Ensuring Transportation for Medicaid Beneficiaries

October 04, 2023

CMS has issued a new Medicaid transportation guide to help states ensure patients can get to appointments and receive the care they need to live healthy lives.

In a new letter to state Medicaid directors, the federal agency highlighted its new “one-stop source” to help states understand federal requirements and flexibilities for Medicaid transportation.

“Medicaid transportation is a critical service that assists beneficiaries with accessing covered Medicaid services and has a direct impact on health outcomes,” wrote Daniel Tsai, deputy administrator and director of the Center for Medicaid and CHIP Services.

Here's what you need to know:

• A strong assurance:  Federal law requires states to assure that beneficiaries have the transportation necessary to access covered medical services, including non-emergency medical transportation.
  • This assurance makes certain that beneficiaries with no other transportation have access to transportation to receive covered care.
• Access requirements:  The two main Medicaid transportation requirements are that it is the least costly/most appropriate mode suited to the needs of the beneficiary, and that it provides transport to the nearest qualified provider.
• Federal update:   The 2021 Consolidated Appropriations Act codified the long-standing transportation assurance for states. States have administrative flexibility to design their transportation programs within certain parameters.
• Noteworthy:  In rural areas, CMS strongly encourages states to “evaluate rate methodologies that recognize the unique transportation issues faced by rural transportation providers.”
• Quotable:  “CMS encourages states to consider how to fully operationalize the transportation assurance and to ensure it is regularly monitored and considered for improvements,” the letter notes.

The letter and new Medicaid transportation coverage guide is available online.