Virginia Non-Emergency Medical Transportation Services Policy Manual

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This policy manual establishes the framework for compliance with 12VAC30-50-530, which governs documentation standards for non-emergency medical transportation (NEMT) services under Virginia’s Medicaid program. This policy ensures that providers deliver safe, reliable, and cost-effective transportation to Medicaid recipients who need access to covered medical services when no other means of transportation is available. Aligned with the Virginia Department of Medical Assistance Services (DMAS) and federal Medicaid regulations (42 CFR §431.53), this policy supports equitable access to healthcare services while maintaining full compliance with state and federal requirements.
Providers must maintain comprehensive documentation for all NEMT services, including trip logs, prior authorizations, and vehicle/driver credentials. Trip logs must record essential details such as dates, times, pick-up/drop-off locations, passenger names, and Medicaid ID numbers. Additional documentation must verify that transportation was medically necessary, economical, and authorized by DMAS or its designated broker. Providers are required to ensure that all vehicles and drivers meet licensing and insurance requirements as specified by Virginia law.
This policy emphasizes the importance of accurate record-keeping to support claims for reimbursement, facilitate audits, and ensure compliance with Medicaid standards. By adhering to 12VAC30-50-530, providers can deliver high-quality non-emergency medical transportation services that enable Medicaid recipients to access critical healthcare services safely and efficiently.