Medicaid NEMT and Ambulance Transportation Programs and Services
Medicaid non-emergency medical transportation (NEMT) and ambulance services are important benefits for beneficiaries who need to get to and from medical services but have no means of transportation. Myers and Stauffer has assisted states with various aspects of their Medicaid NEMT and ambulance transportation programs, including policy analysis, developing or updating rates, designing and implementing supplemental payment programs, and evaluating NEMT broker programs.
Interested in learning about our Medicaid emergency transportation programs and services?
We provide the following services:
Medicaid Financing and Reporting
Tim Guerrant, CPA
State Medicaid programs are increasingly looking to supplemental payment programs to provide additional reimbursement to ambulance providers to ensure adequate access to emergency ambulance services. These programs often rely on state share funding strategies to leverage federal matching funds. Our team has assisted states in successfully designing and implementing ambulance supplemental payment programs in fee-for-service and managed care environments. Our services include:
- Design supplemental payment programs and payment methodologies.
- Develop cost reporting tools and collect cost data from providers.
- Analyze state share funding strategies.
- Develop federally-compliant payment structures in managed care.
- Calculate fiscal impact estimates.
Tim Guerrant, CPA
Myers and Stauffer’s rate setting expertise includes rate and payment development for NEMT and ambulance services. Services we provide to our clients for their NEMT and ambulance programs include:
- Stakeholder engagement.
- Policy and benefit analysis.
- Rate adequacy studies.
- Develop cost reporting tools and collect cost report data from providers.
- Conduct research and analysis of reimbursement rates and service utilization.
- Update transportation fee schedule rates.
- Calculate supplemental payments.
- Implementation assistance.
- Socialization planning.
- State plan/regulation amendments.
Created by federal mandate, NEMT is an important Medicaid benefit designed to allow beneficiary access to medically necessary services. The scope and delivery for these services resides with individual states and can leave these NEMT programs vulnerable to fraud, waste, and abuse.
Myers and Stauffer understands the oversight risks and challenges associated with NEMT programs. Our extensive knowledge of benefit and program integrity includes decades of experiences in detecting fraud, waste, and abuse. We can provide a range of targeted and timely solutions to protect the integrity of your state’s program. See our NEMT one-sheet for more information.
Managed Care Oversight and Compliance
Mike Johnson, CPA, CFE
The extensive services offered by our highly skilled managed care engagement team are generally focused on the oversight of health plans but can impact all provider types, including ambulance and transportation providers. These services include:
- Encounter data reconciliation and validation.
- Financial audits, performance audits, and program effectiveness audits.
- Network adequacy assessments and member access compliance.
- Readiness reviews.
- Claims payment and denial assessments, accuracy, and timeliness.
- Medical record review.
- Grievance and appeals analysis.
- Contract compliance.
- Other provider-specific issue review and resolution activities.