Provider Notice issued 07/27/07

Prior Approval Required for Non-Emergency Transportation for Long Term Care Residents

The purpose of this notice is to advise of a change in the department’s Non-Emergency Transportation Services Prior Approval Program (NETSPAP). In the past, residents of long term care (LTC) facilities have not been included in NETSPAP. Effective October 1, 2007, prior approval will be required for non-emergency transportation for LTC residents.

The department contracts with First Transit, Inc. to administer the NETSPAP. First Transit will accept prior approval requests for LTC residents beginning on September 17, 2007, for dates of service on, or after, October 1, 2007. To assist providers in implementing this change, First Transit will conduct NETSPAP training for both LTC facilities and non-emergency transportation providers. First Transit will send detailed information on the training in the near future.

The department will be updating the Chapter 200, Handbook for Transportation Services to reflect the addition of the LTC resident population under NETSPAP. Topic T-211 of the handbook contains information specific to the prior approval process. Because some LTC facilities utilize the services of specific transportation providers, First Transit will work cooperatively with LTC facilities and transportation providers to continue those established relationships, in accordance with the department’s policies.

Please note that the department does not reimburse transportation provided in connection with any services not reimbursed by the department’s Medical Programs, such as, but not limited to, early intervention services, sheltered workshops, day care programs, social rehabilitation programs or day training services. This policy is stated in Topic T-204, Non Covered Services, of the handbook. The transportation provider should look to the training center or workshop for compensation.

We recommend that LTC facilities read the Handbook for Transportation Services available on the department’s Web site at: http://www.hfs.illinois.gov/handbooks/

If you do not have access to the Internet, or need a paper copy, printed copies are available upon written request. You need to specify a physical street address to ensure delivery. Submit your written request or fax to:

HFS -Provider Participation Unit

Post Office Box 19114

Springfield, Illinois 62794-9114

Fax Number: 217-557-8800

E-mail address is HFS.Webmaster@illinois.gov

Questions regarding the prior approval process for non-emergency transportation should be directed to the First Transit Provider Line at 1-866-503-9040. Questions regarding billing should be directed to the Bureau of Comprehensive Health Services at 1-877-782-5565.

Theresa A. Eagleson, Administrator

Division of Medical Programs