Code of Maine Rules › 10 - DEPARTMENT OF HEALTH AND HUMAN SERVICES › 144 - DEPARTMENT OF HEALTH AND HUMAN SERVICES - GENERAL › Chapter 101 - MAINECARE BENEFITS MANUAL (FORMERLY MAINE MEDICAL ASSISTANCE MANUAL) › Chapter II - Specific Policies By Service › Section 144-101-II-113 - Non-Emergency Transportation (NET) Services › Subsection 144-101-II-113.01 - DEFINITIONS

Current through 2024-29, July 17, 2024
113.01-1
Attendant:
An employee
					 of an Agency Transporter or Broker, approved and reimbursed by the Broker, who
					 assists the driver and accompanies a Member or group of Members during
					 transport in order to ensure the safe operation of the vehicle and the safety
					 of the Members. Attendants must be at least 18 years of age.
113.01-2
Broker:
An entity with
					 which the Department has contracted to manage, authorize, coordinate, and
					 reimburse the provision of necessary Non-Emergency Transportation for eligible
					 MaineCare Members.
113.01-3
Department:
The Maine Department of Health and Human Services,
					 acting through the Office of MaineCare Services.
113.01-4
Escort:
A personal
					 assistant, family member, friend, volunteer or facility employee who
					 accompanies a Member for the entire trip and stays with the Member at the
					 destination.
113.01-5
Incident:
Any unanticipated event, other than a motor vehicle
					 accident, which results in a disruption of services.
113.01-6
Late:
More than 15
					 minutes after the scheduled pick-up time from a Point of Origin, more than 5
					 minutes after the scheduled drop-off time for an appointment/ MaineCare covered
					 service, or more than 30 minutes after the scheduled pick-up time from an
					 appointment/MaineCare covered service.
113.01-7
MaineCare Covered
					 Services:
Services covered and reimbursed through MaineCare, as provided
					 in the MaineCare Benefits Manual.
113.01-8
Member:
Any person
					 certified as eligible for services under the MaineCare program.
113.01-9
NET:
Non-Emergency
					 Transportation.
113.01-10
No
					 Show:
A failure by the Member to utilize previously scheduled
					 transportation without contacting the Broker in advance of the trip to cancel
					 it. This includes the Member failing to be at the agreed upon Point of Origin
					 no later than 10 minutes after the scheduled pick up time or canceling with the
					 Transporter at its arrival at the Point of Origin location.
113.01-11
On Time:
From thirty
					 (30) minutes before until fifteen (15) minutes after the scheduled pick-up time
					 from a Point of Origin; from thirty (30) minutes before until five (5) minutes
					 after the scheduled drop-off time at an appointment/MaineCare covered service;
					 and until thirty (30) minutes after the scheduled pick-up time from an
					 appointment/MaineCare covered service. For an unscheduled pick-up (e.g., when
					 the Member will call after a medical appointment), "on time" is within two (2)
					 hours of the time the Broker is notified that the Member is ready to be picked
					 up in a rural area, and within (1) hour of the call to a Broker in an urban
					 area.
113.01-12
Personal
					 Assistant:
A person who is designated by a Member to assist with one or
					 more daily life functions, including helping the Member use transportation
					 services. A fare is not charged for the Personal Assistant to ride with the
					 Member. Personal assistants are not provided by the Broker.
113.01-13
Point of Origin:
Location (usually, but not always, a residence) where a Member first boards a
					 ride.
113.01-14
Public
					 Transportation:
Buses, trains, ferries, and other forms of
					 transportation that charge set fares, run on fixed routes, and are available to
					 the public.
113.01-15
Records:
All documents
					 relating to the services performed by the Broker or Transporter, including but
					 not limited to books, notes, meeting agendas, schedules, phone records,
					 voicemail messages, email and other communications, payrolls, papers,
					 accounting records and other documents that contain information regarding the
					 subject matter of this Section.
113.01-16
Related Travel
					 Expenses:
Expenses incurred by the Transporter, Member, or Escort during
					 the provision of NET services that are necessary to ensure Member access to
					 MaineCare covered services. These expenses may include overnight lodging and
					 meal expenses.
113.01-17
Reports:
Regularly
					 scheduled submissions that the Broker is contractually required to submit to
					 the Department so that the Department can monitor the Broker's
					 performance.
113.01-18
Rural:
Areas not defined as Urban by the Maine Department of
					 Transportation. Current definitions can be found at
http://www.maine.gov/mdot/csd/mts/stateurbancompact.htm
.
113.01-19
Standing Orders:
Recurring or repetitive trips that occur one (1) or more days a week with the
					 same Point of Origin, MaineCare covered service destination and
					 return.
113.01-20
Transporters:
Any entity, organization or individual that provides
					 transportation services reimbursable by a Broker under the NET program. This
					 includes agents of the Broker with which the Broker has entered a Service
					 Agreement ("Agency Transporters"), public transportation, commercial taxis,
					 volunteers, and friends and family.
113.01-21
Urban:
Areas defined as
					 Urban by the Maine Department of Transportation. These include those areas in
					 which, according to the last United States census, the population (1) exceeds
					 7,500 inhabitants or (2) is less than 7,500 inhabitants but more than 2,499
					 inhabitants, and the ratio of people whose place of employment is in a given
					 municipality to employed people residing in that same municipality is 1.0 or
					 greater, and when the municipality has not exercised the opt-out provision as
					 set forth by the Maine Department of Transportation. A current list of urban
					 areas can be found at
http://www.maine.gov/mdot/csd/mts/stateurbancompact.htm
..
113.01-22
Urgent Trip:
An
					 unscheduled and irregular situation in which there is no immediate threat to
					 life or limb but the Member must be seen on the day of request and treatment
					 cannot be delayed until the next day (e.g. follow-up); appointments scheduled
					 less than 5 days after the last appointment; unexpected pre-operative
					 appointments; hospital discharges; appointments for new medical conditions or
					 tests when the Member must be seen; dialysis; and urgent pharmacy trips.
113.01-23
Wheelchair
					 Accessible Vehicle:
A motorized vehicle equipped specifically with
					 certified wheelchair lifts or other equipment designed to allow persons in
					 wheelchairs or other mobility devices to safely enter a vehicle and secure
					 their wheelchair or device for transportation in accordance with national
					 safety standards.