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Panel advances one-year extension and study of nonemergency medical transportation contracts
Summary
Lawmakers adopted a committee substitute extending current broker contracts for nonemergency medical transport for one year and ordered a statewide study after testimony that the current brokered system may leave many Medicaid-eligible patients without rides to routine care.
The House Standing Committee on Health Services voted to advance a committee substitute to House Bill 61, which extends existing contracts for the state’s nonemergency medical-transportation (NEMT) program for one year and directs a study of the program’s structure and use.
Representative Steve Bratcher, who presented the bill, said Medicaid currently spends nearly $400 million annually on NEMT, but state Department of Transportation figures show low utilization: “In 2022 and 2023… we had a 15% utilization rate,” he said, meaning a large share of paid services were not completed. The sponsor told members that missed routine care can become more costly later when conditions worsen and patients require emergency transport and hospital stays.
The committee substitute narrows the committee’s immediate policy change to: (1) extend select regional broker contracts for one year to allow continuity while a study is completed; (2) authorize certain providers — including nursing homes and hospitals — to provide NEMT in limited circumstances when brokers cannot serve a route; and (3) require a study and evaluation of the program and upcoming requests for proposals in 2025 and 2026.
Witnesses included Emily Beauregard of Kentucky Voices for Health, Lisa Biddlepuffer of the Kentucky Association of Healthcare Facilities, and Chuck O’Neil of the Kentucky Primary Care Association, who supported the substitute. Members praised the compromise and said the extension would buy time for a planned federal- or state-level review panel to examine the program’s costs and delivery.
Representative Fleming said the one-year extension aligns with the broader Medicaid oversight work now under way and allows for a careful review. The committee approved the substitute on a roll call and the chair announced, “House Bill 61 as amended by the committee sub passes with favorable expression.”
What the substitution does and why: Sponsors said the one-year extension coincides with staggered broker contract renewals and gives time to study whether brokers are meeting demand and whether the program design is producing avoidable emergency care costs.
Next steps: With the committee’s favorable report, the bill moves forward in the House. The substitute directs a study of regional contracts and provides limited exceptions to allow certain providers to fill transportation gaps while RFPs and contract rollovers are completed.
