TRANSPORTATION SERVICES PROVIDER IN ILLINOIS

ENABLING ACCESS TO HEALTHCARE, COMMUNITY ACTIVITIES, AND INDEPENDENT LIVING THROUGH SPECIALIZED TRANSPORTATION

Transportation Services in Illinois support individuals who require non-emergency, non-medical, or medical transportation to access healthcare, employment, education, and community activities. These services are authorized under the Illinois Medicaid State Plan, Home and Community-Based Services (HCBS) Waiver programs, and specialized transportation initiatives, helping participants maintain independence and community integration.

1. GOVERNING AGENCIES

Agency: Illinois Department of Healthcare and Family Services (HFS)

Role: Administers Medicaid Non-Emergency Transportation (NET) and waiver-based Transportation Services, oversees provider enrollment, and ensures service quality and billing compliance

Agency: Illinois Department of Human Services (DHS) — Division of Developmental Disabilities (DDD) and Division of Rehabilitation Services (DRS)

Role: Coordinates transportation authorizations under waiver programs and monitors compliance with service delivery standards

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Provides federal oversight, ensuring Medicaid-funded Transportation Services meet HCBS person-centered planning, safety, and quality standards

2. TRANSPORTATION SERVICE OVERVIEW

Transportation Services ensure eligible participants can access essential services and activities safely when they are unable to drive or utilize conventional transportation options.

Approved providers may deliver:

• Non-Medical Transportation: Transportation to employment sites, adult day programs, therapy sessions, education/training programs, and community activities

• Non-Emergency Medical Transportation (NEMT): Transportation to Medicaid-covered healthcare appointments, treatments, and evaluations

• Door-to-door or curb-to-curb services based on the participant’s needs

• Wheelchair-accessible transportation for individuals with mobility limitations

• Escort services (when medically or behaviorally necessary)

All transportation must align with the participant’s Individualized Service Plan (ISP) or be authorized through a Medicaid transportation broker.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

• Register business entity with the Illinois Secretary of State

• Obtain EIN from the IRS and NPI (Type 2)

• Obtain necessary Transportation Company License (Public Carrier Certificate through the Illinois Commerce Commission [ICC]) if operating specialized vehicles

• Enroll as a Medicaid Transportation Provider through the Illinois Medicaid Provider Enrollment Portal (IMPACT system)

• Maintain vehicle liability insurance, general liability insurance, and worker’s compensation insurance (if applicable)

• Ensure all vehicles meet Illinois Department of Transportation (IDOT) safety standards and undergo regular inspections

• Develop policies for participant safety, driver training, incident reporting, emergency procedures, and infection control

• Ensure drivers meet background checks, drug screenings, driver’s license verification, and specialized training requirements

4. ILLINOIS PROVIDER ENROLLMENT PROCESS

Initial Interest and Application:

• Submit Provider Enrollment Application through the IMPACT system for Transportation Services under the Medicaid State Plan or waiver-funded transportation

Application and Documentation Submission:

• Submit Articles of Incorporation, proof of EIN/NPI, vehicle documentation, insurance certificates, driver credentialing records, and transportation service policies

Program Readiness Review:

• DHS and/or HFS review transportation readiness, including vehicle inspections, driver training records, participant safety protocols, and Medicaid billing processes

Approval & Medicaid Enrollment:

• Upon approval, providers are assigned billing codes for mileage-based or trip-based reimbursement

5. REQUIRED DOCUMENTATION

• Articles of Incorporation or Business License (Illinois Secretary of State)

• IRS EIN confirmation

• NPI confirmation

• Illinois Commerce Commission (ICC) license (if applicable)

• Proof of vehicle liability, general liability, and professional liability insurance

• Transportation Services Policy & Procedure Manual including:

  • Participant intake, trip scheduling, and service authorization procedures

  • Vehicle maintenance, inspection, and safety procedures

  • Driver hiring, training, credentialing, and supervision protocols

  • Incident reporting, emergency preparedness, and participant protection standards

  • HIPAA compliance and participant confidentiality policies

  • Medicaid billing documentation and service log tracking systems

6. STAFFING REQUIREMENTS

Role: Transportation Program Manager / Supervisor

Requirements: Experience in transportation operations or healthcare transportation management preferred; background clearance; knowledge of Medicaid transportation standards

Role: Drivers / Transportation Specialists

Requirements: Valid Illinois driver’s license; clean driving record; CPR/First Aid certification preferred; completion of wheelchair securement and defensive driving training; background screening and drug screening clearance

All staff must complete:

• Participant safety and disability awareness training

• Emergency response and incident reporting training

• HIPAA compliance and participant confidentiality training

• Annual driving record reviews and ongoing professional development

7. MEDICAID WAIVER PROGRAMS AND STATE PLAN COVERAGE

Transportation Services are reimbursed through:

• Illinois Medicaid State Plan Non-Emergency Transportation Program: Administered by First Transit (broker) for medical transportation

• HCBS Waivers: Providing non-medical transportation to enhance community access, including:

  • Adults with Developmental Disabilities Waiver

  • Children and Young Adults with Developmental Disabilities Waiver

  • Persons with Brain Injury (BI) Waiver

  • Persons with Disabilities (PD) Waiver

Approved providers may deliver:

• Scheduled rides to medical appointments, employment sites, community activities, or educational programs

• Wheelchair-accessible or specialized transport services

• Group or individual transportation based on service plans

8. TIMELINE TO LAUNCH

Phase: Business Formation, Licensing, and Vehicle Setup

Timeline: 1–3 months

Phase: Driver Hiring, Credentialing, and Training

Timeline: 1–2 months

Phase: IMPACT Medicaid Provider Enrollment and Readiness Review

Timeline: 60–90 days

Phase: Medicaid Billing Setup and Transportation Service Launch

Timeline: 30–45 days

9. CONTACT INFORMATION

Illinois Department of Healthcare and Family Services (HFS)

Website: https://www.hfs.illinois.gov/

Illinois Department of Human Services (DHS)

Website: https://www.dhs.state.il.us/

Illinois Commerce Commission (ICC) — Transportation Division

Website: https://www.icc.illinois.gov/transportation/

Centers for Medicare & Medicaid Services (CMS)

Website: https://www.cms.gov/

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — ILLINOIS TRANSPORTATION SERVICES PROVIDER

WCG assists non-emergency transportation companies, home care agencies, and community-based providers in launching Medicaid-compliant Transportation Services across Illinois.

​​​​​​​​​​​​​​​Scope of Work:

• Business registration, ICC licensing (if needed), Medicaid enrollment, and broker credentialing support

• Development of Transportation Services Policy & Procedure Manual

• Staff credentialing templates, trip logs, vehicle inspection templates, and emergency procedures manuals

• Medicaid billing system setup and audit-ready claims management

• Website, domain, and professional branding support

• Trip scheduling templates, fleet management guidance, and safety training programs

• Quality assurance systems for transportation service tracking and incident reporting

• Partnership development with waiver service agencies, case managers, and healthcare providers

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