Transcription of PROVIDER TYPE SPECIFIC CHECKLIST PACKET FOR THE …
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PROVIDER TYPE SPECIFIC CHECKLIST PACKET FOR THE …
(PT 42) Revised 05/14 PROVIDER TYPE SPECIFIC CHECKLIST PACKET FOR THE louisiana MEDICAL ASSISTANCE PROGRAM ( louisiana Medicaid Program) Non-Emergency Medical Transportation (PT 42) Revised 05/14 STOP!!! If an owner or a co-owner has been convicted of any of the criminal offenses listed below, you must contact NEMT Program Desk at 225 342-9404 before going any further: Medicaid, Medicare, any other healthcare program fraud; Neglect or abuse of a patient; Unlawful manufacture, distribution, prescription or dispensing of a controlled substance; Fraud, theft, embezzlement, breach of fiduciary responsibility, or other financial misconduct; Sexual acts.
Obtain the required Healthcare Provider Criminal Background Check from the Louisiana State Police, Bureau of Criminal Identification or one of their authorized vendors for any and all drivers you intend to hire. The Department will need to review the healthcare provider’s criminal background check prior to approving your application.
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