Okla. Admin. Code § 340:75-13-79 - Transportation and travel expenses for necessary medical services outside the child's community

(a) Transportation for medical services outside the child's community. Oklahoma Health Care Authority (OHCA) ensures that necessary transportation is available to a child approved for Medicaid who is in need of medical services that are unavailable in the child's community.

(1) Community-based residential care contractors providing transportation do not receive transportation reimbursement.

(2) Placement providers are responsible for transporting the child to routine medical appointments.

(3) Placement providers who must travel out of the community for necessary and non-routine medical services for the child use the SoonerRideNon-Emergency Transportation (NET) service.

(A) NET is used for transportation for routine medical services and must be scheduled by appointment at least three business days prior to the child's health care appointment, but may be scheduled up to 14 business days in advance.

(B) Standing transportation appointments for the child with NET may be scheduled beyond the 14-day time requirements, not to exceed 30 days.

(C) When scheduling SoonerRide transportation, the placement provider identifies himself or herself as the child's foster parent.

(D) The placement provider has the option of receiving gasoline reimbursement for providing transportation when the provider chooses not to use public transportation or when public transportation is not available.

(b) Transportation for urgent care. When the child's condition requires urgent care, the placement provider must attempt to schedule NET services through SoonerRide.

(1) SoonerRide must be contacted on or before the date of service to allow for assignment of a trip number and mailing of a reimbursement form to the placement provider. The reservation center is open 24 hours a day, seven days a week.

(2) When SoonerRide cannot provide transportation or the placement provider chooses not to use NET for urgent care, the placement provider may receive gasoline reimbursement.

(c) Transportation by commercial airline. When a child requires out-of-state medical care that involves the use of a commercial airline, approval and flight arrangements must be secured by contacting OHCA, Care Management Unit.

(d) Ambulance services. Ambulance service is compensable for the child when other forms of transportation do not meet the medical needs of the child. Arrangements must be secured by contacting OHCA SoonerRide coordinator.

(e) Reimbursement for transportation and travel expenses. Travel expenses may be reimbursed only when necessary medical services are unavailable in the community where a child in Oklahoma Department of Human Services (OKDHS) custody and out-of-home placement resides.

(1) Travel, lodging, and meals are paid with Title XIX funds for the child and one essential person when travel outside the child's community is necessary to secure necessary medical services.

(2) Any associated travel expense claimed on Form 10AD006E, Travel Claim, must be documented with receipt and is initially processed through the local OKDHS office. Completed Form 10AD006E, is sent to OHCA Finance Division Travel Claims.

Notes

Okla. Admin. Code § 340:75-13-79

Amended at 10 Ok Reg 3987, eff 7-13-93 (emergency); Amended at 11 Ok Reg 505, eff 11-15-93 (emergency); Amended at 11 Ok Reg 1733, eff 5-12-94; Amended at 16 Ok Reg 102, eff 10-13-98 (preemptive); Amended at 19 Ok Reg 2265, eff 6-27-02; Amended at 23 Ok Reg 1024, eff 5-11-06; Amended at 24 Ok Reg 1323, eff 6-1-07 ; Amended at 25 Ok Reg 1335, eff 6-1-08; Amended at 29 Ok Reg 635, eff 6-1-12