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West Virginia Income Maintenance Manual Chapter 27

West Virginia Income Maintenance Manual Page 2 Chapter 27 Non-Emergency Medical Transportation (NEMT)

27.2 NEMT REQUEST PROCESS 27.2.1 BEGINNING DATE OF ELIGIBILITY Medicaid clients are eligible for non-emergency medical transportation (NEMT) beginning the first day of the month in which Medicaid is approved. Clients of Children with Special Health Care Needs (CSHCN) and others who qualify for reimbursement of transportation expenses are eligible for NEMT beginning the month of approval, as determined by the program that provides the medical services. 27.2.2 THE BENEFIT Services provided under this program include reimbursement for transportation and certain related expenses necessary to secure medical services normally covered by Medicaid. Funding for this program is provided by three different sources: • Title XIX funds for all Medicaid clients, including foster children • Title V funds for non-Medicaid eligible clients of CSHCN • Agency administrative funds (cash assistance or Medicaid) for applicants who need a physical examination in order to complete the eligibility process Reimbursement for transportation and related expenses is available to Medicaid clients who: • Require transportation to keep an appointment for medical services covered under the approved Medicaid group; • Receive scheduled Medicaid-covered services at a clinic, hospital, or doctor’s office; or • Receive pre-authorization as necessary. 27.2.3 THE NEMT REQUEST FORM The medical service provider, or his designee, is required to sign the section verifying that the individual had an appointment and was seen for Medicaid-covered treatment or services. Medical service providers include doctors, nurses, nurse practitioners, physicians’ assistants,