Delaware Health 

And Social Services 

DIVISION OF MANAGEMENT SERVICES 



 

 PROCUREMENT 

 

 

 

 DATE: November 5, 2010 

 

 HSS-10-091 

 

Non-Emergency Medical Transportation Services 

 

for 

 

 

DIVISION OF MEDICAID AND MEDICAL ASSISTANCE 

 

 

 

 Date Due: November 30, 2010 

 By 11:00 A.M. 

 

 

ADDENDUM # 4 

 Clarify Section 2.23 

 Revise Section 2.51(d) 

 

 PLEASE NOTE: 

THE ATTACHED SHEETS HEREBY BECOME A PART OF THE ABOVE 
MENTIONED RFP. 

 

 ___________________________ 

 BRUCE KRUG 

 PROCUREMENT ADMINISTRATOR 

 (302)255-9291 

 

 

 ___________________________ 

 JOYCE PINKETT 

 PROGRAM MANAGER 

 (302) 255-9616 

 

 


2.23 VISITATION/PATIENT EDUCATION Deleted 10/29/2010 

 

A parent, foster parent or guardian is eligible to be transported to visit his or her DMAP client minor 
child (ren) who is an inpatient of a hospital, whether or not the parent is DMAP eligible themselves. 
Transportation of individuals who are not Medicaid clients should be reported under the minor child's 
DMAP eligibility number. Transportation to visit adult DMAP client inpatients is not covered. 

 

 

2.23 CLIENT HEALTH EDUCATION AND ANTICIPATORY GUIDANCE Inserted 10/29/2010 

 

A parent, foster parent or guardian of an eligible child, who has no other means of transportation, is 
eligible to receive NET service to and from a hospital. The purpose of this transportation is for a parent, 
foster parent or guardian to keep abreast of their child's medical condition when hospitalized and to be 
able to obtain any and all health education and training from the child's attending physician, specialists, 
and hospital support staff in order to prepare for the child's return home. 

 

Transportation of a parent, foster parent or guardian who is not a Medicaid client should be reported 
under the eligible child’s DMAP number. 

 

 

2.51 DENIAL OF SERVICE Revised 10/29/2010 

 

When denying a request for transportation, The Contractor shall orally notify each recipient at 
the time of the request and state the reason for the denial. The Contractor shall also notify the 
recipient in writing of the reason for denying transportation service within two business days of 
the denial. The written notification shall use a template provided by DMMA upon contract 
award. The template shall state the reason for the denial, citing the specific law, regulation or 
DMMA policy. It shall also include a description of the recipient’s appeal rights and a copy of the 
form for requesting an appeal hearing from DMMA. The Contractor shall prepare for and 
participate in recipient appeals as requested by DMMA, at the Contractor’s expense. 

 

In individual cases where the contract requirements or the DMMA Transportation Manual do not 
provide clear guidance, DMMA shall retain ultimate decision-making authority on authorization 
of transportation services. The decisions of the Appeals Division of DMMA on matters involving 
the Contractor’s denial of transportation requests shall be final and binding on the Contractor. 

 

Penalties: In the event the Contractor fails to notify a recipient in writing of the reason for 
denying transportation service within two business days of the denial, DMMA may apply 
financial penalties against the Contractor’s monthly payment from DMMA up to $250.00 per 
incident. 

 

The Broker may deny a trip or immediately discontinue a trip for any client who: 

a. refuses to cooperate in determining status of Medicaid eligibility; 
b. refuses to provide the documentation requested to determine need for NET services; 
c. is found to be ineligible for NET services on the basis of the documented 
information that cannot be otherwise confirmed; 
d. exhibits uncooperative behavior or misuses/abuses NET services; 





is uncooperative when boarding the vehicle or during the trip; 

e. is not ready to board NET transport ten (10) minutes after the scheduled pick up time; 
or 
f. fails to request a reservation two (2) days in advance of appointment without good 
cause. For purposes of this section, “good cause” is created by factors such as, but not 
limited to, any of the following: 


1. urgent care; 
2. post-surgical and/or medical follow-up care specified by a health care provider 
to occur in fewer than three days; 
3. imminent availability of an appointment with a specialist when the next 
available appointment would require a delay of two weeks or more; or 
4. the result of administrative or technical delay caused by the Broker and 
requiring that an appointment be rescheduled. 


 

The Broker must provide in writing to clients who have been denied or terminated NET services the 
specific reason for denial or termination and the client's right to appeal (see Section 2.52 for notice 
requirements).