Documentation Requirements for New York Medicaid Transportation Providers

The New York Medicaid Program pays costs of all emergency ambulance and medically necessary non-emergency transportation, as well as the necessary transportation expenses for Medicaid enrollees who must travel an extraordinary distance to receive medical care. The New York Medicaid Program will only reimburse transportation providers if specific records verifying an occurrence of a trip are maintained for each leg of the trip.

There are three non-emergency transportation services available for patients with different medical needs: a) ambulance (ground and air); b) ambulette (wheelchair van); and c) taxi/livery. Medicaid rules require that transportation services maintain certain documents to demonstrate the provision of services in order to obtain reimbursement.

Ambulance

Ambulance service providers must maintain the Pre-Hospital Care Report, which is a complete record of the ambulance trip that satisfies Medicaid’s trip documentation requirements.

Ambulette, Taxi, Livery, and Group Ride Providers

Medicaid requires that the driver verify at the time of the trip and at each leg of the trip the following information:

1. The Medicaid enrollee’s name and Medicaid identification number;
2. The date of the transport;
3. Both the origination of the trip and the time of pickup;
4. Both the destination of the trip and the time of drop off;
5. The vehicle license plate number; and
6. The full printed name of the driver providing the transportation

Medicaid will deny claims if any of the information is “lacking, illegible, or false.”

Although currently not required, Medicaid also recommends that the driver’s signature be included together with an attestation in the trip documentation that states, “I provided the indicated transportation services.” Medicaid also recommends maintaining the weekly eMedNY-generated prior authorization roster listing all authorized trips.

Finally, transportation providers are reminded that the following documentation is considered only supplemental and does not meet the Medicaid record keeping requirements specified above:

1. Driver/vehicle manifest or dispatch sheet;
2. Issuance of a prior authorization by an approved official with subsequent checkmarks;
3. A prior authorization roster; or
4. An attendance log from a day program

Transportation providers must maintain these records for a period of six years. Such records must be readily accessible to the Office of Medicaid Inspector General for audit purposes. Providers should consult Medicaid rules for any other additional requirements.

If you have questions about the New York Medicaid Transportation service requirements or need legal assistance, please contact us.