Transportation Providers Forms & Resources
In response to the Consolidated Appropriations Act, 2021, transportation providers must ensure they have several processes in place as described below:
- Each such provider has in place a process to address any violation of a state drug law.
- Each such provider has in place a process to disclose to the state Medicaid program the driving history, including any traffic violations, of each such individual driver employed by such provider, including any traffic violations.
These processes must be fully documented, and available upon request for review and in place no later than December 27, 2021. The Accident Incident Form may be helpful in reporting incidents as specified above.
**Attention Transportation Providers**
The moratorium on ambulette provider applications to provide ambulette services in New York City, Nassau and Suffolk Counties will be lifted effective December 1, 2021. Click here for more information
Forms
- Department of Health Accident & Incident Reporting Policy opens a new window
- NEMT Accident and Incident Report Form opens a new window
Please email completed forms to: compliance@medanswering.com - MAS Back-Dated Trip Request Form opens a new window (updated 11/14/24)
Resources
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