75 for the base rate and $2.40 per mile for protected transport; and

deleted text begin (7)deleted text endnew text begin (8)new text end $60 for the base rate and $2.40 per mile for stretcher transport, and $9 per trip
for an additional attendant if deemed medically necessary.

(n) The base rate for nonemergency medical transportation services in areas defined
under RUCA to be super rural is equal to 111.3 percent of the respective base rate in
paragraph (m), clauses (1) to deleted text begin(7)deleted text endnew text begin (8)new text end. The mileage rate for nonemergency medical
transportation services in areas defined under RUCA to be rural or super rural areas is:

(1) for a trip equal to 17 miles or less, equal to 125 percent of the respective mileage
rate in paragraph (m), clauses (1) to deleted text begin(7)deleted text endnew text begin (8)new text end; and

(2) for a trip between 18 and 50 miles, equal to 112.5 percent of the respective mileage
rate in paragraph (m), clauses (1) to deleted text begin(7)deleted text endnew text begin (8)new text end.

(o) For purposes of reimbursement rates for nonemergency medical transportation
services under paragraphs (m) and (n), the zip code of the recipient's place of residence
shall determine whether the urban, rural, or super rural reimbursement rate applies.

(p) 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.

new text begin (q) In addition to existing nonemergency medical transportation provider standards under
this subdivision, sections 174.29 to 174.30, and Minnesota Rules, chapter 8840,
nonemergency medical transportation providers transporting unaccompanied children 17
years of age or younger must:
new text end

new text begin (1) use only drivers who meet the requirements of paragraph (r) when transporting a
child;
new text end

new text begin (2) supply car seats that are age and size appropriate for the child being transported;
new text end

new text begin (3) maintain an emergency telephone line that is answered by a live person during hours
of operation;
new text end

new text begin (4) inform the child's family and health care providers of the protocols followed by the
provider and its drivers in case of an emergency or incident out of the ordinary;
new text end

new text begin (5) provide the child's family and health care providers with a copy of the provider's
complaint process;
new text end

new text begin (6) provide the child's family with a copy of the provider's written policy concerning
actions to be taken by the provider's drivers if a child engages in challenging or unsafe
behavior;
new text end

new text begin (7) make every effort to maintain consistent driver assignments and traffic routes for
each child;
new text end

new text begin (8) allow the child's family or health care providers to submit written suggestions on
strategies that will best support the child during transit;
new text end

new text begin (9) not transport a child with other passengers unless the other passengers are children,
caregivers of transported children, or a qualified attendant;
new text end

new text begin (10) before transporting a child with other passengers, inform the child's family of both
the number of total riders and attendants that will be transported with the child and the
anticipated time that the child will spend in transit; and
new text end

new text begin (11) provide an extra qualified attendant when three or more children are being
transported together.
new text end

new text begin (r) In addition to existing nonemergency medical transportation driver standards under
this subdivision, sections 174.29 to 174.30, and Minnesota Rules, chapter 8840, drivers
transporting children must have a valid child transportation certification as defined by the
commissioner. Drivers providing service under a child transportation certification must:
new text end

new text begin (1) select, install, and secure a provider-supplied car seat that is age- and size-appropriate
for the child being transported;
new text end

new text begin (2) seat children at least an arm's length apart from each other; and
new text end

new text begin (3) never deviate from the scheduled route or make unplanned stops except in cases of
emergency.
new text end

new text begin (s) Transportation coordinators must provide confirmation within one business day when
a family or health provider requests a change for a child in the schedule or route.
new text end