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DHS COVID-19 PROVIDER RESOURCES // OMAP

OMAP Announcement 05-08-2020-01:
MATP Guidance during the COVID-19 Pandemic

Issued: May 8, 2020

Audience

All County Administrators of the Medical Assistance Transportation Program (MATP), All Brokers of the MATP, All Contracted Transit Agencies of the MATP

Purpose

The purpose of this communication is to advise all county administrators, brokers, and all contracted transit agencies (collectively referred to as MATP agencies) of the precautions necessary to ensure safe provision of non-emergency medical transportation services to Medical Assistance beneficiaries while the Governor’s Proclamation of Disaster Emergency issued on March 6, 2020, remains in effect.

Discussion

Determining the Need for MATP

MATP agencies should triage consumers through their call systems and should screen consumers to advise them when to use MATP. MATP agencies should start by asking consumers to call their medical providers to see if a visit is necessary, or whether the medical issue can be addressed using telemedicine. Guidance is provided below regarding the priority of in-person medical visits. The consumers’ medical providers should work with consumers and MATP agencies to determine if a face-to-face visit is necessary. An MATP agency may contact the consumer’s provider, their managed care organization’s (MCO’s) member services division, or the Bureau of Fee-for-Service Programs (BFFSP) to confirm that the face-to-face visit is necessary.

Use of Alternatives

Many but not all visits can be conducted through telemedicine based on recent guidance from OMAP. The following types of face-to-face visits should be prioritized:

    • Dialysis
    • Chemotherapy
    • Radiation therapy
    • Intravenous therapeutic treatments that cannot be administered in a home setting
    • High-risk obstetrical care
    • Non-emergent but urgent clinical visits
    • Trips to pharmacies
    • Medication assisted treatment (methadone, buprenorphine, and naltrexone)
    • Other medical visits that the provider confirms must be done face to face

Routine obstetrical visits and non-urgent follow-up for chronic conditions may be able to be performed using telemedicine. Routine physicals and well child visits may be rescheduled once the COVID-19 proclamation of disaster emergency is lifted.

Obtain MATP

If the visit is recommended by the medical provider, the MATP agency should ask the consumer when scheduling the MATP trip if they or anyone in their household: 

    1. Have a fever higher than 100.4 degrees or COVID-19 respiratory symptoms such as cough, shortness of breath, or sore throat;
    2. Had contact with a person (live with or are within 6 ft. for a 10 to 30 minute period) in the past 14 days with someone who tested positive for COVID-19 or was told by a medical provider that they may or do have COVID-19; or
    3. Have tested positive for COVID-19 or been told by a medical provider that they may or do have COVID-19.

Safety

As a reminder, all MATP drivers must wear a face mask. See Department of Health FAQs regarding safe business practices, including wearing a face mask

If the answer to all three questions above is no, then the consumer can use MATP and transportation should be arranged in a manner that limits the driver’s physical contact with the consumer and allows for social distancing. This may require fewer people in a common vehicle or more individual rides. MATP riders should wear a mask or other face covering (e.g., bandanna, scarf, etc.) unless they cannot wear a mask or other face covering for a medical reason, or unless they are unable to afford providing themselves with a mask or other face covering. MATP agencies that are able to provide masks or face coverings for its customers should make attempts to do so. 

If the answer is yes to just one of either question 1 or 2 above, the consumer can use MATP under the following circumstances:

    • The consumer is transported as an individual ride;
    • The consumer should wear a mask or other face covering (e.g., bandanna, scarf, etc.) unless they cannot wear a mask or other face covering for a medical reason, or unless they are unable to provide themselves with a mask or face covering or unless they are unable to afford providing themselves with a mask of other face covering.
    • MATP agencies that are able to provide masks or face coverings for its customers should make attempts to do so.

If the answers to both questions 1 and 2 above are yes, then the consumer cannot use MATP. If the answer to question 3 above is yes, then the consumer cannot use MATP. In situations where it is not advisable for the consumer to use MATP, the MATP agency must complete the referral form and issue a written notice of denial, explaining the reason for denial. In addition, the MATP agency should make every effort to assist the consumer in finding suitable transportation, including non-emergency ambulance transportation. 

For consumers who receive services in the fee-for-service delivery system, such efforts include contacting BFFSP for further guidance or, at a minimum, providing the consumer with the following contact information: BFFSP’s Intense Medical Case Management Unit may be reached at (717) 772-6777 (Ms. Jean Whitehead) or (717) 772-6782 (Ms. Mallie Carter). 

For consumers who are enrolled in a MCO, such efforts include contacting the consumer’s MCO for further guidance or, at a minimum, providing the consumer with the MCO’s contact information.

When Should Individuals With Suspected or Test Confirmed Positive for COVID-19Be Allowed to Use MATP Again?

The Pennsylvania Department of Health recommends that persons with suspected or confirmed COVID-19 under home isolation be released from isolation after a minimum of three days (72 hours) after resolution of fever without the use of fever-reducing medicines and improvement in respiratory symptoms (cough, shortness of breath) and at least ten days have passed since symptoms first appeared. If a consumer has been released from home isolation after testing positive for COVID-19, the consumer should be transported as an individual rider, and should wear a mask or other face covering (e.g., bandanna, scarf, etc.), unless they cannot wear a mask or other face covering for a medical reason, or unless they are unable to afford providing themselves with a mask or face covering, until all of the consumer’s symptoms are completely resolved or until 14 days after symptoms first appeared, whichever is longer. The driver must wear a face mask.

Screening Flow Chart 

Please refer to the diagram below, which provides a screening flow chart to determine whether use of MATP is appropriate for a consumer. Drivers should follow basic guidance on prevention of COVID-19: 

    1. Washing hands often with warm water and soap for at least 20 seconds or use alcoholbased hand sanitizer if frequent hand washing is not possible; 
    2. Covering your mouth when you cough or sneeze, using a tissue or the inside of your elbow;
    3. Limiting physical contact with beneficiaries; and
    4. Cleaning and disinfecting the vehicle thoroughly after the consumer has been transported. See the CDC website for advice. 

The Department of Human Services (DHS) temporarily increased the mileage reimbursement rate per mile for the use of personal vehicles under MATP and notified all MATP agencies of the increase in a separate notice. MATP agencies should encourage individuals to use personal vehicles whenever possible. 

This guidance will remain in effect while the proclamation of disaster emergency remains in effect. OMAP may update this guidance as appropriate. 

Visit the PA Department of Health’s dedicated Coronavirus webpage for the most up-to-date information regarding COVID-19. Please continue to check the DHS COVID-19 website for updates for DHS providers. 

Thank you for your service to MATP consumers.