1.1 A bill for an act
1.2 relating to human services; increasing payment rates for nonemergency medical
1.3 transportation; amending Minnesota Statutes 2022, section 256B.0625, subdivision
1.4 17.
1.5BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.6 Section 1. Minnesota Statutes 2022, section 256B.0625, subdivision 17, is amended to
1.7read:
1.8 Subd. 17.Transportation costs.(a) "Nonemergency medical transportation service"
1.9means motor vehicle transportation provided by a public or private person that serves
1.10Minnesota health care program beneficiaries who do not require emergency ambulance
1.11service, as defined in section 144E.001, subdivision 3, to obtain covered medical services.
1.12 (b) Medical assistance covers medical transportation costs incurred solely for obtaining
1.13emergency medical care or transportation costs incurred by eligible persons in obtaining
1.14emergency or nonemergency medical care when paid directly to an ambulance company,
1.15nonemergency medical transportation company, or other recognized providers of
1.16transportation services. Medical transportation must be provided by:
1.17 (1) nonemergency medical transportation providers who meet the requirements of this
1.18subdivision;
1.19 (2) ambulances, as defined in section 144E.001, subdivision 2;
1.20 (3) taxicabs that meet the requirements of this subdivision;
1.21 (4) public transit, as defined in section 174.22, subdivision 7; or
1Section 1.
REVISOR AGW/AD 23-0016401/03/23
State of Minnesota
This Document can be made available
in alternative formats upon request
HOUSE OF REPRESENTATIVES
H. F. No. 435
NINETY-THIRD SESSION 2.1 (5) not-for-hire vehicles, including volunteer drivers, as defined in section 65B.472,
2.2subdivision 1, paragraph (h).
2.3 (c) Medical assistance covers nonemergency medical transportation provided by
2.4nonemergency medical transportation providers enrolled in the Minnesota health care
2.5programs. All nonemergency medical transportation providers must comply with the
2.6operating standards for special transportation service as defined in sections 174.29 to 174.30
2.7and Minnesota Rules, chapter 8840, and all drivers must be individually enrolled with the
2.8commissioner and reported on the claim as the individual who provided the service. All
2.9nonemergency medical transportation providers shall bill for nonemergency medical
2.10transportation services in accordance with Minnesota health care programs criteria. Publicly
2.11operated transit systems, volunteers, and not-for-hire vehicles are exempt from the
2.12requirements outlined in this paragraph.
2.13 (d) An organization may be terminated, denied, or suspended from enrollment if:
2.14 (1) the provider has not initiated background studies on the individuals specified in
2.15section 174.30, subdivision 10, paragraph (a), clauses (1) to (3); or
2.16 (2) the provider has initiated background studies on the individuals specified in section
2.17174.30, subdivision 10, paragraph (a), clauses (1) to (3), and:
2.18 (i) the commissioner has sent the provider a notice that the individual has been
2.19disqualified under section 245C.14; and
2.20 (ii) the individual has not received a disqualification set-aside specific to the special
2.21transportation services provider under sections 245C.22 and 245C.23.
2.22 (e) The administrative agency of nonemergency medical transportation must:
2.23 (1) adhere to the policies defined by the commissioner;
2.24 (2) pay nonemergency medical transportation providers for services provided to
2.25Minnesota health care programs beneficiaries to obtain covered medical services;
2.26 (3) provide data monthly to the commissioner on appeals, complaints, no-shows, canceled
2.27trips, and number of trips by mode; and
2.28 (4) by July 1, 2016, in accordance with subdivision 18e, utilize a web-based single
2.29administrative structure assessment tool that meets the technical requirements established
2.30by the commissioner, reconciles trip information with claims being submitted by providers,
2.31and ensures prompt payment for nonemergency medical transportation services.
2Section 1.
REVISOR AGW/AD 23-0016401/03/23 3.1 (f) Until the commissioner implements the single administrative structure and delivery
3.2system under subdivision 18e, clients shall obtain their level-of-service certificate from the
3.3commissioner or an entity approved by the commissioner that does not dispatch rides for
3.4clients using modes of transportation under paragraph (i), clauses (4), (5), (6), and (7).
3.5 (g) The commissioner may use an order by the recipient's attending physician, advanced
3.6practice registered nurse, physician assistant, or a medical or mental health professional to
3.7certify that the recipient requires nonemergency medical transportation services.
3.8Nonemergency medical transportation providers shall perform driver-assisted services for
3.9eligible individuals, when appropriate. Driver-assisted service includes passenger pickup
3.10at and return to the individual's residence or place of business, assistance with admittance
3.11of the individual to the medical facility, and assistance in passenger securement or in securing
3.12of wheelchairs, child seats, or stretchers in the vehicle.
3.13 Nonemergency medical transportation providers must take clients to the health care
3.14provider using the most direct route, and must not exceed 30 miles for a trip to a primary
3.15care provider or 60 miles for a trip to a specialty care provider, unless the client receives
3.16authorization from the local agency.
3.17 Nonemergency medical transportation providers may not bill for separate base rates for
3.18the continuation of a trip beyond the original destination. Nonemergency medical
3.19transportation providers must maintain trip logs, which include pickup and drop-off times,
3.20signed by the medical provider or client, whichever is deemed most appropriate, attesting
3.21to mileage traveled to obtain covered medical services. Clients requesting client mileage
3.22reimbursement must sign the trip log attesting mileage traveled to obtain covered medical
3.23services.
3.24 (h) The administrative agency shall use the level of service process established by the
3.25commissioner to determine the client's most appropriate mode of transportation. If public
3.26transit or a certified transportation provider is not available to provide the appropriate service
3.27mode for the client, the client may receive a onetime service upgrade.
3.28 (i) The covered modes of transportation are:
3.29 (1) client reimbursement, which includes client mileage reimbursement provided to
3.30clients who have their own transportation, or to family or an acquaintance who provides
3.31transportation to the client;
3.32 (2) volunteer transport, which includes transportation by volunteers using their own
3.33vehicle;
3Section 1.
REVISOR AGW/AD 23-0016401/03/23 4.1 (3) unassisted transport, which includes transportation provided to a client by a taxicab
4.2or public transit. If a taxicab or public transit is not available, the client can receive
4.3transportation from another nonemergency medical transportation provider;
4.4 (4) assisted transport, which includes transport provided to clients who require assistance
4.5by a nonemergency medical transportation provider;
4.6 (5) lift-equipped/ramp transport, which includes transport provided to a client who is
4.7dependent on a device and requires a nonemergency medical transportation provider with
4.8a vehicle containing a lift or ramp;
4.9 (6) protected transport, which includes transport provided to a client who has received
4.10a prescreening that has deemed other forms of transportation inappropriate and who requires
4.11a provider: (i) with a protected vehicle that is not an ambulance or police car and has safety
4.12locks, a video recorder, and a transparent thermoplastic partition between the passenger and
4.13the vehicle driver; and (ii) who is certified as a protected transport provider; and
4.14 (7) stretcher transport, which includes transport for a client in a prone or supine position
4.15and requires a nonemergency medical transportation provider with a vehicle that can transport
4.16a client in a prone or supine position.
4.17 (j) The local agency shall be the single administrative agency and shall administer and
4.18reimburse for modes defined in paragraph (i) according to paragraphs (m) and (n) when the
4.19commissioner has developed, made available, and funded the web-based single administrative
4.20structure, assessment tool, and level of need assessment under subdivision 18e. The local
4.21agency's financial obligation is limited to funds provided by the state or federal government.
4.22 (k) The commissioner shall:
4.23 (1) verify that the mode and use of nonemergency medical transportation is appropriate;
4.24 (2) verify that the client is going to an approved medical appointment; and
4.25 (3) investigate all complaints and appeals.
4.26 (l) The administrative agency shall pay for the services provided in this subdivision and
4.27seek reimbursement from the commissioner, if appropriate. As vendors of medical care,
4.28local agencies are subject to the provisions in section 256B.041, the sanctions and monetary
4.29recovery actions in section 256B.064, and Minnesota Rules, parts 9505.2160 to 9505.2245.
4.30 (m) Payments for nonemergency medical transportation must be paid based on the client's
4.31assessed mode under paragraph (h), not the type of vehicle used to provide the service. The
4.32medical assistance reimbursement rates for nonemergency medical transportation services
4Section 1.
REVISOR AGW/AD 23-0016401/03/23 5.1that are payable by or on behalf of the commissioner for nonemergency medical
5.2transportation services are:
5.3 (1) $0.22 per mile for client reimbursement;
5.4 (2) up to 100 percent of the Internal Revenue Service business deduction rate for volunteer
5.5transport;
5.6 (3) equivalent to the standard fare for unassisted transport when provided by public
5.7transit, and $11 $17 for the base rate and $1.30 $2.38 per mile when provided by a
5.8nonemergency medical transportation provider;
5.9 (4) $13 $22 for the base rate and $1.30 $2.38 per mile for assisted transport;
5.10 (5) $18 $31 for the base rate and $1.55 $2.65 per mile for lift-equipped/ramp transport;
5.11 (6) $75 for the base rate and $2.40 per mile for protected transport; and
5.12 (7) $60 for the base rate and $2.40 per mile for stretcher transport, and $9 per trip for
5.13an additional attendant if deemed medically necessary.
5.14 (n) The base rate for nonemergency medical transportation services in areas defined
5.15under RUCA to be super rural is equal to 111.3 percent of the respective base rate in
5.16paragraph (m), clauses (1) to (7). The mileage rate for nonemergency medical transportation
5.17services in areas defined under RUCA to be rural or super rural areas is:
5.18 (1) for a trip equal to 17 miles or less, equal to 125 percent of the respective mileage
5.19rate in paragraph (m), clauses (1) to (7); and
5.20 (2) for a trip between 18 and 50 miles, equal to 112.5 percent of the respective mileage
5.21rate in paragraph (m), clauses (1) to (7).
5.22 (o) For purposes of reimbursement rates for nonemergency medical transportation
5.23services under paragraphs (m) and (n), the zip code of the recipient's place of residence
5.24shall determine whether the urban, rural, or super rural reimbursement rate applies.
5.25 (p) For purposes of this subdivision, "rural urban commuting area" or "RUCA" means
5.26a census-tract based classification system under which a geographical area is determined
5.27to be urban, rural, or super rural.
5.28 (q) The commissioner, when determining reimbursement rates for nonemergency medical
5.29transportation under paragraphs (m) and (n), shall exempt all modes of transportation listed
5.30under paragraph (i) from Minnesota Rules, part 9505.0445, item R, subitem (2).
5Section 1.
REVISOR AGW/AD 23-0016401/03/23