The Vendor is required to provide parties capable and interested in operating and managing access to care through the facilitation of non-emergency ground transportation (NEMT) for eligible Medicaid recipients.
- The interested party should consider its ability to assist eligible Medicaid recipients with transportation services to medical appointments, including coverage of ground transportation, airfare, ferry transportation, lodging, and meals.
- There are five key components that must be established for travel to be covered. 
- Healthcare providers must provide supporting information for all 5 components. 
- The provider will provide the request to the broker, including these qualifying components for their client:
• Medicaid benefit: both the referring and receiving healthcare provider must be an enrolled provider with state medicaid; exceptions include military and VA facilities as well as emergency situations where the member was traveled to the closest acute care hospital that could meet their needs.
• Covered service: the service the travel is needed for must be state medicaid-covered service.
• Closest, most appropriate provider: transportation must be to the closest most appropriate healthcare provider that can meet the member’s needs; however, state natives may be approved for traveling to the nearest tribal health facility; does not apply to travel services in a member’s home community.
• Medical necessity: the healthcare service(s) must be reasonable, necessary, and appropriate, based on evidence-based clinical standards of care; medical necessity also applies to products used to treat or prevent diseases and disorders; state medicaid uses criteria established by the department of health or by standards of practice applicable to the ordering or referring healthcare provider’s license or certification.
• Medical Provider Burden: Writing, tracking, mailing, and ordering vouchers is administratively burdensome on the healthcare providers causing some to refuse participation.
• Member Access to Vouchers: It can be challenging for members to get vouchers in time for their travel, get more vouchers if needed in the middle of a travel event, and members may lose vouchers.
• Incorrect or Incomplete Vouchers: Transportation providers have difficulty getting paid for services provided due to vouchers being incorrectly filled out.
- Ground transportation services are reimbursed at billed charges for all modalities except wheelchair van which has a set urban and rural rate.
- Contract Period/Term: 1 year