SF2125

This bill, Minnesota Senate File No. 2125, proposes amendments to Minnesota Statutes 2024, section 256B.0625, subdivision 17, to increase payment rates for nonemergency medical transportation (NEMT) services under the state's Medical Assistance (Medicaid) program.

Key Provisions:

1. Definition & Coverage

   • NEMT includes motor vehicle transport for Medicaid beneficiaries who do not require emergency ambulance services.
   • Covered transportation modes include nonemergency medical transportation providers, ambulances, taxicabs, public transit, volunteer drivers, and other recognized providers.
   • Transport must be for medically necessary services and provided using the most direct and cost-effective route.

2. Provider Standards & Requirements

   • NEMT providers must be enrolled in the Minnesota Health Care Programs (MHCP).
   • Drivers must be individually enrolled and comply with state safety and operational standards.
   • Providers must maintain trip logs and follow billing guidelines.

3. Administrative Oversight

   • A single administrative structure will be used for trip assessment, payment processing, and data collection.
   • Reimbursement and service levels will be subject to state-defined assessments to ensure appropriate transport mode.

4. Reimbursement Rates

   • The bill increases reimbursement rates for NEMT providers, with higher base rates and per-mile payments beginning January 1, 2026, or upon federal approval.
   • Example Rate Changes:
     • Unassisted transport (taxicabs, public transit): Base rate increase from $12.10 to $17; per-mile increase from $1.43 to $2.38.
     • Assisted transport: Base rate increase from $14.30 to $22; per-mile increase from $1.43 to $2.38.
     • Lift-equipped (wheelchair) transport: Base rate increase from $19.80 to $31; per-mile increase from $1.70 to $2.65.
     • Protected transport (secured transport for individuals with special needs): $75 base rate & $2.40 per mile.
     • Stretcher transport: $60 base rate & $2.40 per mile, with $9 per trip for an additional attendant if medically necessary.
   • Rural and Super Rural Adjustments:
     • Base rates in super rural areas set at 111.3% of the standard rate.
     • Mileage rates adjusted by 125% for trips under 17 miles and 112.5% for trips between 18-50 miles.

5. Gasoline Price Adjustments

   • If the gasoline price exceeds $3 per gallon, the commissioner must adjust the per-mile rate by 1% for every $0.10 increase or decrease in fuel costs.

Purpose of the Bill:

The bill aims to improve access to nonemergency medical transportation for Minnesota Medicaid beneficiaries by raising provider reimbursement rates and streamlining administrative processes. The increased payments account for inflation, rising costs, and the need for higher-quality transportation services.

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