The Medical Transportation Access Coalition (MTAC) wishes to thank Health Management Associates (HMA) for completing a first-of-its-kind research report and toolkit on the non-emergency medical transportation (NEMT) benefit in Medicaid. MTAC provided funding and direction for HMA’s work. The report and toolkit include recommendations for NEMT requests for proposals (RFPs) and contracts gathered from HMA’s survey of NEMT contracting materials and interviews with state Medicaid officials, brokers and providers, managed care organizations (MCOs) and other stakeholders.
NEMT is an important mandatory Medicaid benefit yet unique in many ways from traditional medical benefits, which makes NEMT particularly challenging for states and MCOs to administer. States often contract with an NEMT broker or MCO to manage NEMT – while this approach has many benefits, it is challenging to set up an RFP or contract that promotes strong competition and a well-performing NEMT program.
“The report comes at an important juncture as states seek to better understand ways to improve their mandatory benefits. The report finds ways for states to ensure their spending achieves improved outcomes for Medicaid enrollees while maintaining sufficient access to NEMT service providers,” remarked MTAC founding member Verida’s Chief Development Officer Dena Adams-McNeish.
The report and accompanying toolkit cover critical areas like member experience, contract specificity and enforcement mechanisms, key performance metrics, provider network development, use of technology, and program integrity safeguards. The findings were synthesized from a months-long process that included a comprehensive scan of relevant NEMT reports, federal regulations, CMS guidance, close review of five diverse states’ NEMT administrative models, including their NEMT RFPs, contract(s), service manuals, and other relevant documents; and 15 interviews with 34 individuals including state Medicaid officials and NEMT brokers, providers, advocates, and subject matter experts (SMEs).
“When talking to state Medicaid leaders across the country, it is clear that technical assistance and clearer articulation of best practices is needed in the NEMT program area,” Phil Stalboerger, Senior Vice President of MTM, an MTAC founding member. Katie Dotto, Director, Government Affairs, of MTAC founding member Modivcare added, “These new resources from HMA build off of and aid in CMS’s work in the past several years to implement the directives in the Consolidated Appropriations Act, 2021, by leveraging the flexibilities states have to design their NEMT programs into concrete, actionable insights for states. Our coalition members look forward to engaging with policymakers and NEMT program staff about how these insights might shape a state’s procurement strategies.”
You can find a link to the report here. A toolkit accompanying the report is here.
MTAC was formed in 2017 to educate federal and state policymakers and other stakeholders about the benefits of medical transportation and the need for policies that support continued access to these services. The coalition’s founding and allied members include a diverse set of transportation management services companies, managed care organizations, trade associations, and patient advocacy groups.