Section 5164.403
(A) Not later than five years after the effective date of this section, the department of medicaid shall develop and implement a system by which global positioning system coordinates data received from a nonemergency medical transportation service provider may be cross-referenced with claims for medicaid payment submitted to the department by other medicaid providers. The system established in accordance with this section shall be capable of verifying all of the following:
(1) The medicaid recipient who received the nonemergency medical transportation services was transported for the purpose of receiving a medicaid service.
(2) The medicaid recipient who received the nonemergency medical transportation services was transported to a medicaid provider with an active and valid provider agreement at the time of transport.
(3) The records are received by the department within an allowable timeframe established under division (B) of this section and reflect an encounter, claim, or billing activity for a service described in division (A)(1) or (2) of this section.
(B) The department shall establish an allowable timeframe under which claims for medicaid payment for transportation claims may be cross-referenced and matched against claims for other medicaid services. The allowable timeframe shall account for documented exceptions that create delays including provider cancellations, appointment rescheduling, emergency diversions, delayed billing, and administrative errors.
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 ]