New Transportation Guidelines for New York Medicaid Providers

The New York State Medicaid transportation program has undergone some changes recently. In January, the New York State Department of Health (DOH or Department) announced that a contract was awarded to LogistiCare Solutions to manage the transportation needs of Medicaid enrollees. Each New York City borough will be brought under the management of the contractor in phases.

As of May 1, 2012, Brooklyn medical providers and facilities must request transportation for fee-for-service Medicaid patients through LogistiCare. Queens providers and facilities are being switched to LogistiCare as of July 1, 2012.

For those Medicaid enrollees who are not able to use mass transit or other modes of transportation used in daily life to get to and from a doctor’s appointment, Medicaid will pay for the least costly, most medically appropriate level of transportation to and from services covered by the Medicaid Program.  All modes of transportation must be prior authorized for payment.  Fee-for-service providers must contact LogistiCare at least 3 days in advance of a patient’s appointment for routine medical care.

Medicaid beneficiaries enrolled in managed care receive transportation services through their health plan until the Department officially announces a change in the program. DOH has previously stated that it anticipates LogistiCare will assume the management of transportation of enrollees covered by managed care plans on Jan. 1, 2013.

If you have questions about the new transportation requirements, New York Medicaid Program or need other legal assistance, please contact us.

According to NYC Guidelines for Medical Practitioners and Facilities, w