Page 2168

West Virginia Income Maintenance Manual Chapter 27

West Virginia Income Maintenance Manual Page 7 Chapter 27 Non-Emergency Medical Transportation (NEMT)

network status are considered in-state providers. o Members are required to contact the broker to schedule the travel for all medical appointments or visits, regardless of the in-network or out-of-network status. • Transportation of an immediate family member (parent, spouse, or child of the patient) to accompany and/or stay with the patient at a medical facility when the need to stay is based on medical necessity and documented by the physician. Exceptions require Bureau for Medical Services (BMS) approval. • Two round trips per scheduled hospitalization (one for admittance and one for discharge) when the parent or family member chooses not to stay with the patient. • Lodging. • Meals, only when lodging is approved. • Transportation via common carrier judged to be the most economical. If the member insists on incurring expenses beyond those approved by the broker, such costs will not be reimbursed. Travel for parents/children to visit or participate in a treatment plan for hospitalized individuals is not authorized when it does not coincide with the patient’s travel. Exceptions require BMS approval. 27.5.3 ROUTINE AUTOMOBILE TRANSPORTATION REQUESTS Members may request reimbursement for costs related to automobile travel, such as mileage, tolls, and parking fees when free parking is not available. The travel must be for scheduled appointments and treatment. Mileage is paid from the patient’s home to the facility and back to the home. When comparable treatment may be obtained at a facility closer to the patient’s home than the one he chooses, mileage reimbursed is limited to the distance to the nearest facility. The client’s statement about the availability of a closer facility is accepted unless the information is questionable. See Determining the Amount of Payment below. Meals are not reimbursed for any travel that does not include an overnight stay. When travel by private automobile is an option, but the member chooses more costly transportation, the rate of reimbursement is limited to the private auto mileage rate. When the member chooses to rent an automobile and submits the costs of the rental and connected fees, and the total is less than the private mileage rate, the lower cost is paid. Members must car-pool when others in the household have appointments the same day at the