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Medical Assistance Transportation Program (MATP)
Program Overview
Medical Assistance Transportation Program provides transportation for treatment, medical evaluation, or to purchase prescription drugs or medical equipment that is compensated by medical assistance.
FACT is the transportation provider for Medical Assistance recipients in Fayette County. To be eligible for Medical Assistance Transportation, you must comply with the provisions of this guide and:
- Have a current Medical Assistance Card (Access Card)
- Be a permanent or temporary resident of Fayette County
- Need transportation to get to a covered medical service from a provider who accepts the ACCESS card, or is a Health Care Provider in your network
How to Use the Medical Assistance Transportation Program
To use the Medical Assistance Transportation Program:
- If the client has access to a vehicle, FACT will offer mileage reimbursement.
- MATP clients are only eligible to go to and from a medical facility or pharmacy. The doctor must be a MA provider.
- You must request an application from FACT and return the original signed application within 30 days of the request to the FACT office.
Escorts
Escorts are permitted if:
- A physician provides a written statement that an escort is necessary for medical reasons
- The effects of treatment may cause temporary incapacity
- The recipient is a minor (18 or younger)
- The recipient needs an interpreter
- You notify FACT at the time the trip is scheduled
- You provide your own escort; FACT cannot provide them for you
- The recipient is physically or mentally incapable of traveling alone
General MATP Program Information
General Information for the MATP Program:
- MATP will not fund trips of less than ¼ mile unless the recipient is unable to walk that distance
- The law requires that we provide the least costly transportation available. FACT may schedule your trip with a bus, public transportation, another social service transportation provider, or by private automobile for mileage reimbursement
- Mileage reimbursement is 12 cents per mile. FACT needs a statement from the physician with his or her provider number, date of service, and the odometer reading to and from the facility in order to reimburse you for this expense. This information may be mailed, faxed, or brought to the office by the end of each month. Reimbursement checks are issued every two weeks. FACT will not reimburse for forms submitted 2 months after the month of service
- MATP is a non-emergency medical transportation program
- Transportation service for eligible institutional residents, i.e. personal care homes, is covered only when the institution can not bill the costs to the Department of Public Welfare
- Only one month may be submitted per each form
Appeals & Fair Hearings
Your Right to Appeal and Have a Fair Hearing
To request a Fair Hearing, send a letter requesting the hearing to:
Department of Public Welfare
Bureau of Hearings and Appeals
2330 Vartan Way, Second floor
Harrisburg, PA 17110-9721
Free Assistance & Legal Services
You can get free assistance if you need help with your appeal at the Legal Services, Inc., office by calling 243-9400.
MATP Payments
MATP pays the entire fare for a trip to a medical appointment that is paid for by Medical Assistance. If you are enrolled in an HMO, we can provide transportation to the primary physician’s office. If you need to go to other medical appointments, they would have to be in your network.
Self Referred Medical Services
Clients may self-refer for particular medical services such as:
- Behavioral health services
- Chiropractic
- Dental
- Family planning
- OB/GYN
- Vision
These services do not require prior approval by a Primary Care Physician (PCP) if the member obtains the services from a Managed Care Organization (MCO) network provider.
Managed Care Organization
To make sure that a provider is a member of a MCO network, contact the designated liaison at the MCO. Family planning services do not require a MCO network provider. Transportation can not be provided for any service from a non-enrolled medical assistance (MA) provider or that is not an MA compensated service.
MATP Urgent Care
Transportation for urgent care services can be provided if a physician/provider identifies it as urgent. FACT must be notified by a physician’s office. For medical emergencies, please dial 911.
Urgent Care Defined
Urgent Care is defined as follows:
Any illness or severe condition which under reasonable standards of medical practice would be diagnosed and treated within a twenty-four (24) hour period and if left untreated, could rapidly become a crisis or an emergency situation: or discharge from a hospital will be delayed until services are approved; or a member’s/ client’s ability to avoid hospitalization depends upon prompt approval of services.
Obtaining Urgent Care
Urgent care transportation is obtained by calling the FACT at:
Phone: (724) 628-7433
8:00 a.m. through 4:30 p.m.
Monday through Friday.
On Saturday, Sunday, or weekdays after 4:30 p.m. or on one of FACT’s holidays, call FACT at (724) 628-7433.
If the transportation can be received during our service hours, notify our office. If you schedule a trip and it is not urgent care, you may be billed for the trip.