TRANSPORTATION SERVICES PROVIDER IN WISCONSIN

Fatumata Kaba
5 days ago
3 min read

ENSURING SAFE, RELIABLE, AND ACCESSIBLE TRANSPORT FOR INDIVIDUALS TO ACCESS ESSENTIAL MEDICAL, THERAPEUTIC, AND COMMUNITY SERVICES

Transportation Services in Wisconsin play a vital role in supporting individuals with disabilities, chronic health conditions, or mobility limitations by helping them travel to medical appointments, therapy sessions, employment sites, day programs, and community activities. These services are essential to maintaining independence, health, and community integration. Transportation is covered under Wisconsin’s Medicaid programs, including the Non-Emergency Medical Transportation (NEMT) benefit and various Home and Community-Based Services (HCBS) Waivers such as IRIS, Family Care, Partnership, and the Children’s Long-Term Support (CLTS) Waiver. All transportation services must be authorized in the participant’s Individualized Service Plan (ISP).

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1. GOVERNING AGENCIES

Agency: Wisconsin Department of Health Services (DHS)

Role: Oversees Medicaid transportation policy and waiver guidelines.

Agency: ForwardHealth

Role: Administers provider enrollment and oversees waiver-based transportation reimbursement.

Agency: IRIS Consultant Agencies / Managed Care Organizations (MCOs)

Role: Approve and authorize transportation services in alignment with participant care plans.

Agency: Medical Transportation Management, Inc. (MTM)

Role: Administers the statewide Non-Emergency Medical Transportation (NEMT) benefit for ForwardHealth Medicaid.

2. TRANSPORTATION SERVICES OVERVIEW

Transportation Services include both scheduled and demand-responsive transport to help participants attend medical appointments, therapy, employment, or community-based services.

Covered transportation services may include:

Medical transportation to clinics, hospitals, or therapy providers
Community access transportation for employment, day programs, or social inclusion
Door-to-door or curb-to-curb transport based on the participant’s mobility needs
Wheelchair-accessible vehicle (WAV) transport
Mileage reimbursement for participant-directed drivers (under IRIS)
Transportation coordination for individuals with complex needs

Note: Transportation must not duplicate NEMT services covered by MTM unless it is clearly documented as a waiver-based or community integration need.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your business with the Wisconsin Department of Financial Institutions (DFI)
Obtain a Federal EIN and Type 2 NPI
Apply for ForwardHealth provider enrollment and/or become a waiver program provider
Maintain commercial vehicle insurance and driver background checks
Hire qualified drivers trained in passenger safety and disability sensitivity
Create a Transportation Services Policy & Procedure Manual
Register vehicles, obtain local permits, and ensure ADA compliance for wheelchair vehicles

4. WISCONSIN PROVIDER ENROLLMENT PROCESS

Step 1: Register business and secure EIN/NPI

Step 2: Apply to ForwardHealth (if serving Medicaid State Plan or CLTS Waiver)

Step 3: Apply for MCO or IRIS provider network enrollment

Step 4: Submit policy manual, insurance documents, and driver/vehicle info

Step 5: Complete any waiver program training (e.g., IRIS Fiscal Employer Agent training)

Step 6: Begin providing services upon ISP approval and authorization

5. REQUIRED DOCUMENTATION

ForwardHealth enrollment documents (if applicable)
Transportation Services Policy & Procedure Manual, including:
- Passenger safety protocols and emergency procedures
- Vehicle inspection and maintenance logs
- Driver qualification and background screening procedures
- Service request intake and scheduling process
- Participant rights and grievance reporting
- HIPAA and confidentiality procedures
- Mileage logs and trip verification forms
- Accessibility standards and wheelchair securement policy
Staff training logs and insurance verification
Driver files, including licenses, medical cards, and CPR/First Aid (if required)

6. STAFFING REQUIREMENTS

Role: Driver / Transportation Provider

Requirements:

Valid Wisconsin driver’s license with a clean driving record
Criminal background check and caregiver screening
CPR/First Aid certification (recommended)
Disability awareness and passenger assistance training
Training in wheelchair securement and vehicle safety (for WAV drivers)

All drivers must receive:

Training in HIPAA, emergency procedures, and abuse prevention
Annual vehicle inspection and documentation audits
Ongoing safety refreshers and incident reporting training

7. MEDICAID PROGRAMS THAT COVER TRANSPORTATION SERVICES

IRIS Waiver: Includes participant-directed or agency-based transportation to employment, day programs, or therapy (not duplicative of MTM)
Family Care / Partnership: MCO-authorized transport for medical, therapy, or community-based supports
Children’s Long-Term Support (CLTS) Waiver: Transportation for children with disabilities to access essential services
ForwardHealth Non-Emergency Medical Transportation (NEMT): Administered by MTM for medical appointments only

Note: Waiver-based transportation must be tied to a functional need and included in the ISP. Documentation must clearly differentiate from NEMT services.

8. TIMELINE TO LAUNCH

Phase: Business Registration & Policy Manual Development

Timeline: 2–3 weeks

Phase: Driver Hiring & Vehicle Setup

Timeline: 30–45 days

Phase: Medicaid/MCO/IRIS Enrollment

Timeline: 1–3 months

Phase: Service Launch

Timeline: Begins after provider approval and plan authorization

9. CONTACT INFORMATION

ForwardHealth Medicaid Portal

Website: https://www.forwardhealth.wi.gov

MTM Wisconsin NEMT Program

Website: https://www.mtm-inc.net/wisconsin/

DHS HCBS Waivers

Website: https://www.dhs.wisconsin.gov/long-term-care-support.htm

IRIS Program Overview

Website: https://www.dhs.wisconsin.gov/iris

MCO Directory – Family Care Providers

Website: https://www.dhs.wisconsin.gov/familycare/mcos.htm

TRANSPORTATION SERVICES PROVIDER IN WISCONSIN

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

WCG helps agencies and solo providers launch Medicaid-compliant transportation services with the tools, policies, and systems required to support vulnerable populations safely and reliably.

Scope of Work: