Non-Emergency Medical Transportation (NEMT)

Overview

Medicaid Non-Emergency Medical Transportation (NEMT) is an important benefit for Medicaid members who need to get to and from Medicaid-covered medical services but have no means of transportation. This site is intended to assist in understanding the Connecticut NEMT program.  The following information and documents summarize the range of Medicaid-covered transportation services, the processes involved and past and current documents related to the Connecticut NEMT program.

NEW  2018-2020 NEMT Procurement Decision (updated June 2, 2017)

 

State of Connecticut Competitive Procurement for Non-Emergency Medical

Transportation Services, Request for Proposals NEMT_RFP_110116

 

The Department of Social Services (DSS) is now in the final stage of procurement for Non-Emergency Medical Transportation (NEMT) Services after evaluation of proposals, pursuant to the Request for Proposals, and selection of a respondent to be awarded the right to negotiate a contract.

 

Upon successful negotiations, DSS will execute a three-year contract for NEMT services, effective January 1, 2018, through December 31, 2020.  The program is being restructured based on a ‘capitated’ payment system, designed to provide the contractor with greater flexibility and capacity to engage local transportation providers (more on this in the ‘Background Information’ section below).  In the interim, DSS has extended the contract of the incumbent NEMT contractor, LogistiCare Solutions LLC, to keep NEMT services operating while the state competitive procurement process is completed.

 

NEMT_RFP_110116 REQUEST FOR PROPOSALS RESPONDENTS (in alphabetical order):

 

  • Coordinated Transportation Solutions, Inc., Trumbull, CT

 

  • LogistiCare Solutions, LLC, Atlanta, GA, with Connecticut office in North Haven

 

  • Total Transit, Inc., Glendale, AZ, with subsidiary Veyo, LLC, San Diego, CA

 

  • Transdev Services Inc., Lombard, IL 

 

 

PROCUREMENT AUTHORITY’S DECISION:

 

The decision of the Department of Social Services is to award the right to negotiate a contract to Total Transit, Inc., with subsidiary Veyo, LLC.  DSS believes that the best interests of the State of Connecticut and Medicaid beneficiaries will be met through this procurement decision, which is based in part on lower proposed costs than other respondents and advanced technological approaches to NEMT services.  Should negotiations with the selected respondent not be successfully concluded with a contract execution, DSS would move to another qualified respondent for contract negotiations.  Maximum administrative services three-year contract value is $23,031,974. 

 

 

BACKGROUND INFORMATION:

 

Non-Emergency Medical Transportation (NEMT) is an important benefit for Medicaid members who need to get to and from covered medical services.  After review of information and options, and based on experience since the last program redesign, DSS decided to change the program structure going forward.  DSS concluded that the current structure is not the best approach to administer this challenging program, which provides over 4 million rides annually to Medicaid enrollees.

 

The current structure is basically a fee-for-service system with a statewide administrator/contractor.  The contractor has no flexibility to incentivize the local transportation providers because the fee structure is fixed.  Beginning January 1, 2018, through the new procurement, DSS is returning to a ‘capitated’ payment system for the service.  Put most basically, the contractor will have the ability to pay local transportation providers with more flexibility according to need in the area and situational requirements on the ground.  For example, if an area needs more providers, the contractor can adjust payments to better incentivize service provision.  The contractor assumes what is known in the process as ‘risk’ for financially covering the rides needed by Medicaid enrollees through a per-enrollee/per-month amount (instead of fixed fee-for-service rates), and is responsible for coordinating the transportation within that total.  Through this change, the overall goal is increase the capacity to engage local transportation providers where and when needed, and to maximize access to services.

 

The department’s approach to NEMT services emphasizes a person-centered service system that is cost-effective while utilizing technology and other innovative solutions in transportation booking, scheduling, monitoring and reporting to provide full access to Medicaid enrollees.

 

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Contract Extension

 

The Department of Social Services has extended the contract of the current NEMT contractor, LogistiCare Solutions LLC, while the ongoing state competitive procurement of NEMT services is completed (see Request for Proposals below). The contract extension covers January through December 2017. Please follow this link  for a copy of the contract extension document