Tri Valley Transit warns funding pressures could strain Medicaid nonemergency transport

Jim Moulton, executive director of Tri Valley Transit and chair of the Vermont Public Transportation Association, told meeting attendees that the state’s Medicaid nonemergency medical transportation program is facing funding pressure and operational strain even as providers work to keep rides available.

Moulton said Medicaid NEMT is an entitlement program, paid on a fixed per‑member basis, and that recent trends — fewer enrolled members but higher ride utilization per member — have raised costs for transit providers while revenue has not increased in step.

That matters because Medicaid beneficiaries rely on NEMT for dialysis, cancer treatment, pharmacy trips and other care; if providers cannot cover costs, service stability could be affected.

Moulton said Tri Valley Transit and other regional providers receive a per‑member payment (operationally discussed as a per‑member‑per‑week/per‑month rate) and that membership counts include people who have taken at least one Medicaid‑eligible ride in the prior 12 months. “Medicaid is an entitlement program, which makes, that's 1 unique element to that. When people need their, medical transportation rides, our purview is to provide the ride, regardless,” Moulton said.

He told the group that the program’s revenue math is the product of the number of members times the…