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Changes to MedicalTransportation in TexasHealth and Human ServicesApril 28, 2021
Agenda What are the services and who can get them How it works today What are the changes Where to find more information
What are the ovide transportationto the doctor, dentist,hospital, pharmacy, andother places thatprovide covered healthcare services for clientswho have no othertransportation optionsTypes of rides Public transportation, like the city bus A taxi or van service Commercial transit, like a bus orplane, to go to another city for anappointmentOther services Money for gas Meals and lodging for children andyouth 20 and younger stayingovernight to get covered health careservices Payment for some out-of-state travel
Who can get the servicesIndividuals enrolled in Medicaid managed care orfee-for-service MedicaidChildren with Special Health Care Needs (CSHCN)program enrolleesIndividuals eligible for Transportation for IndigentCancer Patients (TICP)4
How it works todayClients get NEMT services through the MedicalTransportation Program (MTP).When requesting a ride, clients call thenumbers below: Clients in the Houston/Beaumont area, call tollfree: 855-687-4786 Clients in the Dallas/Fort Worth area, call toll-free:855-687-3255 Clients anywhere else in Texas, call toll-free:877-633-8747 (877-MED-TRIP)
Summary of changesIn 2019, the Texas legislature passed a bill changinghow HHSC will deliver NEMT services to clients.123Beginning June 1, 2021, Medicaid clients who have a health planwill get their NEMT services from their health planHHSC and health plans may contract with transportation networkcompanies (e.g. Uber or Lyft) to provide NEMT services tomembersNEMT services will be provided with less than 48 hours notice if theindividual is: 4Being picked up after being discharged from a hospitalTraveling to the pharmacy to pick up medication or approved medicalsuppliesTraveling to receive treatment for an urgent conditionBeginning June 1, 2021, Medicaid clients who do not have a healthplan will call one central number to schedule a ride6
Process changes for clientsRides for appointmentsbefore June 1, 2021All clients followcurrent process Clients in theHouston/Beaumont area, calltoll-free: 855-687-4786Clients in the Dallas/Fort Wortharea, call toll-free: 855-6873255Clients anywhere else in Texas,call toll-free: 877-633-8747(877-MED-TRIP)Rides for appointments onor after June 1, 2021Clients with a health planOn or after May 14: Contact theirhealth plan or its transportationsubcontractor at the phone number ontheir member ID or the transportationphone number on their websiteClients without a health planCall 877-633-8747 (877-MED-TRIP)
What happens if A client calls their usual phonenumber now to schedule a ride foran appointment after June 1?They will be advised to contact theirhealth plan or health plan’s transportationphone number on or after May 14A client calls their usual phonenumber on May 14 to schedule aride for an appointment afterJune 1?They will be advised to contact their healthplan or health plan’s transportation phonenumberA client contacts their health plannow to schedule a ride for anappointment before June 1.They will be transferred to the current callcenterA client contacts their health plannow to schedule a ride for anappointment after June 1.Their health plan will ask them to call backon or after May 14
Complaints and appealsTo submit a complaint or file an appeal forappointments on and after June 1, 2021, followthese steps:Clients with a Medicaidhealth planFollow their health plan’sprocess for submittingcomplaints and appealsClients without aMedicaid health planCall 877-633-8747(877-MED-TRIP)9
Where to find more information A flier will be mailed with anoverview of the changes The client’s health plan websitewill have their transportationcontact number and moreinformation Member handbooks will beupdated to reflect these changes The HHSC Medical TransportationProgram ) will be kept updated
Thank you!11
HHSC and health plans may contract with transportation network companies (e.g. Uber or Lyft) to provide NEMT services to members 1 NEMT services will be provided with less than 48 hours notice if the individual is: Being picked up after being discharged from a hospital Traveling to the pharmacy to pick up medication or approved medical
