Date: November 17, 2022
To: Enrolled Ambulance Providers
Re: Change to Non-Emergency Ambulance Transportation Criteria for Stairs/Lifting Assistance per Public Act 102-1037 Effective December 1, 2022
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Pursuant to the passage of Public Act 102-1037, the Illinois Department of Healthcare and Family Services (HFS) has updated the criteria for non-emergency ambulance transports. This change applies to prior approval requests and claims for customers covered under Medicaid fee-for-service (FFS) as well as HealthChoice Illinois (HCI) managed care plans (MCOs) and the Medicare/Medicaid Alignment Initiative (MMAI) plans with dates of service on and after December 1, 2022.
In accordance with the Act, beginning December 1, 2022, HFS will allow approval of ground ambulance services when the sole purpose of transport is the navigation of stairs or the lifting of a customer at a medical facility or during a medical appointment. Approval will be given only in situations in which another transportation provider is unable to be secured.
Based on this legislative change, amendments to 89 Ill. Admin. Code Section 140.Table A have recently been adopted and both the HFS 2270, Physician Certification Statement (PCS) and HFS 2271, Certification of Transportation Services (CTS) forms have been updated.
Questions regarding this notice may be directed to the Bureau of Professional and Ancillary Services at 877-782-5565 for FFS customers or the applicable HCI MCO.
Kelly Cunningham, Administrator
Division of Medical Programs
