Date: February 2, 2021
To: Enrolled Transportation Providers
Re: Reimbursement Clarification for Participants Covered under Managed Long Term Services and Supports (MLTSS)
This notice provides transportation reimbursement policy clarification for participants who are eligible under Managed Long Term Services and Supports (MLTSS).
The managed care plan MLTSS covers the following non-emergency transportation categories of service listed below:
· 051 Non-Emergency Ambulance
· 052 Medicar
· 053 Taxi
· 054 Service Car
· 055 Private Auto
· 056 Other Transportation
If a non-emergency transportation service is allowed by Medicare and Medicare makes a payment, reimbursement of the Medicare cost-sharing is the responsibility of the HealthChoice Illinois managed care plan.
The Medicaid portion of cost sharing for MLTSS emergency transportation after Medicare adjudication should be billed to the Department. All providers of Medicaid covered services, including cost shared services, must be enrolled with Illinois Medicaid via IMPACT.
As a reminder, all Medicare-Medicaid Alignment Initiative (MMAI) services should be billed to the applicable managed care plan.
Additional information regarding MLTSS can be found in the May 14, 2019 notice. Questions regarding this notice may be directed to the Bureau of Professional and Ancillary Services at 877-782-5565.
Kelly Cunningham, Administrator
Division of Medical Programs