What are NEMTs?
An NEMT is non-emergency medical transportation. NEMTs are used by people who need help with transportation to and from their medical appointments for various reasons. An NEMT only provides transportation to appointments and does not provide transportation for emergencies.
NEMTs are used by Medicaid providers to transport enrollees. Medicaid differs from traditional health insurance because it has an NEMT benefit which ensures transportation to necessary medical care. This service is important for getting Medicaid beneficiaries to appointments with no other transportation options. However, this benefit was not a requirement under Florida law until 2021. The requirement was an interpretation via regulation and was subject to different interpretations and waivers.
Florida statute 316.87 governs NEMTs and imposes certain requirements for NEMT companies. NEMT companies must be under contract with a Medicaid-managed care plan or with a transportation broker for a Medicaid-managed care plan. All of these companies and their drivers must be properly screened and conform to federal Medicaid requirements to legally operate in Florida.
What are TNCs?
Transportation Network Companies (TNCs) use online platforms to provide transportation to riders. TNC drivers are independent contractors and use their vehicles to provide services to riders. A TNC is not deemed to own, control, or operate the vehicle, but only connects drivers with passengers. A TNC vehicle differs from a taxi because the car is owned by the driver rather than the company, whereas taxi companies still own the vehicles.
Can TNCs provide NEMT services for Medicaid users in Florida?
Florida statute 627.748 governs TNCs. The statute was updated in 2019 to allow TNCs to operate as NEMTs under the Florida Medicaid program under certain conditions. Additionally, the Medicaid Agency updated its coverage policies for this change to the statute. However, if the managed care plan wants to use TNCs to provide NEMT services under the care plan it must get approval from the Agency.
The managed care plan (or contract transportation broker) must schedule the trips for the enrollee with the TNC. The managed care plan must arrange all scheduled trips for the enrollee and may not delegate this duty. The managed care plan is additionally responsible for ensuring that the TNC meets all requirements, including a background check, and that the car can accommodate disabilities. The new legislation regarding TNCs for Medicaid transport stated that the requirements imposed on TNCs by the Agency could not exceed those already imposed under Florida Statute 627.748 governing TNCs. TNCs offer managed care plans and transportation brokers more options for providing transportation for Medicaid enrollees.
If you have questions about the NEMT services and TNCs or need guidance on your obligations, our knowledgeable business law attorneys at EPGD Business Law are here to help. Call us at (786) 837-6787 or email us to schedule a consultation.
