Managed Transportation Organization (MTO) – Texas Medicaid

In 2014, the Texas Health and Human Services Commission (HHSC) named Amistad as its Managed Transportation Organization (MTO) for West Texas, Region 2. Project Amistad began providing expanded transportation services to Medicaid beneficiaries in 23 West Texas counties including El Paso and the Greater Midland – Odessa region on September 01, 2014

Amistad arranges cost-effective nonemergency medical transportation (NEMT) services to eligible Medicaid clients, Children with Special Health Care Needs (CSHCN) Services Program clients, and Transportation for Indigent Cancer Patients (TICP) who are diagnosed with cancer or cancer-related illness and meet program financial and residential eligibility criteria and who have no other means of transportation. Amistad will arrange the mode of transportation that is most appropriate and meets the client’s health care needs.


Mass transit is public transportation by intra-city, inter-city bus, rail, ferry, either publicly or privately owned, which provides general or special service transportation to the public on a regular and continuing basis. Amistad, through its call center, will determine if mass transit is the appropriate mode of transportation that meets the client’s health care needs for eligible clients. If a client lives within a quarter mile (¼) from a public fixed-route stop, Amistad will ensure clients are provided with mass transit tickets prior to the medical appointment.

Individual Transportation Participant (ITP) services are provided by individuals who volunteer to participate by entering into an agreement with Amistad. This service allows the flexibility for individuals to transport clients in personal cars to health care appointments. ITPs must maintain a current valid driver’s license, vehicle insurance, vehicle inspection, and vehicle registration during each ride. Amistad will reimburse ITPs for mileage at the current state employee rate as adopted by HHSC of 565 cents per mile effective January 01, 2021.

The client must enroll with Amistad prior to providing ITP services. Amistad will need:

  • A copy of your completed ITP Application
  • A copy of your current valid Driver’s License (Physical address on Driver’s License must match the one the ITP Application.)
  • A copy of your current auto insurance card
  • A copy of your Social Security card(The name on your driver’s license and social security card must be the same)
  • A copy of the vehicle registration and inspection receipt. Additional program standards apply for ITPs who provide transportation for MTP eligible clients other than themselves or their family members and are subject to: a criminal background check, insurance requirements, and standards for motor vehicles.
  • You will need to call Amistad at 1-877-633-8747 with at least 2 business days in advance of the health care appointment to schedule your transportation service. Any ITP trips that are not scheduled in advance will not be paid.
  • When you call Amistad at 1-877-633-8747, the agent will provide you with a confirmation number for every scheduled trip. Please keep that number for your records and write it down on your ITP Service Record Form.
  • Write the full address of the Medical Provider on the form. Documents missing ANY information will be returned to the ITP and will delay reimbursement.
  • Make sure to get the ITP Service Record Form signed by the health care provider at the Medical Facility. The physicians signature  is required for mileage reimbursement.
  • Pharmacy trips will be reimbursed with the submission of the receipt. Please send your pharmacy receipt(s) along with your ITP Service Record Form. Write your Driver License Number on the top right corner of all documentation submitted to Amistad or your MTI Number. If you do not know your MTI number, you can contact Amistad.
  • All trips are verified with the health care provider.
  • The mileage reimbursement (payment) amount is based on a mileage calculation computed by Amistad using a nationally recognized system of the shortest distance of the trip and not the number of clients who are onboard of the vehicle at the time a service is provided. The ITP will be paid based on predetermined mileage.
  • All mileage reimbursement payments to ITPs are reported to the Internal Revenue Service (IRS).
  • The ITP Service Record Form must be submitted within 95 days from the date of the service for mileage reimbursement.

Meals and Lodging are provided for eligible Medicaid children and CSHCN Program Services and their attendant when health care treatment requires an overnight stay outside their county of residence or beyond adjacent counties. Amistad provides the client and attendant (regardless of age) an allowance of $25 per day per person.

Funds are authorized by Amistad in advance of travel and provided to the client or attendant to cover authorized transportation services e.g. gas money for travel to a medically necessary health care service, lodging/or meals. These funds are available to Medicaid eligible clients through age twenty (20); CSHCN clients twenty-one (21) and over who have been diagnosed with cystic fibrosis.

Amistad will arrange transportation for MTP eligible clients who need to travel to other adjoining states for medically necessary care or to receive health care services that cannot be provided within the State of Texas. Amistad provides transportation to contiguous counties or bordering counties in adjoining states (Louisiana, Arkansas, Oklahoma, and New Mexico) that are within 50 miles of the Texas border.

Out-of-state nonemergency transportation services for clients require prior authorization(s) from HHSC. Amistad will refer the requests to the Medical Transportation Program when requesting out-of-state nonemergency medical transportation services for Medicaid Fee-for-Service clients. HHSC will communicate the outcome of the request to Amistad via the approved communication protocols. All requests must comply with Texas Administrative Code, Title 1, Part 15, Subchapter B, Rule §380.205(2).

An attendant is an adult or service animal that accompanies a prior authorized MTP eligible client to provide necessary mobility, personal or language assistance to the client during the time transportation services are provided.  Once the attendant is approved, Amistad will provide transportation services for both the client and attendant.

  • A client 14 years of age and under must be accompanied by a parent, guardian, or other authorized adult to accompany the client on all trips. A parent or guardian must complete the Parental Accompaniment Form in order to authorize another adult to ride with the minor.
  • Clients 15 to 17 years of age must be accompanied by a parent, guardian, or other authorized adult unless parent or legal guardian has provided a signed written consent for the client to travel alone or the treatment to which the minor is being transported is such that the law extends confidentiality to the minor for the treatment.
  • Other clients who can travel without an adult are 1) teens who are parents, 2) individuals who have been emancipated by the court and 3) clients that have a doctor visit that must be kept private.
  • Adults that require an attendant or service animal obtain the Attendant Services Form complete by their physician and submit to Amistad (PA vs Amistad) prior to their appointment.

Amistad will arrange commercial airline transportation for MTP eligible clients and attendant to a covered health care service when it is the most cost-effective option or when necessary to meet the client’s medical needs. Amistad will verify if the medical care or other health care services are prior authorized by the health care provider and medical necessity for air travel is documented.

Clients must provide Amistad a five (5) business days’ notice before the scheduled appointment date. In some instances, more time may be necessary to allow for the pre-authorization process to be completed. Amistad will choose a flight that reduces the number of transfers, travel time, departure and arrival times based on the medical needs of the client and attendant.

How To Schedule A Trip

Clients must:

  • Call 1-877-633-8747 Monday through Friday between 7 a.m. and 5 p.m. MST to schedule transportation services. Amistad’s agents will accommodate other languages as needed to meet the caller’s needs.
  • Call at least two (2) business days in advance of the health care appointment and five (5) business days in advance for a trip outside your county of residence. Amistad will attempt to accommodate urgent requests but transportation is not guaranteed.
  • Be prepared to provide our Call Center Agents (CCA) with the following information when you call to request transportation services:
    • Medicaid ID number,
    • First and Last Name,
    • Phone Number,
    • Home address, City, State and ZIP code,
    • Name, address, and ZIP code of the health care provider,
    • Date and time of appointment
  • Trips can be scheduled as far as 30 days in advance.
    Inform the CCA if you require any special equipment for your trip such as a wheelchair, car seat, booster seat, walker, oxygen tank, or any other equipment that is required during your transportation service.
  • A client 14 years of age and under must be accompanied by a parent, guardian, or other authorized adult on all trips. Fill out a Parent Authorization Form (PAF) to let Amistad know which adults can travel with the child. If you have not filled out the form, call  Amistad at 1-877-633-8747.
  • Clients 15 to 17 years of age must be accompanied by a parent, guardian, or other authorized adult unless parent or legal guardian has provided a signed written consent for the client to travel alone. Other children who can travel without an adult are 1) teens who are parents, 2) children who have been emancipated by the court, and 3) children that have a doctor visit that must be kept private such as family planning.

When you call, the agents will ask you several questions in order to identify the most appropriate mode of transportation to fit your individual health care needs. Please keep in mind, this may include public transit (e.g., bus). or mileage reimbursement for a friend or family member to transport you to and from your appointment.

Amistad contracts with several transportation providers. The driver and vehicle type may not be the same each time.. You will receive a phone call from the transportation provider the day before your appointment, to confirm the appointment details.

On the day of your appointment, you should be ready between 60 minutes before your appointment time if you live within the city limits. Your transportation provider should arrive within that timeframe. In more rural areas, the transportation provider might ask that you are ready 90 minutes or more in advance for a long distance trip. At the time of drop off, your driver will give you a card containing a phone number you should call when your medical appointment is complete and you’re ready to return home. Please note that your driver has one hour from the time you call to pick you up for the return trip.

Client’ Rights and Responsibilities For Eligible MTP Clients For NEMT Services:

  • You have the right to receive prompt, courteous service by  Amistad and our network of transportation providers.
  • You have the right to be picked up on time by a courteous, helpful driver in a clean, safe vehicle.
  • If you are asked to share a vehicle with another rider, your travel time cannot be more than one hour longer than the travel time for direct transport.
  • You have the right to have an attendant accompany you, if medically necessary or required by program rules.
  • You have the right to complain to  Amistad or the Texas of Health and Human Services Commission (HHSC), about any problems or issues with NEMT services. You can call   Amistad at 1-877-633-8747 press option 2, or by contacting HHSC Ombudsman Office at 1-877-787-8999.
  • If a decision about a complaint is rendered, and you do not agree with the decision, you have the right to appeal that decision: first to  Amistad and then to HHSC.
  • If a service is denied and you do not agree with the decision, you have the right to appeal that decision. You will receive a denial decision letter in the mail which will identify the process for registering an appeal.


  • Call to schedule trips 48 hours (2 business days) in advance of the health care appointment(s) or 5 days in advance for appointments outside your region. If you call to schedule your trip with less than the required 2 business days’ notice, we will do our best to accommodate your needs, but transportation is not guaranteed.
  • You have the responsibility to cancel your transportation service at minimum 4 hours in advance of the scheduled trip.
  • It is your responsibility to provide any special equipment for your use during your trip (such as a wheelchair, car seat, booster seat, oxygen tank, walker, or any other equipment). Please note that the equipment cannot remain in the vehicle during your appointment.
  • It is your responsibility to call for your return trip once you are done with your appointment. The transportation provider will pick you up at the same location where you were dropped off.
  • When a client or responsible adult requests transportation, he/she must provide the following information:
    • Client name, address, and if available, telephone number;
    • Medicaid Number, Transportation for Indigent Cancer Patients Program or Children with Special Health Care Needs services program client identification number (if applicable) or Social Security number, and date of birth;
    • Name, address, and telephone number of health care provider and/or referring health-care provider;
    • Date and time of appointment;
    • Affirmation that no other means of transportation is available;
    • Special needs, including wheelchair lift or attendant(s);
    • Medical necessity verified by the Health Care Provider’s Statement of Need, if applicable; and
    • Affirmation that advance funds are needed when a lack of transportation funds will prevent the child from traveling to a covered health care service, if applicable.
  • Clients must reimburse   Amistad for any advanced funds, and any portion thereof when a verification that the client attended the covered health services is not submitted.
  • Clients must refrain from verbal and/or physical abuse or sexual harassment toward another client or passenger, transportation provider or performing provider employees, or   Amistad employees while requesting or receiving medical transportation services.
  • Clients must safeguard all bus tickets and/or tokens from loss and theft and must return unused tickets or tokens to   Amistad.
  • Clients who receive mass transit bus tickets or tokens must complete a verification form. Clients must return this verification form prior to their next request for tickets or tokens. A letter from the health care provider verifying delivery of services may be substituted for the disbursement of mass transit tickets or tokens verification form. Exceptions to this documentation may be granted when circumstances occur that are beyond the client’s control. Exceptions will be documented in the client’s record.
  • Clients must not use authorized medical transportation for purposes other than travel to and from health care services.
  • If the client does not need to use the authorized transportation services, the client or the responsible adult should   Amistad to cancel the particular trip no less than four (4) hours prior to the time of the authorized trip.
  • Clients who receive advance funds for meals, lodging, and/or travel must return written documentation from the health care provider verifying services were provided, prior to receiving future advance funds.
  • Clients must cancel requests for advance funds or lodging when not needed and must refund any disbursed advance funds to   Amistad.
  • Clients must provide the following when seeking reimbursement for lodging in situations where prior authorization could not be obtained in advance:
    • original receipt from the lodging establishment showing its name and address, the client’s name as an occupant, and specific services for which the occupant was charged (e.g., room rent, tax);
    • letter from the client or attendant requesting reimbursement for out-of-pocket expenses; and
    • copies of the client or attendant’s Social Security card and valid state-issued identification.