(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.]