Transportation
Transportation

Transportation Programs and Services

Managing transportation services for government programs requires careful oversight, compliance, and strategic coordination. State and federal agencies depend on reliable transportation solutions to ensure access to essential services while adhering to regulatory requirements. At Myers and Stauffer, we provide comprehensive transportation program support, helping our clients navigate compliance challenges, enhance efficiency, and improve service delivery.

Emergency Transportation Programs and Services

Medicaid emergency medical transportation program supplemental financing has expanded rapidly, driven by increased ambulance provider taxes and supplemental payments through intergovernmental transfers (IGTs) and certified public expenditures (CPEs). This growth creates a rising demand for audits, program development, Medicaid financing strategies, and compliance assistance. While many programs are initiated by industry representatives, it’s crucial for states to ensure compliance with Centers for Medicare & Medicaid Services (CMS) standards to prevent future recoupments and optimize payments. Myers and Stauffer, which exclusively represents state and federal government clients, has experts in all aspects of Medicaid emergency medical transportation.

Ground Emergency Medical Transportation Programs

Fee-for-service supplemental and managed care state-directed payments for Medicaid ground emergency medical transportation (GEMT) services have grown in recent years, with the Centers for Medicare & Medicaid Services (CMS) continuing to approve new GEMT programs. Some states are also introducing legislation for new GEMT initiatives. These programs benefit public providers and Medicaid beneficiaries, often without requiring new state funds due to intergovernmental transfers (IGTs), certified public expenditures, and assessments. Since many programs are initiated by industry consultants, it’s essential for states to have their own experts to guide program development, Medicaid financing strategies, and compliance while safeguarding the state’s interests, such as ensuring proper financing, covering administrative costs, and minimizing liability for overpayments.

Non-Emergency Medical Transportation

Ensuring access to health care through Non-Emergency Medical Transportation (NEMT) requires careful coordination, regulatory adherence, and program integrity. Government agencies depend on NEMT services to provide safe, reliable transportation for beneficiaries while preventing fraud and inefficiencies. Myers and Stauffer supports clients with expert guidance in compliance, program optimization, and operational effectiveness to enhance service delivery and accountability.

Medicaid Financing and Reporting

Tim Guerrant, CPA
member
tguerrant@mslc.com
317.846.9521

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.

Rate Setting

Tim Guerrant, CPA
member
tguerrant@mslc.com
317.846.9521

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.

Benefit/Program Integrity

 

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
Member
mjohnson@mslc.com
404.524.0775

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.