Section 182-546-6000. Nonemergency transportation—Authorization.

(1) The medicaid agency contracts with brokers to authorize or deny requests for transportation services.

(2) Exceptional requests to transport a client may be referred to the agency's medical director or designee for review.

(3) Nonemergency medical transportation, other than ambulance, must be prior authorized by the broker. See WAC 182-546-5200 (3) and (4) and 182-546-6200(4) for granting retroactive authorization.

(4) The broker mails a written notice of denial to each client who is denied authorization of transportation.

(5) A client who is denied nonemergency transportation under this chapter may request an administrative hearing, if one is available under state and federal law.

(6) If the agency approves a medical service under exception to rule (ETR), the authorization requirements of this section apply to transportation services related to the ETR service.

[Statutory Authority: RCW 41.05.021, 41.05.160. WSR 16-12-022, § 182-546-6000, filed 5/20/16, effective 6/20/16; WSR 15-03-050, § 182-546-6000, filed 1/14/15, effective 2/14/15. WSR 11-17-032, recodified as § 182-546-6000, filed 8/9/11, effective 8/9/11. Statutory Authority: RCW 74.04.057, 74.08.090, and 74.09.500. WSR 11-15-029, § 388-546-6000, filed 7/12/11, effective 8/12/11.]

RCW 41.05.021, 41.05.160. WSR 16-12-022, § 182-546-6000, filed 5/20/16, effective 6/20/16; WSR 15-03-050, § 182-546-6000, filed 1/14/15, effective 2/14/15. WSR 11-17-032, recodified as § 182-546-6000, filed 8/9/11, effective 8/9/11. Statutory Authority: RCW 74.04.057, 74.08.090, and 74.09.500. WSR 11-15-029, § 388-546-6000, filed 7/12/11, effective 8/12/11.

Rules

182-546-5200,182-546-6200,