Medicaid provides transportation for emergency and non-emergency care.
Access to health care for the low-income beneficiaries of Medicaid poses an ongoing challenge to state health plans. This is due to the reality that automobile ownership is not as prevalent among Medicaid enrollees, coupled with the high ratio of the elderly and children. The federal government, which co-funds the Medicaid program with every state, provides flexibility for states to devise individual transportation assistance.
Medicaid Transportation Generally
Medicaid is the largest single purchaser of public transportation services within the nation. In 2006, it is estimated that the Medicaid program spent roughly $3 billion on medical transport. The provision of transportation is one of the elements that distinguishes Medicaid from a more traditional health insurance plan.
The Deficit Reduction Act of 2005 includes provisions that took effect in July, 2010, further expanding Medicaid transportation coverage. Under the act, the Centers for Medicare and Medicaid (CMS) implemented new regulations located at 42 CFR 440.390 which is referred to as the Assurance of Transportation provision.
This provision requires that a Medicaid plan assure that emergency and non-emergency transportation is covered.by continuing to require medical and non-medical transportation by Medicaid programs even if such services are not otherwise offered in the state in private, or other public, health plans.
Prior to this change, several states had dropped Medicaid transportation coverage as part of a Medicaid benchmarking program which allowed state Medicaid programs to limit services in a fashion similar to private plans. This is no longer possible under the new regulatory provisions, thus assuring continued transportation access for Medicaid beneficiaries.
CMS Regulations on Non-Emergency Transport
The general transportation assurance rule requires state plans ensure necessary transportation for recipients to providers under Section 1902(a)(4) of the Social Security Act. States must develop their transportation systems, describing the methods and providing for access. The states are also free to individually decide treat such services as either an administrative cost or as a medical service for reimbursement purposes. Any transportation provision, including bus and transit passes, must be shown to be the most cost-effective means of transportation.
Non-Medical Transport
Medicaid transportation regulations are focused on emergency and non-emergency transportation. Under 42 CFR 431.53, there is no requirement that transportation be made available for non-medical reasons.
Tags: emergency non-emergency, emergency non-emergency transportation, health plans, Medicaid program, Medicaid programs, Medicaid transportation, Medicaid transportation coverage
