1. (a) FPEC recipients shall be ensured assistance with locating or being reimbursed for transportation to Title XIX providers in order to access necessary family planning and family planning-related services described in He-W 509.

2. (b) FPEC recipients who wish to be reimbursed for transportation shall:

   1. (1) Enroll in the transportation provider system in accordance with He-W 574.10(b)–(e); and
   2. (2) Be known as a recipient driver only for enrollment and payment purposes.

3. (c) FPEC recipients shall only be reimbursed for transportation under the following circumstances:

   1. (1) Transportation shall be to in-state or border Title XIX enrolled providers, except as described in (2) below;
   2. (2) Transportation to out-of-area providers shall be authorized in advance in accordance with He-W 574.08;
   3. (3) There is no transportation available free of charge or payable by any other agency;
   4. (4) Only one trip per day, whether one-way or round-trip, shall be covered;
   5. (5) Only the actual number of miles driven from the individual’s residence to the Title XIX provider and return to individual’s residence shall be reimbursed; and
   6. (6) Transportation shall be to the nearest available provider of the necessary covered family planning services or family planning-related services via the shortest, most economical route, as described in He-W 574.14(b).
4. (d) FPEC recipients shall submit transportation claims in accordance with He-W 574.06.
5. (e) The above transportation claims shall be paid in accordance with He-W 574.07.
6. (f) The provisions of He-W 574.12 and He-W 574.14 regarding hearings and utilization review and control shall apply to FPEC recipients.
7. (g) FPEC recipients who request transportation assistance via wheelchair van in order to access family planning services or family planning-related services shall qualify for wheelchair van transportation if they meet the requirements in He-W 573.02(a)(1) and (2), except that eligibility as an FPEC recipient shall be substituted for the requirements in He-W 573.02(a) to be a Title XIX recipient.
8. (h) FPEC recipients utilizing wheelchair van transportation shall be subject to the provisions of He-W 573.04, He-W 573.10, He-W 573.11, and He-W 573.12 regarding service limits, prior authorization to exceed service limits, utilization review and control, and third party liability.
9. (i) FPEC recipient shall utilize Title XIX enrolled wheelchair van providers who meet the requirements of He-W 573.
10. (j) FPEC recipients shall be eligible to be transported by volunteer drivers in accordance with He-W 574 only for the purpose of accessing family planning services or family planning-related services.

Source. #10357, eff 7-1-13