Ordering Guidelines

LogistiCare will be managing non-emergency medical transportation services (NEMT) for Nassau and Suffolk County Medicaid enrollees beginning July 1, 2015. LogistiCare will manage transportation for Fee-for-Service (FFS) enrollees (i.e., those not in a managed care plan or organization (MCO). Note that LogistiCare currently manages some MCO clients but will not manage all MCO clients until December 2015, when transportation for MCO enrollees under the age of 65 will no longer be the responsibility of the MCO. For a list of those MCOs that LogistiCare will begin managing transportation beginning December 2015 see the list below:

The Following are basic rules for ordering transportation

  • An enrollee’s family member, care-giver or Brooklyn medical provider can request NEMT services for an enrollee with certain conditions.
  • LogistiCare takes requests for routine transportation by phone (844-678-1103) or fax (855-848-8640) Monday through Friday from 7:00 a.m. to 6:00 p.m. Requests may be submitted on-line 24 hours a day.
  • Please submit requests for routine transportation 72 hours in advance of the trip.
  • Requests for urgent transportation are taken 24x7 by phone. Requests for emergency medical service do not go through LogistiCare and should be directed to 911.
  • If the enrollee lives within 1/2 mile of the medical practitioner and can walk there, the enrollee should not request transportation services from LogistiCare.
  • If the enrollee is able to utilize mass transit and is traveling to a medical practitioner who participates in the Public Transit Automated Reimbursement (PTAR) system, the enrollee must request a Metro Card directly from that medical practitioner. If the medical practitioner does not participate in PTAR, the enrollee may request transportation from LogistiCare.
  • Enrollees who are not able to utilize mass transit must ask their medical practitioner to request their transportation from LogistiCare for the first trip. Trip requests for a mode of transportation other than mass transit require that the medical practitioner fill out and sign a Medical Necessity Form (MNF). For a copy of the MNF, click here.
  • If a medical practitioner has previously requested transportation for an enrollee and has already filled out the MNF, and the medical needs of the enrollee have not changed, then the enrollee may book the ride themselves with LogistiCare.
  • Enrollees are expected to attend services in their Common Medical Marketing Area (CMMA). The CMMA is considered to be the area around the enrollee’s home address that is within 5 miles as traveled. Enrollees can attend services outside their CMMA if referred there by a practitioner or if they are going to a specialist that provides specific services and those services are not available in the CMMA.
  • Enrollees and medical practitioners can request that a specific transportation company provide their transportation. LogistiCare will make every effort to assign transportation to the requested transportation provider.
  • For more information, see the Frequently Asked Questions (FAQ) page.

Guidelines for ordering each mode of transport:

Bus/Subway: The enrollee lives within ½ mile of a bus or subway stop, the medical facility is within ½ mile of the bus/subway, the enrollee can walk ½ mile and understands common signs and directions.
Livery: The enrollee can walk to the curb and board and exit the vehicle unassisted, but cannot utilize the bus or subway.
Ambulette Ambulatory: The enrollee can walk but requires driver assistance from residence to the medical appointment.
Ambulette Wheelchair: The enrollee is a wheelchair user, requires a lift-equipped or roll-up wheelchair vehicle and driver assistance.

MCOs Served
Non-emergency medical transportation of Medicaid managed care plan enrollees who are Nassau and Suffolk County residents that went into effect December 1, 2015.
On December 1, 2015 non-emergency medical transportation for Medicaid managed care plan enrollees who are Nassau and Suffolk County residents was removed from the scope of benefits of the commercial managed care plans named below.

Each plan has a unique 2 letter/digit identifier, which is given when eligibility is checked via ePaces. That identifier is shown as a code in the list below.

Affinity Health Plan, Inc.
(82)
AMERIGROUP
(Empire BCBS) (KP)
Health Insurance Plan of Greater NY
(Emblem Health) (HT and HY)
HealthFirst PHSP, Inc.
(SF)
New York State Catholic Health Plan, Inc.
(dba Fidelis Care New York) (SP)
UnitedHealthcare of New York, Inc.
(MO)
Neighborhood Health Providers, Inc.
(NP)
OMH
OPWDD