Senate panel, Medicaid officials seek fix to NEMT contracting language and funding for driver recruitment

Ashley Berlinger, director of Medicaid policy for the Agency of Human Services, told the Senate Transportation Committee on April 23 that proposed changes in Sections 27 and 29 of the transportation bill would force the state to consider matters outside the scope of Medicaid when contracting for nonemergency medical transportation (NEMT).

Berlinger said federal Medicaid rules — and Centers for Medicare & Medicaid Services (CMS) guidance tied to Vermont's 1115 Global Commitment to Health waiver — prohibit considering other programs or the financial stability of the public transit system when awarding an NEMT contract. "We cannot consider anything beyond the scope of NEMT for Medicaid," she said, and added that federal reviewers are now scrutinizing contracts, manuals and communications more closely than before under a "fraud, waste and abuse" lens.

The testimony prompted committee members, AHS and public-transit providers to agree to redraft the bill language. AHS said it will provide written follow-up with citations and will propose alternative wording intended to avoid any conflict with federal law. The committee aims to circulate revised language by Friday and, if stakeholders agree, amend the T bill before its second reading, which is scheduled for Tuesday.

Why it matters: NEMT provides rides for Medicaid members who need nonemergency medical care. If state contract language requires an agency to analyze impacts beyond NEMT — for example, the financial stability of public transit or effects on an older-adults and persons-with-disability (O & D) program — AHS warns that CMS could…