Medicaid Nonemergency Medical Transportation

     The bill creates requires the transportation broker (broker) to establish the transportation community advisory board (TCAB) within the department of health care policy and financing (state department) and requires the state department of health care policy and financing (state department) to collaborate with the TCAB prior to establishing rules and processes for the safety and oversight of nonmedical transportation services and nonemergency medical transportation (NEMT) services. The bill states which rules for NEMT the state department, in collaboration with the TCAB, must adopt.

     The bill establishes how a transportation broker (broker) must roll out their implementation and requires the broker to provide all transportation providers (providers) with software, a communication toolkit, training, and technical assistance to facilitate NEMT services. The broker may require encourage medicaid members (members) to book transportation services more than at least 2 days before their requested transportation date , and the broker shall accept and make reasonable efforts to fulfill same-day and next-day transportation requests . The bill requires providers , only after all service regions have been implemented, to accommodate member requests for preferred or alternate drivers when operationally feasible.

     The bill requires the broker, and, if there is no broker, the transportation providers to verify that individuals using the transportation services are eligible members during the scheduling of transportation services. The bill prohibits the broker from operating, owning, or controlling a provider in Colorado. The bill requires providers the broker to provide their trip assignment rules and procedures to the state department for approval and for publication on the state department's website. The bill also defines when a transportation network company may provide NEMT services.

     The bill prohibits the state department from denying payment of services to transportation providers solely because the broker or state department determines that a member's eligibility or trip information was inaccurate if the provider provides scheduled transportation services in good faith based on the information provided by the transportation broker, or if the provider had no knowledge of an inaccuracy and the provider followed all applicable rules and procedures. Subject to available appropriations, the bill requires the state department to annually audit brokers and a random group of providers to make the audit reports publicly available audit providers and audit the broker annually .

     The bill requires the state department to categorize all NEMT expenditures as medical services and make changes to the NEMT program as necessary to obtain medical services federal match rates for NEMT services. The bill also eliminates the requirement that the state department provide transportation services as an administrative cost.

      The bill reduces appropriations to the state department for medical and long-term care services for medicaid eligible individuals.

(Note: Italicized words indicate new material added to the original summary; dashes through words indicate deletions from the original summary.)


(Note: This summary applies to the reengrossed version of this bill as introduced in the second house.)