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September 5, 2006

 
 
MEDICAID INFORMATION RELEASE MA06-35
 
TO:  Commercial & Agency Transportation Providers and Regional DD Staff, DD Service Coordination Agencies
 
FROM:  Leslie M Clement, Administrator
 
SUBJECT:  Change in Adult Developmental Disabilities (DD) Transportation Prior Authorization (PA) Requirements for Commercial and Agency Transportation Providers
 
As of September 1st, 2006 Commercial & Agency transportation providers will not be required to send PA requests to the Medicaid Transportation staff for Adult Developmental Therapy Services using the Billing Codes A0110 Or S0215 For Adult Developmental Therapy Transportation.   This includes transportation to Community Access services as listed on the client’s care plan. Community Access is only for services listed in the DDA plan of care.  (Waiver participants may receive waiver, non-medical transportation to access the community but that is separate from this IR.) 
 
The PA of all commercial transportation and agency transportation (over 20 miles round trip/per day) will be done as part of the authorization of participant’s Individual Support Plan (ISP).  Plan Developers will be required to coordinate this service with the transportation agency. 
 
Medicaid will begin to coordinate Medicaid Adult DD participants who utilize Commercial or Agency Medicaid transportation to and from their developmental therapy based on the client’s annual care plan.  Commercial and Agency PA’s that were submitted prior to September 1st, 2006 will be extended by the Medicaid Transportation Unit. This extension will allow the transportation costs to be Prior Authorized at the time of the person’s annual plan.  Transportation providers DO NOT need to send in an additional PA.  Any changes in a DD client’s transportation needs to or from their developmental therapy would be addressed through regional staff and/or client’s plan developers. The regional staff may contact the transportation provider to set up and confirm the client’s transportation services.
 
PLEASE NOTE THIS IS ONLY FOR ADULT DEVELOPMENTAL THERAPY TRANSPORTATION – ALL OTHER TRANSPORTS MUST STILL BE PRIOR AUTHORIZED.
If you have any questions concerning the information contained in this release, please contact the Medicaid Transportation Unit at 208-287-1171.