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West Virginia Income Maintenance Manual Chapter 27

West Virginia Income Maintenance Manual Page 11 Chapter 27 Non-Emergency Medical Transportation (NEMT)

27.5.6.F Limitations and Restrictions Anyone may volunteer to provide transportation for Medicaid clients for reimbursement of expenses only. However, the broker does not reimburse any volunteer for more than 6,000 miles in any calendar year except as follows: • No public transportation is available, and the client does not drive and has no one else who can provide transportation. • The patient requires frequent medical treatment (e.g., dialysis, chemotherapy) and local staff have approved the continued use of the same provider. Employees of entities that provide Medicaid services (e.g., personal attendant, behavioral health rehabilitation providers, Aged and Disabled [ADW] providers, Traumatic Brain Injury [TBI] providers, Intellectual/Developmental Disability Waiver [I/DD] providers) cannot be reimbursed as an NEMT provider when transporting individuals while being paid by that Medicaid provider (e.g., being on the clock and being paid for NEMT at the same time). I/DD Waiver providers must bill NEMT for Medicaid-approved services unless training is occurring during the transportation time. If a provider is billing another State Plan (non-waiver) Medicaid service, then the provider must utilize NEMT for transportation costs.

NOTE: A volunteer is a person, other than the client, his family, or friends, who provides transportation to medical appointments for Medicaid clients. The 6,000-mile limit does not apply to family or friends who have been selected by the Medicaid client to provide the transportation. The limit does not apply to common carriers.