Non-Emergency Medical Transport

Providence provides non-emergency medical transportation (NEMT) services in 36 states and the District of Columbia through its wholly owned subsidiary, LogistiCare. NEMT includes all forms of transportation used by people to travel to medical appointments, other than emergency (911) ambulance transport. NEMT can involve a bus trip for those who can use public transit, or a van trip for a mother taking her children for their check-ups, or a daily sedan ride to dialysis, or an ambulance or stretcher trip for someone who needs to be transported in the prone position. Whatever the mode of transportation used, the goal of an NEMT program is always the same – to ensure that individuals have reliable, safe transportation access to health care services.

Lack of transportation is frequently cited as a major reason for missed medical appointments. According to a recent federal transportation report, enhanced access to reliable NEMT services can lead to overall health care cost savings for certain types of medical conditions (diabetes, asthma, and prenatal care), as well as improved quality of life for patients.

While NEMT services are provided by a variety of health care organizations for their patients and members, including state Medicaid agencies, managed care organizations (MCOs) serving Medicaid, Medicare, or commercial clientele, hospitals, physician groups, and other health care organizations, by far the largest funder of NEMT services is the Medicaid program. Medicaid recipients are entitled to NEMT transportation services as long as the requested trip is to a Medicaid covered services, the destination facility is the closest appropriate service provider, the mode of transportation is the least costly, medically-appropriate, available, and the recipient has no other means of transportation. While states have some flexibility in how they define their Medicaid NEMT benefit, they all have to meet these fundamental eligibility criteria.

States also use a variety of program designs to deliver Medicaid NEMT services. Some states simply credential and enroll transportation companies and pay claims, leaving it up to recipients and health care providers to arrange trips. Others require prior approval of trip requests and either perform the authorization function themselves or outsource to a prior approval agent. When states outsource the whole NEMT program (prior approval, network credentialing and management, quality assurance, etc) the program is usually referred to as “brokered”. Other states that use MCOs to deliver some Medicaid services include NEMT among the MCOs’ responsibilities. The MCOs, in turn, vary in the extent to which they manage the programs themselves or subcontract to an NEMT management company (or “broker”). LogistiCare is the largest and most experienced NEMT broker in the country.

LogistiCare provides services in the following states: Arizona, Arkansas, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Maine, Maryland, Massachusetts, Michigan, Mississippi, Missouri, Nebraska, Nevada, New Jersey, New Mexico, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, Utah, Virginia, Washington, and Wisconsin.