Effective: December 1, 2006 | |
28.05.15ar1 - Access Services (Archive) |
Archived: June 1, 2009 |
Access services are transportation and other enabling services to help enrollees obtain medically necessary health care. County agencies and MinnesotaCare Operations must provide access services to enrollees who are eligible for access services and who do not receive the services through a Managed Care Organization (MCO) An organization certified by the Minnesota Department of Health which agrees to provide all defined health care benefits to individuals in return for a capitated payment. MCOs are also referred to as "health plans.". For enrollees who reside in the eleven-county metro area, access transportation services are provided through a transportation coordinator – the Minnesota Non-Emergency Transportation (MNET) program.
Access service plans must cover reimbursement for the following items:
l Cost of transportation to receive medical services.
n Enrollees must use the most cost-effective available means of transportation.
n For guidelines on which transportation costs may or may not be reimbursed, see Transportation Costs.
l Lodging if necessary for the enrollee to obtain services outside the local area.
Note: The local agency must prior-authorize charges over $50 per night.
l Meals if necessary to obtain services. Maximum reimbursement amounts are:
n Breakfast - $5.50.
n Lunch - $6.50.
n Dinner - $8.00.
l Transportation, meals and lodging for people required to accompany the enrollee to obtain services or whose involvement in a treatment program is part of the enrollee’s written treatment plan.
l Interpreter services for hearing impaired people to obtain services at the local agency or from a provider with fewer than 15 employees. Required services include sign language interpreters, oral or lip-reading interpreters, and interpreters for people who are deaf/blind.
Note: Providers with 15 or more employees and MCOs must provide these services.
For guidelines on who may be eligible for access services, see Eligibility Requirements.