(1) The following service categories cited in WAC
388-501-0060 are subject to the following exclusions and limitations:
(a) Adult day health (ADH) - Nonemergency transportation for ADH services is not provided through the brokers. ADH providers are responsible for arranging or providing transportation to ADH services.
(b) Ambulance - Nonemergency ambulance transportation is not provided through the brokers except as specified in WAC
388-546-5200 (1)(d).
(c) Family planning services - Nonemergency transportation is not provided through the brokers for clients that are enrolled only in
TAKE CHARGE or family planning only services.
(d) Hospice services - Nonemergency transportation is not provided through the brokers when the health care service is related to a client's hospice diagnosis. See WAC
388-551-1210.
(e) Medical equipment, durable (DME) - Nonemergency transportation is not provided through the brokers for DME services, with the exception of DME equipment that needs to be fitted to the client.
(f) Medical nutrition services - Nonemergency transportation is not provided through the brokers to pick up medical nutrition products.
(g) Medical supplies/equipment, nondurable (MSE) - Nonemergency transportation is not provided through the brokers for MSE services.
(h) Mental health services:
(i) Nonemergency transportation brokers generally provide one round trip per day to or from a mental health service. Additional trips for off-site activities, such as a visit to a recreational park, are the responsibility of the provider/facility.
(ii) Nonemergency transportation of involuntarily detained persons under the involuntary treatment act (ITA) is not a service provided or authorized by transportation brokers. Involuntary transportation is a service provided by an ambulance or a designated ITA transportation provider. See WAC
388-546-4000.
(i) Substance abuse services - Nonemergency transportation is not provided through the brokers for substance abuse services for clients under the state-funded medical programs (medical care services program (MCS)). See WAC
388-546-5200(2).
(j) Chemical dependency services - Nonemergency transportation is not provided through the brokers to or from the following:
(i) Residential treatment;
(ii) Intensive inpatient;
(iii) Recovery house;
(iv) Long-term treatment;
(v) Information and assistance services, which include:
(A) Alcohol and drug information school;
(B) Information and crisis services; and
(C) Emergency service patrol.
(2) The following medical assistance programs have limitations on trips:
(a) State-funded medical care services (MCS) program for clients covered by the disability lifeline program and the Alcohol and Drug Addiction Treatment and Support Act (ADATSA) - Nonemergency transportation for mental health services and substance abuse services is not provided through the brokers. The department does pay for nonemergency transportation to and from medical services as specified in WAC
388-501-0060, excluding mental health services and substance abuse services, and subject to any other limitations in this chapter or other program rules.
(b) Transitional bridge waiver for clients covered by the disability lifeline program and the Alcohol and Drug Addiction Treatment and Support Act (ADATSA) - Nonemergency transportation for mental health services and substance abuse services is not provided through the brokers. The department does pay for nonemergency transportation to and from medical services as covered in the transitional bridge waiver approved by the Centers for Medicare and Medicaid Services, excluding mental health services and substance abuse services, and subject to any other limitations in this chapter or other program rules.
[11-17-059, recodified as WAC 182-546-5550, filed 8/15/11, effective 8/15/11. Statutory Authority: RCW 74.04.057, 74.08.090, and 74.09.500. 11-15-029, § 388-546-5550, filed 7/12/11, effective 8/12/11.]