ANCOR joined 57 other organizations in a group letter asking Congress to finalize legislation passed by the House earlier this fall, but not the Senate, that would codify non-emergency medical transportation as an essential Medicaid benefit. As explained in the letter:
“NEMT has been a mandatory benefit in the Medicaid program since its earliest days but has never been explicitly required in statute. While medical appointments vary by state, beneficiaries use NEMT to access critical services including COVID-19 testing, kidney dialysis, substance use disorder (SUD) treatments, behavioral health appointments, and primary care preventive health visits. The NEMT benefit is used by only 7 percent of the Medicaid population and accounts for less than 1 percent of total Medicaid spending. Yet for those who rely most upon NEMT—beneficiaries with chronic care need including those with ESRD who account for two-thirds of NEMT rides—it can be a lifeline allowing beneficiaries to stay in their homes and out of the hospital.
Despite this dire need for NEMT services at this time as well as the need for the additional services that NEMT networks provide in this crisis, CMS is planning to make the benefit optional at the state level and was scheduled to release an RFI to that effect in December. Further, the administration’s new Healthy Adult Opportunity Section 1115 waiver process encourages states to curtail the benefit.
Bipartisan legislation (HR. 3935) codifying the benefit and ensuring appropriate use has passed the House by unanimous voice vote on the suspension calendar and is pending in the Senate (S. 2846). As our healthcare system strains to meet the needs of the COVID-19 pandemic, now is the time for Congress to act to ensure the NEMT benefit is available for Medicaid’s most vulnerable beneficiaries.”
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