Provider Notice issued 11/30/12

Transportation for Hospice Patients

By Non-Coverage of Specified Services for Hospice-Enrolled Participants, an informational notice dated June 27, 2012, the department defined certain services that, effective with dates of service on or after July 1, 2012, would no longer be covered separately outside of the hospice benefit. Transportation services were identified as one of the services that would no longer be covered for a hospice patient.

The department has reconsidered that position on transportation services, and will allow both emergency and non-emergency transportation services for a hospice-enrolled patient to and from medical care unrelated to the terminal illness. This policy will be retroactive to July 1, 2012.

In particular, the department has received inquiries regarding transportation for dialysis services. The department will authorize transportation to dialysis facilities when needed for any hospice-enrolled patient.

The department contracts with First Transit Inc. to prior approve requests for non-emergency transportation services. The request for transportation must be made by calling First Transit, toll-free, at: 1-866-503-9040 (TTY: 1-630-873-1449 for the hearing impaired) 8 a.m. to 5 p.m., Monday through Friday (closed on State holidays). The request must be made to First Transit at least seven (7) business days (excluding weekends and holidays) prior to the trip. Trips may be requested as a single trip or a standing prior approval. Additional information regarding transportation services is contained in the Handbook for Providers of Transportation Services.

Questions regarding the hospice benefit may be directed to a hospice billing consultant in the Bureau of Comprehensive Health Services at 1-877-782-5565, Option 1. Questions regarding the transportation program may be directed to a transportation billing consultant also at the number above, Option 3, then Option 3.

Theresa A. Eagleson, Administrator

Division of Medical Programs