Capitol Correspondence - 03.10.20

Congress Calls Out Administration for Defying Mandated Pause on Non-Emergency Medical Transportation Rulemaking

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A bipartisan group of U.S. Representatives asked the Office of Management and Budget (OMB) to halt on-going rulemaking by the Centers for Medicare and Medicaid Services (CMS) to make Medicaid’s non-emergency medical transportation (NEMT) benefit optional. OMB reviews rules by all agencies before they are released to the public, and in December 2019 Congress required CMS to pause rulemaking on this issue until a study of the NEMT benefit’s value could be conducted. CMS prompted this letter because it appears to be continuing rulemaking despite the December law. ANCOR is concerned about this because without NEMT, people with disabilities would not be able to access critical health services, like dialysis, primary care, preventive care and care for substance use disorders. This has led us to support a legislative solution by one of the House letter signatories, U.S. Representative Buddy Carter (R-GA), to codify in the law that NEMT is in fact a mandatory benefit.

As written in the letter by U.S. Representative Carter, as well as U.S. Representatives Tony Cardenas (D-CA), Tom Graves (R-GA) and Sanford Bishop (D-GA):

“We are encouraging the President to delay any and all action on the proposed request for information (RFI) and potential rulemaking to addressing the Medicaid requirement for states to provide non-emergency medical transportation (NEMT) for beneficiaries outlined in the Fall 2019 OMB Unified Agenda (RIN: 0938-AT81). Under this revised schedule, CMS intends to accelerate its timeline and publish an RFI early this year, and a proposed rule possibly by December 2020, as opposed to a proposed rule in December 2021 as indicated in the Spring 2019 OMB Unified Agenda.

NEMT has been a mandatory benefit by regulation since the Medicaid program’s inception in 1966. The NEMT benefit, which provides the country’s most vulnerable patients with over 100 million rides to medical services annually, allows people with chronic conditions to access life-saving treatment for end-state renal disease, cancer, or substance abuse disorder. NEMT also providers hundreds of thousands of children (18 percent of all riders) access to check-up, vaccines and other pediatric care. Overall, the benefit is used by seven percent of beneficiaries but accounts for less than one percent of total Medicaid spending.

While we support flexibility for states, we do not support overturning a Medicaid policy in place for over 50 years without a careful examination of the consequences affecting our most vulnerable constituents.”