TRANSPORTATION SERVICES PROVIDER IN PENNSYLVANIA

Fatumata Kaba
Oct 8
4 min read

HELPING INDIVIDUALS ACCESS HEALTH CARE, COMMUNITY ACTIVITIES, AND ESSENTIAL SERVICES THROUGH RELIABLE, MEDICAID-FUNDED TRANSPORTATION

Transportation Services in Pennsylvania are Medicaid-funded supports that assist individuals with disabilities, chronic health conditions, and aging-related needs in traveling to medical appointments, waiver services, employment, and community activities. These services promote independence, prevent isolation, and ensure access to vital resources. Transportation is authorized through the Department of Human Services (DHS), the Office of Long-Term Living (OLTL), the Office of Developmental Programs (ODP), and Community HealthChoices (CHC) Managed Care Organizations (MCOs).

1. GOVERNING AGENCIES

Agency: Pennsylvania Department of Human Services (DHS) – OLTL & ODP

Role: Funds transportation under HCBS waivers and ensures coordination with service plans.

Agency: Community HealthChoices (CHC) Managed Care Organizations (MCOs)

Role: Authorize and reimburse transportation for CHC members.

Agency: Medical Assistance Transportation Program (MATP) – County-Based

Role: Offers non-emergency transportation for Medicaid members not enrolled in CHC.

Agency: Centers for Medicare & Medicaid Services (CMS)**

Role: Oversees federal compliance for Medicaid-funded transportation services.

Agency: Pennsylvania Department of State

Role: Handles business registration for transportation providers.

Agency: Pennsylvania Public Utility Commission (PUC)

Role: Regulates non-emergency medical transportation (NEMT) providers operating for-hire vehicles.

2. TRANSPORTATION SERVICES OVERVIEW

These services ensure individuals can travel safely to approved Medicaid-covered appointments and community-based services as outlined in their care plans.

Approved providers may deliver:

Non-Emergency Medical Transportation (NEMT): Travel to doctors, therapy sessions, day programs, and other Medicaid-covered services.
Community Participation Transportation: Travel to recreational, social, or volunteer activities authorized through HCBS waivers.
Job & Employment Access: Transporting individuals to and from supported employment or vocational training sites.
Escort Support (optional): Staff accompaniment when individuals require supervision or assistance during travel.
Wheelchair-Accessible Transport: Specialized vehicles to support individuals with mobility needs.
Documentation: Trip logs, driver records, incident reports, and Medicaid billing logs.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your transportation company with the PA Department of State.
Obtain an EIN and a Type 2 NPI.
Apply for a PUC Operating Authority (if transporting for compensation).
Enroll with PROMISe™ as a Medicaid Transportation Provider.
Contract with CHC MCOs and coordinate with ODP/OLTL Service Coordinators.
Maintain general liability, vehicle, and workers’ compensation insurance.
Develop a Transportation Services Policy & Procedure Manual covering routing, safety, and billing protocols.

4. PENNSYLVANIA PROVIDER ENROLLMENT PROCESS

Step 1: Form a legal business entity and obtain EIN, NPI, and commercial insurance.

Step 2: Register as a transportation business with the PUC (Class B, C, or D depending on services).

Step 3: Enroll in PROMISe™ as a transportation service provider.

Step 4: Contract with MCOs (CHC), ODP AEs, or MATP vendors.

Step 5: Submit staff and driver credentials, policy documentation, and fleet info.

Step 6: Begin providing services upon contract execution and authorization.

5. REQUIRED DOCUMENTATION

Business registration and Articles of Incorporation
EIN and NPI confirmation
PUC certificate and driver clearances
Commercial auto and liability insurance
Vehicle inspection certificates
Transportation Services Policy & Procedure Manual including:
- Trip authorization, pickup, and drop-off protocols
- Vehicle safety, maintenance, and inspection guidelines
- HIPAA and participant confidentiality safeguards
- Emergency procedures and incident reporting
- Driver background checks, training logs, and driving records
- Trip logs, mileage tracking, and Medicaid billing forms

6. STAFFING REQUIREMENTS

Role: Transportation Driver

Requirements: Valid PA driver’s license; clean driving record; CPR/First Aid (recommended); background check; wheelchair securement and passenger safety training.

Role: Transportation Coordinator / Dispatcher

Requirements: Oversees scheduling, fleet management, routing, and client communication.

Role: Escort / Travel Aide (optional)

Requirements: Supports riders with behavioral, mobility, or cognitive needs.

All staff must complete:

HIPAA and abuse prevention training
Defensive driving and wheelchair securement (if applicable)
Incident reporting and client communication training
Annual DMV record checks and performance reviews

7. MEDICAID WAIVER PROGRAMS

Transportation services are funded through:

Community HealthChoices (CHC): Travel to waiver-authorized services and appointments
Independence, OBRA, and Aging Waivers (OLTL): For individuals needing accessible or escorted transport
Consolidated, Community Living, and P/FDS Waivers (ODP): Transport to day programs, employment, and community participation
Medical Assistance Transportation Program (MATP): Non-emergency transport for Medicaid beneficiaries not under CHC

8. TIMELINE TO LAUNCH

Phase: Business Formation & Manual Development

Timeline: 1–2 months

Phase: PUC Certification & Medicaid Enrollment

Timeline: 2–3 months

Phase: Driver Hiring, Credentialing & Vehicle Prep

Timeline: 30–60 days

Phase: Contracting & Service Launch

Timeline: Begins once provider is onboarded by CHC MCO or AE and authorized for trip coordination

9. CONTACT INFORMATION

PA DHS – Office of Long-Term Living (OLTL)

Website: https://www.dhs.pa.gov

PA DHS – Office of Developmental Programs (ODP)

Website: https://www.myodp.org

PA Public Utility Commission (PUC)

Website: https://www.puc.pa.gov

PROMISe™ Medicaid Provider Portal

Website: https://promise.dpw.state.pa.us

Community HealthChoices MCOs:

UPMC CHC – https://www.upmchealthplan.com
Keystone First CHC – https://www.keystonefirstchc.com
PA Health & Wellness – https://www.pahealthwellness.com

Centers for Medicare & Medicaid Services (CMS)

Website: https://www.cms.gov

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

WCG helps Transportation providers in Pennsylvania become Medicaid-authorized, compliance-ready vendors serving individuals across waiver and MCO programs.

Scope of Work: