Section 5164.402
(A) Upon full implementation of the electronic verification systems developed, procured, certified, or approved in accordance with section 5164.401 of the Revised Code, no nonemergency medical transportation service provider shall be eligible to receive medicaid payment for transportation services provided to a medicaid recipient unless the provider submits all necessary data through an electronic verification system. The department of medicaid shall pay a claim for transportation services submitted through an electronic verification system if both of the following conditions are satisfied:
(1) All required GPS-based verification and timestamp data are present.
(2) No unresolved discrepancies about the claim exist.
(B) The department shall establish a process by which a nonemergency medical transportation service provider may seek an exemption from utilizing an electronic verification system. The department may permit an exemption for any of the following reasons:
(1) Equipment failure or network unavailability, including rural connectivity issues;
(2) Emergencies;
(3) Concerns for the safety of the medicaid recipient.
(C) Before granting an exemption under division (B) of this section, the department shall require a nonemergency medical transportation service provider to submit written documentation detailing why an exemption should be granted. The department shall routinely monitor the number of exemptions requested by a provider.
Last updated August 12, 2026 at 4:32 PM
Available Versions of this Section
- October 6, 2026 – Enacted by Senate Bill 315 - 136th General Assembly [ View October 6, 2026 Version ]