The NEMT benefit is provided to Medicaid beneficiaries as a way to ensure access to medical services. The program helps Medicaid beneficiaries who are disadvantaged or living in rural areas reach medical facilities in a timely and convenient manner. It is particularly important for Medicaid beneficiaries, who lack transportation resources and may require frequent medical assistance.
The NEMT program is widely used by Medicaid beneficiaries. Many of them use a NEMT service to access behavioral health services. The program can be used to improve the quality of behavioral health care in Medicaid beneficiaries who do not want to travel far for treatment. The program can also be used to improve the use of technology such as mobile applications and GPS trackers. States should improve their oversight capabilities and offer performance incentives to encourage participants to participate in the NEMT program.
While NEMT has been an important benefit for Medicaid beneficiaries for decades, it is important to note that it is not widely used in all areas. While the total number of rides in the NEMT program is still higher than that of pre-COVID-19 levels, providers are experiencing driver shortages across the state. The Southwest and Northern Virginia regions experience the greatest driver shortages. Furthermore, TNCs are often limited to transporting only one Medicaid member at a time, and the drivers cannot provide hands-on care.
However, the program has had some lapses in program integrity. Fraud is not immune to the NEMT program and investigators have found numerous examples of bad behavior by vendors. For example, one ride vendor in Massachusetts billed rides for a deceased beneficiary while another in Connecticut billed rides for dialysis when an ambulance was not needed. The two cases led to settlements that topped $300,000, which may explain why states turned to a brokerage model to improve the quality of their NEMT program.
Medicaid plans arrange NEMT with transportation brokers and providers in their counties. For more information, consult your Medicaid plan’s website or call a county transportation broker or Medicaid Transportation Coordinator to arrange a ride. Some rides may take as much as 7 days to be approved. In some cases, you may be required to pay a small fee or copay.
The NEMT program has significant effects on Medicaid beneficiaries’ access to health care services. It affects the amount of health services used, the types of Medicaid expenditures, and the use of specific health services. The results of a two-part model show that Medicaid beneficiaries who use NEMT services are likely to use medical services at a lower cost.
The study sample is drawn from all Medicaid beneficiaries under age 65 in the two states. It involves a claim and eligibility file, which contains medical expenditures, provider characteristics, diagnosis-related group codes, and beneficiary demographics. The claims files are used for individual-level analysis, which includes estimating changes in expenditures.