Handbook for Examining the Effects of Non-Emergency Medical Transportation Brokerages on Transportation Coordination (2018) / Chapter Skim
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50 [In Florida] MCOs are responsible for NEMT as a service of the managed care plan.
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Models for Providing Non-Emergency Medical Transportation 51 Each MCO Contracts with Private For-Profit Brokers Each MCO contracts with one of three for-profit brokers to provide NEMT under the managed care plan. The brokers contract with a variety of transportation providers including taxi companies, public transit agencies, human services transportation providers, and for-profit transportation companies.
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52 Handbook for Examining the Effects of Non-Emergency Medical Transportation Brokerages on Transportation Coordination transportation coordinated transportation. Human services transportation contracts with six regional transit authorities to act as brokers for transportation services for EOHHS clients.
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Models for Providing Non-Emergency Medical Transportation 53 County-Based Management for NEMT Using Community Transportation Each county DSS contracts with the local community transportation provider to provide NEMT on a fee-for-service basis. DSS is responsible for determining if a Medicaid beneficiary is eligible for NEMT, authorizing trip eligibility, and record keeping for post-trip verification.
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54 Handbook for Examining the Effects of Non-Emergency Medical Transportation Brokerages on Transportation Coordination Pennsylvania: In-House Management and Regional Broker County Coordinators for Transportation Services In Pennsylvania, NEMT is called the Medical Assistance Transportation Program (MATP)
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Models for Providing Non-Emergency Medical Transportation 55 for failure to maintain adequate financial records and client encounter data, and HHSC assumed responsibility for in-house management in that one region. Benefits of the Change to Regional Brokers From the perspective of the state Medicaid agency, the change to regional brokers lowered the capitated payment for NEMT after 2014 and reduced the potential for fraud, waste, and abuse.
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56 Handbook for Examining the Effects of Non-Emergency Medical Transportation Brokerages on Transportation Coordination In-House Management Case study states for in-house management are North Carolina and Pennsylvania. In both states, the NEMT model is in-house management for county-based, coordinated transportation, shown in Table 8.
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Models for Providing Non-Emergency Medical Transportation 57 Regional Brokers Case study states for regional brokers are Massachusetts and Texas. In Massachusetts, the regional brokers are regional transit authorities.
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58 Handbook for Examining the Effects of Non-Emergency Medical Transportation Brokerages on Transportation Coordination Effects Massachusetts Texas Access to Medicaid services • The use of regional transit authorities to broker coordinated human services transportation has produced positive results for the state Medicaid agency by containing costs per passenger trip and ensuring service quality. • Massachusetts reports a lower cost per passenger trip for NEMT compared to other case study states.
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Models for Providing Non-Emergency Medical Transportation 59 Summary This chapter examines how the different NEMT models affect access to Medicaid services and coordination with human services transportation and public transportation. The different NEMT models are in-house management, statewide broker, regional brokers, and MCOs.
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