Frequently Asked Questions
What is non-emergency medical transportation?
Who can receive NEMT services?
Why is medical transportation required?
What types of transportation are provided?
What types of appointments are patients traveling to and from?
- Dialysis services for patients with End-Stage Renal Disease (ESRD)
- Substance abuse counseling sessions
- Behavioral health or mental health appointments
- Visits with primary care physicians or specialists
- Chemotherapy or other recurring infusion treatments
How much does NEMT cost?
 Transit Cooperative Research Program, Impact of the Affordable Care Act on Non-Emergency Medical Transportation: Assessment for Transit Agencies at 2 (Oct. 2014), available at: http://onlinepubs.trb.org/onlinepubs/tcrp/tcrp_rrd_109.pdf.
How much does a single trip cost?
What are the economic benefits of NEMT?
 Florida Transportation Disadvantaged Program, Return on Investment Study at 6 (Mar. 2008), available at: http://tmi.cob.fsu.edu/roi_final_report_0308.pdf.
 See: https://www.cbo.gov/sites/default/files/109th-congress-2005-2006/costestimate/s1932conf0.pdf, Page 36
What services does an NEMT broker provide?
Researchers who study transportation programs have found that capabilities like computer-aided scheduling and tight controls on eligibility – all common services provided by NEMT brokers – can increase the capacity of available service by reducing average trip length, transporting multiple passengers simultaneously and decreasing the number of ineligible trips, thereby reducing average trip cost and allowing the program to run efficiently.
 Wallace, R., P. Hughes-Cromwick, H. Mull, and S. Khasnabis, Access to Health Care and Nonemergency Medical Transportation: Two Missing Links, Transportation Research Record Journal of the Transportation Research Board, January 2005, available at: https://www.researchgate.net/publication/39967547_Access_to_Health_Care_and_Nonemergency_Medical_Transportation_Two_Missing_Links
What percentage of NEMT services are provided to the Medicaid expansion population?
Both expansion population members and traditional Medicaid beneficiaries use NEMT services for Mental Health/Substance Abuse visits as their top two treatment needs. Data reflects that the expansion population uses NEMT services to access most of the same targeted and non-repetitive medical care services as the traditional Medicaid population. When looking at preventative care trips specifically, the expansion population uses NEMT services to access preventive care on average 65 percent more than the traditional population. This data reflects pent up demand and underscores the benefits of providing access to primary and preventative health services rather than acute or critical care.
What is the President’s FY 2019 Budget proposing to do on NEMT?
The President’s budget contains many proposals – some of which likely will not come to pass. If the Centers for Medicare and Medicaid Services, the federal agency responsible for Medicaid, publishes a draft regulation on NEMT, that regulation will be subject to public comment and cannot be finalized without consideration of public comments. Supporters of NEMT will want to comment on any proposed regulation. If NEMT becomes an optional benefit, states will still need to consider what changes, if any, to make to their NEMT benefit. To date, a few states have curtailed, or proposed to curtail, NEMT for Medicaid Expansion populations.
MTAC will continue providing evidence that access to NEMT results in better health outcomes for beneficiaries while also controlling costs by avoiding or minimizing the use of more intensive – and higher cost – healthcare services. MTAC is also encouraged that in a recent speech, Health and Human Services Secretary Alex Azar specifically recognized the benefits of providing persons in need with access to low-cost transportation to get them to their healthcare appointments and that such services provide a sizable return on investment.
Have states pursued limits to NEMT for the core Medicaid population?
Are more hospitals and providers offering NEMT as part of the transition to value based care?
HHS Secretary Alex Azar discussed this problem in a March 2018 speech to the Federation of American Hospitals: “Many providers have taken advantage of the recent rise of ride-sharing services to provide reliable, low-cost transportation to appointments. But an array of federal regulations has limited the degree to which this can occur: The amount of free rides that can be provided to a patient in a given year, for instance, is strictly limited. These are the kinds of wraparound services that can often improve outcomes at incredibly low cost. We’re devoted to figuring out ways for providers to take advantage of them.”
MTAC hopes to work with Secretary Azar and other stakeholders to reassess regulations that limit the provision of NEMT by healthcare providers.