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.
| State | SPA Summary | Effective Date |
| Alabama | Ensures 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 |
| California | This 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 |
| Colorado | Medicaid 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 |
| Connecticut | This 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 Columbia | This 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 |
| Georgia | This amendment proposes to provide attestation of transportation minimum requirements. | 10/10/21 |
| Hawaii | Attests to the state’s compliance with the transportation requirements outlined in sections 1902(a)(87) of the Social Security Act. | 12/27/21 |
| Louisiana | Updates 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 |
| Maine | SPA implements transportation assurances federally required by the Consolidated Appropriations Act, 2021, Division CC, Title II, Section 209. | 12/27/21 |
| Massachusetts | This 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 |
| Minnesota | Attests to the state’s compliance with the transportation requirements outlined in sections 1902(a)(87) of the Social Security Act. | 12/27/21 |
| Missouri | Includes 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 |
| Montana | This 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 |
| Nebraska | This amendment provides requirements for non-emergency medical transportation (NEMT) | 12/27/21 |
| Nevada | This 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 Hampshire | This 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 Carolina | This 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 Dakota | Identifies minimum requirements for non-emergency transportation providers. | 12/27/21 |
| Oregon | Makes 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 |
| Pennsylvania | Provides 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 Island | Attestation to compliance with the NEMT Consolidated Appropriations Act, 2021, Division CC, Title II, Section 209. | 12/1/21 |
| South Carolina | Brings the State Plan into compliance with the Transportation requirements under the Consolidated Appropriations Act of 2021. | 12/15/21 |
| South Dakota | The 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 |
| Texas | Effective 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 |
| Utah | Assures the State complies with the federal medical transpo1iation requirements added by the Consolidated Appropriations Act, 2021. | 10/1/21 |
| Vermont | Proposes to update the coverage description of non-emergency medical transportation (NEMT) and ambulance services. | 4/1/21 |
| Virgin Islands | Amendment to attest to compliance with the NEMT provider and driver requirements. | 10/1/21 |
| Virginia | This 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 Virginia | This amendment provides assurance that the state is in compliance with the non-emergency medical transportation requirements. | 1/1/22 |
| Wisconsin | The 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 |