Mandatory Medicaid Benefit Campaign | Simon&Co., LLC https://mjsimonandcompany.com/issues/non-emergency-medical-transport/mandatory-medicaid-benefit-campaign/ Experts in Health and Human Services Policy, Appropriations, & Budget Strategies Thu, 12 Oct 2023 17:47:20 +0000 en-US hourly 1 https://mjsimonandcompany.com/wp-content/uploads/cropped-Simon-Co-icon-32x32.png Mandatory Medicaid Benefit Campaign | Simon&Co., LLC https://mjsimonandcompany.com/issues/non-emergency-medical-transport/mandatory-medicaid-benefit-campaign/ 32 32 29 States Have CMS-Approved State Plan Amendments (SPAs) to Implement the New Non-Emergency Medical Transportation (NEMT) Requirements https://mjsimonandcompany.com/non-emergency-medical-transport/mandatory-medicaid-benefit-campaign/half-of-states-have-cms-approved-state-plan-amendments-spas-to-implement-the-new-non-emergency-medical-transportation-nemt-requirements/ Thu, 31 Mar 2022 17:13:43 +0000 https://mjsimonandcompany.com/?p=1562 Since non-emergency medical transportation (NEMT) was codified into law in Section 209 of the Consolidated Appropriations Act, 2021 (passed on December 27, 2020), 29 states and one territory have implemented Medicaid and CHIP state plan amendments (SPAs) to ensure states meet the NEMT requirements for driver and transportation provider safety. The quick passage of these …

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]]> Since non-emergency medical transportation (NEMT) was codified into law in Section 209 of the Consolidated Appropriations Act, 2021 (passed on December 27, 2020), 29 states and one territory have implemented Medicaid and CHIP state plan amendments (SPAs) to ensure states meet the NEMT requirements for driver and transportation provider safety. The quick passage of these SPAs illustrates the importance of codifying into law the longstanding CMS regulation requiring states to “assure necessary transportation for beneficiaries to and from covered services.”

Below is a table of states that have implemented SPAs related to NEMT as of April 4, 2022. Karen Late, Senior Director at Simon&Co., reviews new SPAs biweekly.

StateSPA SummaryEffective Date
AlabamaEnsures Non-Emergency Medical Transportation’s (NEMT) provider and driver requirements are satisfied and add to the Alabama Medicaid Agency’s State Plan as a statutory requirement for the assurance of transportation under Title 42 CFR § 431.53.12/27/21
CaliforniaThis SPA will add the state’s attestation that it meets all the minimum requirements under Section 1902(a)(87) of the Social Security Act – also known as Section 209 of the Medicaid Coverage of Certain Medical Transportation Under the Consolidated Appropriations Act of 2021 (P.L. 116-260). Separately, the SPA also removes the requirement for prior authorization for nonmedical transportation.
Effective July 1, 2017, this amendment adjusts the Alternative Benefit Plan (ABP) to add nonmedical transportation (NMT) services as a covered ABP benefit to all eligible Medi-Cal beneficiaries to align with the addition of NMT services as a covered benefit.		12/1/21
ColoradoMedicaid coverage of certain medical transportation. It attests that all the minimum requirements outlined in 1902(a)(87) of the Social Security Act are met.12/27/21
ConnecticutThis SPA amends Attachment 3.1-D of the state plan to comply with the requirements for assurance of Medicaid coverage for non-emergency medically-related transportation in accordance with section 209 of the Consolidated Appropriations Act of 2021.12/27/21
District of ColumbiaThis amendment provides assurances to comply with federal non-emergency medical transportation requirements, as directed by CMCS in July 12, 2021, CMCS Information Bulletin.12/27/21
GeorgiaThis amendment proposes to provide attestation of transportation minimum requirements.10/10/21
HawaiiAttests to the state’s compliance with the transportation requirements outlined in sections 1902(a)(87) of the Social Security Act.12/27/21
LouisianaUpdates provisions governing medical transportation in order to assure necessary transportation for beneficiaries to and from covered services, helping to ensure access to care for beneficiaries who have no other means of transportation, in accordance with the requirements under the Consolidated Appropriations Act, 2021.12/27/21
MaineSPA implements transportation assurances federally required by the Consolidated Appropriations Act, 2021, Division CC, Title II, Section 209.12/27/21
MassachusettsThis SPA amends Attachment 3.1-D of the state plan to comply with the requirements for assurance of Medicaid coverage for non-emergency medically-related transportation.12/27/21
MinnesotaAttests to the state’s compliance with the transportation requirements outlined in sections 1902(a)(87) of the Social Security Act.12/27/21
MissouriIncludes new federal requirements that transportation providers and drivers must meet in order to provide Non-emergency Medical Transpo1iation (NEMT) services under the Medicaid program.12/27/21
MontanaThis amendment adds the state’s attestation that it meets all the minimum requirements under Section 1902(a)(87) of the Social Security Act; otherwise known as Section 209 of the Medicaid Coverage of Certain Medical Transportation under the Consolidated Appropriations Act, 2021.12/1/21
NebraskaThis amendment provides requirements for non-emergency medical transportation (NEMT)12/27/21
NevadaThis amendment proposes changes to incorporate language based on provisions for Medicaid non-emergency medical transpo1iation (NEMT) services added to Section 1902(a)(87), Title XIX of the Social Security Act, as part of the Consolidated Appropriations Act, 2021.12/1/21
New HampshireThis amendment was submitted to include an attestation to compliance with the Consolidated Appropriations Act, 2021, Division CC, Title II, Section 209.10/1/21
North CarolinaThis amendment ensures compliance with Section 209 of the Consolidated Appropriations Act of 2021. CMS supports this change because it brings the state into compliance.12/27/21
North DakotaIdentifies minimum requirements for non-emergency transportation providers.12/27/21
OregonMakes assurances for provisions added by the Consolidated Appropriations Act, 2021, Division CC, Title II, Section 209, concerning Medicaid coverage of certain medical transportation (section 209).12/27/21
PennsylvaniaProvides assurance that the state is in compliance with the non-emergency medical transportation (NEMT) requirements outlined in Section 1902(a)(87) of the Social Security Act.12/27/21
Rhode IslandAttestation to compliance with the NEMT Consolidated Appropriations Act, 2021, Division CC, Title II, Section 209.12/1/21
South CarolinaBrings the State Plan into compliance with the Transportation requirements under the Consolidated Appropriations Act of 2021.12/15/21
South DakotaThe SPA provides an assurance that the State complies with federal minimum requirements regarding medical transportation added by the Consolidated Appropriations Act, 2021. The SPA also clarifies language on the coverage and reimbursement transportation pages to better reflect current practice.12/27/21
TexasEffective June 1, 2021, this amendment updates the non-emergency medical transportation (NEMT) fee schedules and requires managed care organizations (MCOs) to provide NEMT services to their Medicaid managed care members. The Health and Human Services Commission (HHSC) will continue to provide NEMT to Medicaid recipients in fee-for-service but will no longer use a transportation broker model.6/1/21
UtahAssures the State complies with the federal medical transpo1iation requirements added by the Consolidated Appropriations Act, 2021.10/1/21
VermontProposes to update the coverage description of non-emergency medical transportation (NEMT) and ambulance services.4/1/21
Virgin IslandsAmendment to attest to compliance with the NEMT provider and driver requirements.10/1/21
VirginiaThis amendment will allow Virginia to add an attestation that the Department of Medical Assistance Services (DMAS) meets all the minimum requirements for Non-Emergency Medical Transportation (NEMT) providers and individual drivers.1/1/22
West VirginiaThis amendment provides assurance that the state is in compliance with the non-emergency medical transportation requirements.1/1/22
WisconsinThe amendment proposes to modify non-emergency medical transportation reimbursement rates and provides assurance that providers and drivers of NEMT meet minimum requirements.11/1/21

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]]> Inside Health Policy Quotes Marsha Simon on NEMT Coverage https://mjsimonandcompany.com/non-emergency-medical-transport/mandatory-medicaid-benefit-campaign/inside-health-policy-quotes-marsha-simon-on-nemt-coverage/ Mon, 01 Nov 2021 14:50:53 +0000 https://mjsimonandcompany.com/?p=1504 Editors Amy Lotven and Maya Goldman at Inside Health Policy, a subscription-based newsletter service covering health policy news, recently quoted Marsha Simon on the push to retain the NEMT benefit in the Build Back Better (BBB) budget reconciliation package. Below is the full excerpt from the article. Advocates had recently urged congressional leaders not to …

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]]> Editors Amy Lotven and Maya Goldman at Inside Health Policy, a subscription-based newsletter service covering health policy news, recently quoted Marsha Simon on the push to retain the NEMT benefit in the Build Back Better (BBB) budget reconciliation package. Below is the full excerpt from the article.

Advocates had recently urged congressional leaders not to omit the NEMT coverage. Health policy expert Marsha Simon, of Simon & Co., LLC, says that considering advocates had been fighting with the previous administration to maintain the NEMT benefit, its inclusion in BBB is a “reversal of fortune.”

“It shows the growing awareness that having insurance coverage is not sufficient to ensure low-income patients can access critical services such as kidney dialysis, cancer care and medication treatment for substance use disorders,” she adds.

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]]> Nearly 60 Medicaid Advocates Urge White House and Congressional Leadership to Retain NEMT Benefit in “Gap” Health Insurance, Benefit Included in House BBB Package https://mjsimonandcompany.com/non-emergency-medical-transport/mandatory-medicaid-benefit-campaign/nearly-60-medicaid-advocates-urge-white-house-and-congressional-leadership-to-retain-nemt-benefit-in-gap-health-insurance-benefit-included-in-house-bbb-package/ Fri, 29 Oct 2021 18:19:37 +0000 https://mjsimonandcompany.com/?p=1500 On October 26, Simon&Co. coordinated a message from nearly 60 Medicaid advocacy organizations urging the White House and congressional majority leadership to retain non-emergency medical transportation (NEMT) as a requirement in the gap health care coverage provision of the final Build, Back, Better (BBB) budget reconciliation package. Yesterday, the leadership released its BBB proposal including NEMT, …

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]]> On October 26, Simon&Co. coordinated a message from nearly 60 Medicaid advocacy organizations urging the White House and congressional majority leadership to retain non-emergency medical transportation (NEMT) as a requirement in the gap health care coverage provision of the final Build, Back, Better (BBB) budget reconciliation package. Yesterday, the leadership released its BBB proposal including NEMT, making it the first additional benefit required on top of the Affordable Care Act (ACA) essential health benefits.

The full message may be viewed here. The language can be viewed here.

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