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Medical Services – Appendix B, Transportation Procedures 01/01/19 Appendix B Page 1 of 4 Transportation Services Federal regulations require that non-emergency transportation services be provided to certain Medicaid recipients: • When necessary for medical care (diagnosis or treatment); • When transportation is otherwise not available; • In the least expensive means suitable to the recipient’s medical needs; and • To transport recipients to qualified providers who are generally available and used by other residents of the community. Transportation services cannot be used by individuals enrolled in ARKids B, Qualified Medicare Beneficiaries (QMB), Specified Low Income Medicare Beneficiaries (SMB), and Qualified Disabled Working Individuals (QDWI). ICF/IID (Intermediate Care Facilities/Individuals with Intellectual Disabilities), nursing home facilities, and the Hot Springs Rehabilitation Center are responsible for transporting their clients. If a nursing home facility administrator believes that unusual circumstances place transportation services outside the scope of his responsibility and requests assistance, the administrator should call the Office of Long Term Care (501-682-8430) for assistance. Services for Which Transportation is Paid Transportation may be provided when a recipient needs to travel to and from a medical facility that provides medical services covered by Medicaid. A medical facility is defined as a place where medical examinations and treatment are received. Medical facilities include hospitals, doctors’ offices, dentists’ offices, clinics, independent laboratories, X-ray facilities, Developmental Day Treatment Clinics, pharmacies and drug stores (for purchase of prescription drugs and prescription medical supplies), and the Health Department. Medicaid transportation will not be provided for a non-Medicaid-covered service (e.g., transportation would not be authorized to a psychologist for an individual over age 21, since this is not a covered service). “Arkansas Medicaid, ARKids First & You” handbook lists the services covered by Medicaid. Primary Care Physicians Some Medicaid recipients are required to choose a primary care physician (PCP) to take care of their medical needs, and can generally obtain other medical services only upon a referral from their PCP. If a recipient is required to have a PCP, transportation only to the PCP or to a physician or the medical services referred to by the PCP when a referral is required, will be provided.