Tex.
Gov't Code Section 533.00258
Nonmedical Transportation Services Under Medicaid Managed Care Program
(a)
In this section:(1)
“Nonmedical transportation service” means:(A)
curb-to-curb transportation to or from a medically necessary, nonemergency covered health care service in a standard passenger vehicle that is scheduled not more than 48 hours before the transportation occurs, that is provided to a recipient enrolled in a managed care plan offered by a Medicaid managed care organization, and that the organization determines meets the level of care that is medically appropriate for the recipient, including transportation related to:(i)
discharge of a recipient from a health care facility;(ii)
receipt of urgent care; and(iii)
obtaining pharmacy services and prescription drugs; and(B)
any other transportation to or from a medically necessary, nonemergency covered health care service the commission considers appropriate to be provided by a transportation vendor, as determined by commission rule or policy.(2)
“Transportation network company” has the meaning assigned by Section 2402.001 (Definitions), Occupations Code.(3)
“Transportation vendor” means an entity, including a transportation network company, that contracts with a Medicaid managed care organization to provide nonmedical transportation services.(b)
The executive commissioner shall adopt rules regarding the manner in which nonmedical transportation services may be arranged and provided.(c)
The rules must require a Medicaid managed care organization to create a process to:(1)
verify that a passenger is eligible to receive nonmedical transportation services;(2)
ensure that nonmedical transportation services are provided only to and from covered health care services in areas in which a transportation network company operates; and(3)
ensure the timely delivery of nonmedical transportation services to a recipient, including by setting reasonable service response goals.(d)
Before September 1, 2020, and subject to Section 533.002581 (Delivery of Nonmedical Transportation Services Under Medicaid Managed Care Program)(h), a rule adopted in accordance with Subsection (c)(3) may not impose a penalty on a Medicaid managed care organization that contracts with a transportation vendor under this section if the vendor is unable to provide nonmedical transportation services to a recipient after the Medicaid managed care organization has made a specific request for those services.(e)
The rules must require a transportation vendor to, before permitting a motor vehicle operator to provide nonmedical transportation services:(1)
confirm that the operator:(A)
is at least 18 years of age;(B)
maintains a valid driver’s license issued by this state, another state, or the District of Columbia; and(C)
possesses proof of registration and automobile financial responsibility for each motor vehicle to be used to provide nonmedical transportation services;(2)
conduct, or cause to be conducted, a local, state, and national criminal background check for the operator that includes the use of:(A)
a commercial multistate and multijurisdiction criminal records locator or other similar commercial nationwide database; and(B)
the national sex offender public website maintained by the United States Department of Justice or a successor agency;(3)
confirm that any vehicle to be used to provide nonmedical transportation services:(A)
meets the applicable requirements of Chapter 548 (Inspection of Vehicles), Transportation Code; and(B)
except as provided by Subsection (j), has at least four doors; and(4)
obtain and review the operator’s driving record.(f)
The rules may not permit a motor vehicle operator to provide nonmedical transportation services if the operator:(1)
has been convicted in the three-year period preceding the issue date of the driving record obtained under Subsection (e)(4) of:(A)
more than three offenses classified by the Department of Public Safety as moving violations; or(B)
one or more of the following offenses:(i)
fleeing or attempting to elude a police officer under Section 545.421 (Fleeing or Attempting to Elude Police Officer; Offense), Transportation Code;(ii)
reckless driving under Section 545.401 (Reckless Driving; Offense), Transportation Code;(iii)
driving without a valid driver’s license under Section 521.025 (License to Be Carried and Exhibited on Demand; Criminal Penalty), Transportation Code; or(iv)
driving with an invalid driver’s license under Section 521.457 (Driving While License Invalid), Transportation Code;(2)
has been convicted in the preceding seven-year period of any of the following:(A)
driving while intoxicated under Section 49.04 (Driving While Intoxicated) or 49.045 (Driving While Intoxicated with Child Passenger), Penal Code;(B)
use of a motor vehicle to commit a felony;(C)
a felony crime involving property damage;(D)
fraud;(E)
theft;(F)
an act of violence; or(G)
an act of terrorism; or(3)
is found to be registered in the national sex offender public website maintained by the United States Department of Justice or a successor agency.(g)
The commission may not require:(1)
a motor vehicle operator to enroll as a Medicaid provider to provide nonmedical transportation services; or(2)
a Medicaid managed care organization to credential a motor vehicle operator to provide nonmedical transportation services.(h)
The commission or a Medicaid managed care organization that contracts with a transportation vendor may require the transportation vendor or a motor vehicle operator who provides services under this section to be periodically screened against the list of excluded individuals and entities maintained by the Office of Inspector General of the United States Department of Health and Human Services.(i)
Notwithstanding any other law, a motor vehicle operator who is part of a transportation network company’s network and who satisfies the driver requirements in Section 2402.107 (Driver Requirements), Occupations Code, is qualified to provide nonmedical transportation services. The commission and a Medicaid managed care organization may not impose any additional requirements on a motor vehicle operator who satisfies the driver requirements in Section 2402.107 (Driver Requirements), Occupations Code, to provide nonmedical transportation services.(j)
For purposes of this section and notwithstanding Section 2402.111 (Vehicle Requirements)(a)(2)(A), Occupations Code, a motor vehicle operator who provides services under this section may use a wheelchair-accessible vehicle equipped with a lift or ramp that is capable of transporting passengers using a fixed-frame wheelchair in the cabin of the vehicle if the vehicle otherwise meets the requirements of Section 2402.111 (Vehicle Requirements), Occupations Code.
Source:
Section 533.00258 — Nonmedical Transportation Services Under Medicaid Managed Care Program, https://statutes.capitol.texas.gov/Docs/GV/htm/GV.533.htm#533.00258 (accessed Apr. 29, 2024).
