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DMAS Fee For Service (FFS)
Non-Emergency Medical Transportation (NEMT)
Driver, Attendant, and Vehicle Requirements
The following DMAS FFS Non-Emergency Transportation (NEMT) requirements are for vehicles,
attendants, and drivers. These requirements are to be used as minimum program guidelines and are
subject to change. Please contact the DMAS Fee For Service Broker or Managed Care plan for which
you are enrolling with for current contract requirements.
or the plan for which you are planning to
contract with for answers.
The requirements listed include training, licensing, vehicle inspection, registration, and insurance
coverage. These requirements should be included in all agreements with NEMT providers. Contractors
may establish additional driver, vehicle, attendant and insurance requirements.
The Contractor shall field monitor provider vehicles for regulation compliance.
Compliance
The Contractor shall ensure that:
a. Vehicles comply with all applicable laws, regulations and ordinances of federal, state and local
agencies in the jurisdictions in which the vehicles are used.
b. Transportation providers with “Taxi” license plates are in compliance with state and local ordinances
for taxis and are currently licensed by the local taxi authority, if one exists, in the jurisdictions in
which they operate. All taxi drivers must be PASS certified.
c. All vehicles are titled and licensed by the Virginia Department of Motor Vehicles to operate in
Virginia and shall have the proper operating authority.
d. Operators of ambulances comply with the State Ambulance Regulations as defined by Code of
Virginia § 32.1-111.1, and the Virginia Department of Health, Office of Emergency Medical Services
(OEMS).
e. NEMT providers that accept out-of-state trips have the proper motor carrier operating authority
from the Federal Motor Carrier Safety Administration.
f. At a minim, subcontracted NEMT providers maintain full coverage insurance as established by the
Commonwealth.
g. Provider network has adequate backup vehicles to recover trips. Backup drivers and vehicles shall
comply with all driver and vehicle requirements herein.
Attendants
The Contractor shall:
a. Provide a transportation attendant for a member or group of members when it is necessary for the
safety of the member(s), to ensure timeliness of the trip or to reduce behavioral problems en route.
b. The Contractor shall submit attendant claims as part of encounters.
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c. Provide an attendant to ride with minors 12 and under when no family member or escort can be
provided.
Volunteer Drivers/Registered Drivers
A Volunteer or Registered Driver is an individual who meets the credentialing and training requirements
as a other provider employed drivers. These drivers transport members in a personal vehicle that meets
the insurance, inspection and other safety requirements as outlined in driver and vehicle requirements;
and, accepts occasional trips (e.g., long-distance trips or recovery trips) from the Contractor in exchange
for gas reimbursement.
The requirements of volunteer drivers include but not limited to:
a. At least 18 years of age and have two years of driving experience
b. Current and valid Virginia driver’s license
c. Good driving record with no more than a (-)2
d. Criminal background and drug screen that meet the driver requirements as listed in vehicle and
drive requirements.
e. Full automobile insurance coverage that does not exempt carrying passengers under volunteer
driver services or any other reimbursement
The Contractor shall:
a. Coordinate a volunteer driver program to ensure sufficient number of volunteer drivers are available
in each region;
b. Ensure all volunteer drivers meet training and credentialing requirements; and
c. Ensure all volunteer driver vehicles meet insurance, inspection and safety requirements.
d. Ensure all volunteer drivers have NPI and taxonomy codes.
Driver and Attendant Requirements
The Contractor shall conduct all driver and attendant credentialing prior to allowing Drivers and
Attendant to transport Medicaid Members. The Contractor shall assure compliance with driver
requirements.
Attendants, when required, must be identified and provided within five (5) business days of approval.
The Contractor shall ensure that all drivers and attendants of vehicles transporting members abide by
state and local laws, and meet the following requirements:
a. Are at least 18 years of age and have had a valid driver’s license for at least two years.
b. Have a current valid driver’s license to operate the transportation vehicle to which they are
assigned.
c. Be prohibited from employment or contracting with the Contractor if they have more than two
chargeable accidents or moving violations in the last three years. The VA DMV Driver’s License
Points may not exceed -2.
d. Drivers and attendants who have had their driver’s license suspended or revoked for moving traffic
violations in the previous five years are prohibited from driving for a provider who contracts with
the Contractor.
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e. Drivers and attendants convicted of a “barrier crime” as defined in Virginia Code § 37.2-314(B) are
prohibited from driving for a provider who contracts with the Contractor. The Contractor must
require that the transportation provider secure, maintain, and provide criminal background checks
from Virginia State Police and/or national databases, including the Sex Offender Registry, on each
driver before the driver transports members under this contract.
f. All NEMT drivers, attendants, taxi drivers, and volunteer drivers, whether contracted or non-
contracted, must complete and pass a Passenger Service and Safety (PASS) Trainer and Driver
Course before transporting any member. Providers who conduct their own internal driver training
program must have written approval from the Contractor that the course meets or exceeds the
NEMT Driver Training Requirements. The Contractor shall keep records of all providers who have
been approved to conduct their own internal training program.
g. All drivers and attendants shall be courteous, patient, and helpful to all members and be neat and
clean in appearance.
h. All drivers shall wear a uniform shirt that displays and/or a NEMT Program ID Badge, received from
the Contractor upon completing PASS certification. The Contractor shall, upon program
implementation and/or completing PASS certification, provide every trained and credentialed driver
without a uniform shirt displaying a name, a NEMT Program ID Badge.
The badge shall be secured to
clothing in a conspicuous location. The driver shall show the ID Badge to the member, facility, or
other service provider employee upon arrival for picking up the member.
i. Driver or attendant shall not use or abuse alcohol, narcotics, illegal drugs, or prescription
medications that impact the ability to perform while on duty or at any time. The transportation
provider shall not use drivers or attendants who are known abusers of alcohol, prescription drugs,
or illegal narcotics or drugs. Drivers or attendants using alcohol, narcotics, or illegal drugs while on
duty will be prohibited from transporting Medicaid members for a provider who contracts with the
Contractor. The Contractor shall maintain, in their database, records of such drivers.
j. Vehicles always shall be tobacco and smoke free. This includes smokeless tobacco, vapor, and
Electronic (E)-cigarettes. Drivers and attendants shall not smoke or use a tobacco delivering device
while in the vehicle, while assisting a member, or in the presence of any member.
k. Drivers shall not use mobile telephones (including texting) or headphones while the vehicle is in
motion.
l. Drivers or attendants must exit the vehicle to open and close vehicle doors when members enter or
exit the vehicle. Drivers or attendants must provide an appropriate level of assistance to members
when requested or when necessitated by the member’s mobility status and personal condition. This
includes curb-to-curb, door-to-door, and hand-to-hand assistance, as shown in the manifest.
m. If a curbside pick-up is not being made, drivers and attendants shall identify themselves, show their
identification and announce their presence at the entrance of the facility or residence at the
specified pick-up location or to attending facility staff.
n. Prior to starting the vehicle, drivers or attendants shall assist members as needed and confirm that
all passengers are seated, all seat belts are properly fastened and all wheelchairs are properly
secured. Passengers will have their seat belts buckled at all times while they are inside the vehicle.
o. Prior to starting the vehicle, drivers and attendants shall properly secure all wheelchairs and
wheelchair passengers.
p. Drivers and attendants shall provide necessary assistance, support, and oral directions to members,
including assistance to members with limited mobility, and with the loading, securing and storing of
mobility aids and wheelchairs.
q. Before departing the drop-off point, drivers shall confirm that the delivered members are safely
inside their destination.
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r. Drivers and attendants shall not touch any member except as appropriate and necessary to assist
the member into or out of the vehicle, into a seat, to secure the seat belt, or to render first aid or
assistance for which the driver has been trained.
s. Drivers and attendants shall not solicit or accept money, goods or additional business from
members.
t. Drivers must be familiar with and knowledgeable of the streets and highways of the localities in
which they are transporting. Drivers must possess current printed street maps or GPS covering the
area, updated to within the current year.
u. Drivers and attendants must comply with HIPAA, by keeping all members’ identifying information
confidential, and not visible to other passengers, and by not discussing identifying information with
anyone who is not involved with the member’s treatment or other health care services.
v. The Contractor shall conduct all driver and attendant credentialing reviews prior to implementation
and at least annually thereafter. All the records of these reviews shall be maintained by the
Contractor.
w. The Contractor shall use DMV’s Driver Alert-Volunteer Driving Record Monitoring Program
x. Volunteer drivers must be licensed to operate the vehicle used, and must conform to the
requirements for Drivers and Attendants.
Vehicle Requirements
The Contractor shall ensure that all vehicles meet the requirements listed in this section. These
requirements shall be included in the Model Contract with NEMT providers. With prior approval from
DMAS, the Contractor may include additional vehicle requirements.
The Contractor shall assure that:
a. Vehicles and all components shall at minimum meet or exceed state, federal, local, and
manufacturer’s safety and mechanical operating and maintenance standards.
b. Vehicles shall comply with the Americans with Disabilities Act (ADA) Accessibility Specifications
for Transportation [1], 49 CFR § 38, Subparts A and B prior to being approved for use under this
contract. The Contractor shall supply all transportation providers with a copy of the ADA vehicle
requirements and inspect for compliance.
c. All vehicles shall be equipped with adequate and functioning heating and air-conditioning
systems. Functionality shall be defined by temperature readings from the rear of the vehicle,
achieving air conditioning to 68 degrees and heating to 74 degrees.
d. Safety belts must be provided for all passengers. Seat belts must be stored off the floor when
not in use. Securement belts must be provided and installed for each wheelchair position.
e. Each vehicle shall utilize age and weight appropriate infant and child safety seats provided by
the parent or guardian when transporting children through the age of seven (7) (until 8th
birthday).
f. Newer vehicles manufactured with longer lap/shoulder belts shall have a minimum of one (1)
seat belt extension. The extension is available for Members with a large girth that prevents the
Member from fastening the vehicles standard seat belt equipment. Older vehicles
manufactured with shorter lap/shoulder belts shall have two (2) seat belt extensions available.
At no time shall a member be transported without a lap/shoulder belt fastened.
g. For use in emergency situations, each vehicle shall be equipped with at least one seat belt cutter
within easy reach of the driver. Exceptions to this requirement must be approved in advance
and in writing by DMAS.
h. All vehicles shall have an accurate speedometer and odometer.
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i. All vehicles shall have two exterior rear view mirrors, one on each side of the vehicle.
j. NEMT vehicles should be driven with head lights on during vehicle operation.
k. All vehicles shall be equipped with an interior mirror for monitoring the passenger
compartment.
l. The exterior of the vehicle shall be clean, free of broken mirrors or windows, excessive grime,
rust, major dents, body damage, damaged bumpers or paint damage that detract from the
overall appearance of the vehicles.
m. The interior of the vehicle shall be clean, free from torn upholstery, floor or ceiling covering;
free from damaged or broken seats; and free from protruding sharp edges. The interior shall
also be free of dirt, oil, grease, and litter.
n. Vehicles shall be free of hazardous debris or unsecured items and shall be operated within the
manufacturer’s safe operating standards at all times.
o. At a minimum, all vehicles shall have the transportation provider’s business name and
telephone number displayed on both sides of the exterior of the vehicle. The business name and
phone number must appear in permanently affixed lettering that is a minimum of three inches
in height and of a color that contrasts with its surrounding background.
p. To comply with HIPAA requirements, the word “Medicaid” or “FAMIS” may not be displayed on
the vehicle or in the name of the business.
q. The vehicle license number, the Contractor’s toll-free and Voice/TTY number(s), and the
complaint procedures shall be prominently displayed on the interior of each vehicle. This
information shall also be available in a written format in each vehicle for distribution to
members upon request.
r. Smoking, including Vapor and E-cigarettes, is prohibited in all vehicles at all times. All vehicles
shall have the following signs posted in all vehicle interiors, easily visible to the passengers: (1)
“NO SMOKING” (including Vapor and E-cigarettes) and (2) “ALL PASSENGERS WILL USE SEAT
BELTS.”
s. All vehicles shall carry a vehicle information packet containing vehicle registration, insurance
card, and the Contractor’s accident and incident procedures and forms. If leased, the packet
shall include the vehicle lease agreement.
t. All vehicles shall be provided with a first aid kit that includes at least the following unexpired
items:
i. Three sizes of adhesive bandages
ii. Antiseptic cleansing wipes
iii. Dressing pads
iv. Oval eye pad
v. Conforming gauze bandage
vi. Triangular bandage
vii. Triple antibiotic
viii. Insect sting relief pads
ix. Cold pack
x. Cotton-tip applicators
xi. Latex gloves
xii. Scissors
xiii. Sterile eyewash
u. All vehicles shall contain a functioning GPS device or current map of the jurisdictions in which
they operate with sufficient detail to locate members, facilities, and other service providers.
v. All vehicles shall be equipped with a working fire extinguisher (Class A, B, C) that shall be
secured within easy reach of the driver.
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w. The Contractor shall ensure that transportation providers with “Taxi” license plates are in
compliance with state and local ordinances for taxis and are currently licensed by the local taxi
authority, if one exists, in the jurisdictions in which they operate.
x. Insurance coverage for all NEMT vehicles shall be verified and maintained during the contract
period in accordance with state and local regulations and contract requirements.
y. Taxis and Multi-Passenger Vans: The required amount of insurance is the greater of the amount
required by the Virginia DMV or the city or county ordinance for taxis.
z. Wheelchair Vans and Stretcher Vans: The amount required by DMV.
aa. Ambulances: The amount required by the Virginia Department of Health, Office of Emergency
Medical Services.
bb. Vehicles shall be equipped with a “Spill Kit” including: liquid spill absorbent, latex gloves,
hazardous waste disposal bags, scrub brush, disinfectant, and deodorizer.
cc. Wheelchair vans willing to accept hospital discharges shall carry on board one wheelchair in
good condition, safely secured, with a minimum seat width of twenty inches (20”). Each wheel
chair van must have four fully functional securements per wheel chair station on vehicle and the
interlock system needs to be in working order. All wheel chair vehicles must have a lap and
shoulder belt that is mounted to the vehicle and installed at every wheelchair station. The lap
and shoulder belt system must be specifically made for securement of wheelchair riders. The
wheelchair van must comply with the Americans with Disabilities Act (ADA).
dd. In order to route trips to NEMT providers with the appropriate lift capacity for members and
their mobility devices, the Contractor shall document the age, manufacturer, model number,
and the manufacturer’s stated lifting capacity of each wheelchair lift in its network of
transportation providers.
ee. The Contractor shall describe its capacity (including providers of bariatric transport and
equipment available) to transport bariatric patients throughout the Commonwealth of Virginia.
The provider must meet the requirements and guidelines established for bariatric transport by
the Virginia Department of Health, Office of Emergency Medical Services.
ff. All vehicles must be inspected prior to transporting members, and re-inspected semi-annually.
Wheelchair vans and stretcher vans require inspections twice annually. Records of all
inspections shall be maintained by the Contractor in an electronic database format.
gg. Describe a semi-annual (every six months) inspection plan to verify that all vehicles used by its
transportation providers meet the requirements of this section and that safety and passenger
comfort features are in good working order.
hh. The Contractor shall visually in person inspect semi-annually all vehicles transporting members
under this contract.
Contracted, non-contracted, in-network, out of network transportation
providers who are not governed by another state agency must have vehicles inspected by the
broker. Upon completion of an inspection, an inspection sticker (supplied by the Contractor)
shall be applied to each provider vehicle. Different stickers shall be used to indicate which
vehicles have successfully passed inspection, which vehicles have provisionally passed
inspection, and which have failed inspection and have been removed from service under this
contract until deficiencies are corrected. To comply with HIPAA requirements, the word
“Medicaid” or “FAMIS” may not be displayed on the inspection stickers. The Contractor shall
place the inspection sticker on the outside of the passenger side rear window in the lower right
corner. The sticker also shall show the license plate number and vehicle identification number of
the vehicle in permanent ink.
ii. Any vehicle or driver found out of compliance with these contract requirements or any state or
federal regulations may be temporarily removed from service immediately by authorized
employees of DMAS or the Contractor until the Contractor verifies that the deficiencies have
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been corrected. Any deficiencies and actions taken shall be documented and become a part of
the vehicle’s and the driver’s permanent records.
The Contractor shall have available monthly vehicle inspection reports to verify that all vehicles used by
its transportation providers meet the requirements of this section and that safety and passenger
comfort features are in good working order.
Public transit is already regulated and is not subject to the training requirements and safety inspections;
DRPT regulates public transit driver training and vehicle safety.
Passenger Safety Requirements
The Contractor, NEMT providers, drivers, and attendants shall ensure compliance with the following
passenger safety requirements:
a. Passengers shall have their seat belts buckled at all times while they are inside the vehicle. The
driver shall assist passengers who are unable to fasten their own seat belts.
b. The driver shall not move the vehicle until all passenger seat belts have been buckled.
c. The number of persons in the vehicle, including the driver, shall not exceed the vehicle
manufacturer’s designed seating capacity.
d. Upon arrival at the destination, the vehicle shall be parked or stopped so that passengers do not
have to cross streets to reach the entrance of their destination.
e. Vehicles should always be visible by the driver.
f. If passenger behavior or other conditions impede the safe operation of the vehicle, the driver
shall park the vehicle in a safe location out of traffic and notify his dispatcher to request
assistance.
Stretcher Van Requirements
Stretcher van service is a level of service provided to a member who cannot be transported in a taxi or
wheelchair van and who does not need the medical services of an ambulance. A driver and an assistant
staff the vehicle that is specifically designed and equipped to provide NEMT for individuals on an
approved stretcher. At other times, the vehicle also may transport passengers in wheelchairs if the
proper anchorages and securement devices are installed. A stretcher van is used for a medically stable
individual who: (1) needs routine transportation to or from a non-emergency medical appointment or
service; (2) is convalescent or otherwise non-ambulatory and cannot use a wheelchair; and, (3) does not
require emergency medical transport, medical monitoring, aid, care or treatment during transport. Self-
administered oxygen is permitted if the oxygen tank is secured safely, as described below.
In addition to the general requirements for all vehicles and drivers operating under this contract,
stretcher vans shall be operated by a driver and an assistant who have completed DMAS approved
training in first aid, handling blood borne pathogens, and in transferring, loading and unloading
passengers in stretchers.
The following restrictions shall apply:
a. A stretcher van passenger shall not be left unattended at any time;
b. The driver and assistant shall confirm that all restraining straps are fastened properly and that the
stretcher, stretcher fasteners and anchorages are properly secured;
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c. The assistant shall be seated in the passenger compartment while the vehicle is in motion and shall
notify the driver of any sudden change in the passenger’s condition; and,
d. The stretcher van vehicle shall not be used:
i. for emergency medical transportation;
ii. to transport a passenger who requires basic or advanced life support;
iii. to transport a passenger who has in place any temporary invasive device (including a saline
lock) or equipment such as an intravenous administration device or an airway maintenance
device;
iv. to transport a passenger who requires close observation or medical monitoring; or,
v. to transport more than one (1) stretcher passenger at a time.
e. A minimum of two (2) crew members shall be in the stretcher van. The second crew member shall
be seated in the passenger compartment while the vehicle is in motion and shall notify the driver of
any sudden change in the passenger’s condition.
f. Ambulances modified to become stretcher vans are required to remove any and all Ambulance
markings, red or amber lights, flashing lights, or any other vehicle modification that indicates this
vehicle could be an ambulance.
g. Ambulances must conform to State Emergency Medical Services Regulations as defined by Code of
Virginia § 32.1-111.1
, and the Virginia Department of Health, Office of Emergency Medical Services
(OEMS).
At a minimum, the Contractor shall inspect and certify that each stretcher vehicle complies with the
following:
a. The vehicle must be equipped with an approved stretcher used to transport individuals in the supine
or Fowler’s position.
b. Passengers shall be loaded headfirst.
c. The driver and attendant shall confirm that all restraining straps are fastened properly and that the
stretcher, stretcher fasteners and anchorages are properly secured.
d. Stretchers shall be one of two styles (excerpted from GSA Federal Specifications KKK-A-1822E, June
1, 2002):
i. Style 1: Elevating wheeled cot with a minimum length of 191/75 (cm/in), a minimum width
of 56/22, and a maximum bed height when collapsed of 38/15 measured to the top of a
positioned 8/3 thick mattress.
ii. Style 2: Elevating wheeled cot with additional front roll in wheels with a minimum length of
200/79 (cm/in), a minimum width of 56/22, a maximum bed height when collapsed of 13/33
measured to the top of a positioned 8/3 thick mattress.
iii. Length and width measurements shall be taken at the metal framing, excluding joint fittings.
Stretchers shall have a polyester foam mattress at least 8 cm (3 inches) thick or an
equivalent mattress covered with vinyl coated, nylon fabric or other non-porous fabric
conforming to FMVSS 302, or equivalent, and restraint straps. At least three strap-type
restraining devices (chest, hip, and knee) shall be provided per stretcher to prevent
longitudinal or transverse dislodgement of the patient during transit. Additionally, the head
of the stretcher shall be furnished with upper torso (over the shoulder) restraints that
mitigate forward motion of the patient during severe braking or in a frontal impact accident.
Restraining straps shall incorporate metal-to-metal quick release buckles, be not less than
51 mm (2 inches) wide and fabricated from nylon or other materials easily cleaned and
disinfected.
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iv. The stretcher fasteners and anchorages shall be a crash-stable side or center mounting cot
fastener assembly with a quick release latch. It shall secure the Style 1 or Style 2 wheeled
stretcher to the van body. The installed stretcher fastener device for wheeled stretchers
shall be tested to comply with a 2200 lb. Pull test in accordance with AMD Standard 004,
Litter Retention System. Additional stretcher related hardware is permitted, provided the
patient compartment exit/entry is not encumbered with the stretcher in place. The
furnished devices shall have a bright colored finish, if the device presents a tripping hazard
in the entry/exit area when the stretcher is removed (excerpted from GSA Federal
Specifications KKK-A-1822E, June 1, 2002).
v. If the passenger needs a scoop, reeves or stair chair stretcher, the NEMT provider must
supply it.
a. The stretcher van must comply with the Americans with Disabilities Act (ADA).
b. A stretcher van must be maintained in good repair and safe operating condition and shall meet the
same motor vehicle safety requirements as apply to all vehicles in Virginia:
i. State motor vehicle safety inspection must be current.
ii. Exterior surfaces of the vehicle including windows, mirrors, warning devices and lights must be
kept clean of dirt and debris.
c. Safety belts must be provided for all passengers.
d. A climate environmental system must supply and maintain clean air conditions and a controlled
temperature inside the passenger compartment.
e. Self-administered oxygen must be secured in accordance with Ambulance Manufacturers Division of
the National Truck Equipment Association Standard 003, "Oxygen Tank Retention System Test."
f. The following must appear on the stretcher vehicle in permanently affixed lettering that is a
minimum of three inches in height and of a color that contrasts with its surrounding background:
i. The business name of the provider vehicle must appear on both sides of the vehicle body.
ii. This lettering may appear as part of an organization's logo or emblem as long as the service
name appears in letters of the required height.
iii. If the transportation provider is also licensed by the OEMS as an EMS agency, the terms
"Ambulance" or "Emergency Medical Service" or any combination of similar terms may
appear on the vehicle only as a part of the service's name.
iv. Any additional lettering, logos or emblems may appear on the vehicle at the discretion of
the transportation provider. The height of any additional lettering must be less than the
lettering used for the service's name.
v. All additional lettering, logos or emblems may not advertise or imply the capability to
provide emergency medical services.
vi. Except for OEMS licensed providers, no vehicle shall display the SOL (Star of Life) emblem or
be equipped with emergency warning devices, audible or visual, such as flashing lights,
sirens, air horns, or such devices except those which are required by the DMV.
The following requirements for sanitary conditions and supplies apply to all stretcher vehicles in
accordance with recommendations and standards established by the Centers for Disease Control and
Prevention (CDC) and the Virginia Occupational Safety and Health Law:
a. The interior of the stretcher vehicle, including all storage areas, equipment, and supplies must be
kept clean and sanitary.
b. Waterless antiseptic hand wash must be available on the unit.
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c. Following transport, and before being occupied by another passenger, all contaminated surfaces
must be cleaned and disinfected using a method recommended by the CDC. Cleaning and
disinfection supplies must be carried on each vehicle.
d. All soiled supplies and used disposable items must be stored or disposed of in plastic bags, covered
containers or compartments provided for this purpose. Red or orange bags must be used for
regulated waste.
e. Clean stretcher linen or disposable sheets and pillowcases or their equivalent shall be available in
the vehicle and shall be changed after each use when used in the transport of a patient.
f. Blankets, pillows, mattresses, and rain cloths, used in the vehicle shall be intact and kept clean and
in good repair.
In determining the appropriate use of stretcher van service, the Contractor shall use the following
guidelines:
a. Prior to implementing this service, the Contractor shall submit an implementation plan to DMAS for
approval. The plan shall be reviewed, revised if necessary, and re-submitted annually for DMAS
approval. The plan shall include:
i. Detailed protocols for determining the eligibility or ineligibility for transport by stretcher van;
ii. Provisions for training the appropriate employees at the call center about these protocols; and,
iii. Provisions for educating appropriate NEMT providers, facilities, other service providers, and
members about these protocols.
b. Eligible users for stretcher van services include medically stable, non-emergency individuals who
need to be transported on a stretcher but do not need any medical monitoring, aid, care or
treatment during transport.
c. Non-eligible users for stretcher van services under this contract include, but are not limited to:
i. Passengers requiring invasive procedures (IV therapy, drug administration, I.V. pumps, etc.);
ii. Passengers requiring mechanical monitoring procedures;
iii. Passengers requiring mechanical respiratory procedures or suctioning;
iv. Passengers requiring oxygen therapy, except for self-administered oxygen;
v. Passengers who have sustained an injury and have not been evaluated by a physician; and,
vi. Passengers who are known to have an acute, infectious process.
d. When the medical condition of a passenger suddenly changes and requires care to be rendered, the
driver shall immediately contact the local 911 dispatcher to request help, then notify their own base
of operations to advise them of the situation. Appropriate first aid may be initiated and continued
until the EMS service has intercepted the transport or arrival at the hospital. Whenever a stretcher
van is diverted to an Emergency Department or requests an EMS intercept, an Exception Report
must be filed by the Contractor with the Virginia Department of Health, Office of Emergency
Medical Service within two business days. A copy must be sent to DMAS at the same time
(Attachment XIII).
e. An ambulance may be used in place of a stretcher vehicle only if it meets the equipment, supply and
staffing requirements for ambulances as specified in Virginia OEMS Regulations (12 VAC5-31-300 et
seq. EMS Vehicle Classification and Requirements).
f. Ambulance billing methodology for dually eligible Medicare and Medicaid members that require
ambulance transport needs to take into consideration:
i. Medicare members have the right to choose providers. However, Medicaid members do not
have the right to choose providers but a provider can be requested.
ii. Ambulance providers should be able to contact Contractor for authorization to transport in case
Medicare denies payment.
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iii. Contractor should not re-assign trip to different provider if every effort is made to ensure
transport meets Medicare criteria for non-emergency transport payment.
iv. If ambulance transport does not meet medical necessity of Medicare criteria, then Contractor
can assign ambulance provider of their choice.
v. Dually eligible Medicare and Medicaid members enrolled in Commonwealth Coordinated Care
or CCC Plus receive all transportation benefits from the MCO plan in which they are enrolled
{with the exception of those members and services who have carved out services).
