Medical Transportation Provider Resources
Non-Emergency Medical Transportation (NEMT)
How to Become a NEMT Provider:
The transportation brokers currently oversee the credentialing and/or management of the NEMT provider network. The chart below is comprised of all Managed Care Organizations (MCOs), its contracted transportation broker, and the transportation broker’s contact information. Please utilize the contact information below to request an enrollment packet(s) to begin service as a Medicaid NEMT provider.
NEMT providers may enter into a contract agreement with one or all of the transportation brokers. LDH has not set limitations on the number of contract agreements per NEMT provider. NEMT providers may enroll with any combination of transportation brokers; however, the NEMT provider must continually meet credentialing standards while functioning as an active participant in the LDH Medicaid NEMT program.
LDH does not require that each transportation broker accept every potential NEMT provider that applies for a contract in the transportation broker’s network. There are several factors used to determine a transportation broker’s network requirements, including the overall number of NEMT providers within the network.
|
Health Plan |
Broker |
Phone Number |
Email Address |
|
Aetna Better Health of Louisiana |
MediTrans |
844.349.4326 (Option 3) |
providers@meditrans.com |
|
AmeriHealth Caritas of Louisiana |
Verida |
888.913.0364 or 855.325.7570 |
|
|
Healthy Blue |
MediTrans |
844.349.4326 (Option 3) |
providers@meditrans.com |
|
Humana Healthy Horizons |
MediTrans |
844.349.4326 (Option 3) |
providers@meditrans.com |
|
Louisiana Healthcare Connections |
MTM |
855.922.1322 |
https://veyo.com/provider-forms/ |
| United Healthcare Community Plan | ModivCare | 512.939.3841 |
Medicaid Enrollment Portal:
All NEMT providers are required to register for the Medicaid Enrollment Portal. Information regarding the Medicaid Provider Enrollment Portal is located here. Each NEMT provider should check the LDH Medicaid Provider Enrollment Portal website periodically to ensure registration by the required dates.
Fee Schedule:
NEMT providers are allowed to individually negotiate reimbursement rates. The LDH NEMT fee schedule is located here. The MCO’s transportation broker may pay more than the minimum fee schedule rates; however, it may not pay less.
Classification of NEMT Providers:
NEMT services are provided to Medicaid beneficiaries through four classifications of NEMT providers. The MCO shall consider scheduling NEMT providers in the following order:
- Public
- Gas reimbursement
- Non-profit
- For-Profit
Public providers include city and parish intrastate mass transit systems (e.g., bus, train).
Gas reimbursement (GR) providers are individuals, including friends or family members, which chose to provide transportation for a beneficiary to and/or from a Medicaid covered service. The GR provider may not reside at the same physical address as the beneficiary being transported. The GR provider may not transport more than five beneficiaries, except where there are more than five beneficiaries in the same household. A beneficiary is not eligible for NEMT services, including gas reimbursement, if a working vehicle is owned by a member of the beneficiary’s residence.
Non-profit providers include those providers who are operated by or affiliated with a public organization such as state, federal, parish or city entities, community action agencies, or parish Councils on Aging. If a provider qualifies as a non-profit entity according to Internal Revenue Service (IRS) regulations, they may only enroll as non-profit providers.
For-Profit providers include corporations, limited liability companies, partnerships, or sole proprietors. For-Profit providers must comply with all state laws and the regulations of any governing state agency, commission, or local entity to which they are subject as a condition of enrollment and continued participation in the Medicaid program.
Scheduling:
Transportation brokers shall assign NEMT services to NEMT providers based on the least costly means available, including the use of free and/or public transportation when possible, with consideration given to the beneficiary’s choice of NEMT provider. The MCO and/or transportation broker shall ensure that the NEMT provider accommodates the level of service required to transport the beneficiary safely (e.g., ambulatory, wheelchair, transfer).
Claims Submission:
NEMT providers will submit all claims and/or encounter data to the respective transportation broker while abiding by the claims adjudication process outlined in the contractual agreement between the NEMT provider and transportation broker.
Informational Bulletin (IB) 21-02:
The escalation process for the NEMT provider’s issue resolution is located within IB 21-02. Claims escalation and appeal information are found within the IB, which is located here.
Provider Notices:
Claims and Payment Issue Escalation Process
LDH American Rescue Plan Act’s (ARPA) Non-Emergency Medical Transportation (NEMT) Program:
The Centers for Medicare and Medicaid Services (CMS) approved the use of funds provided under the American Rescue Plan Act of 2021 (ARPA) for bonus payments to providers of non-emergency medical transportation (NEMT) services. NEMT providers that are fully credentialed in the Medicaid Program may be eligible to receive a bonus payment under the LDH ARPA.
NEMT providers that meet all requirements set forth by LDH are eligible for a $500 LDH ARPA NEMT Program payment for each credentialed vehicle, for up to three vehicles per month, totaling a maximum LDH ARPA NEMT Program payment of $1500 per month for each qualified NEMT provider.
LDH requires that the NEMT provider completes at least one (1) non-emergency medical round trip, consisting of a minimum of two (2) consecutive legs, per calendar day for an enrolled Medicaid beneficiary for a minimum of twenty (20) days per calendar month and is fully credentialed within the Louisiana Medicaid Program.
Beginning in 2022, LDH and representatives from each MCO, began working together to ensure a seamless implementation of the ARPA NEMT Bonus payment. NEMT providers with questions regarding ARPA program rules, ARPA policies, ARPA payments, ARPA distribution lists, etc. should contact the MCO and/or its respective broker. Using the information below for all questions and/or concerns will afford the NEMT broker accurate information directly from each MCO/broker. NEMT providers should refrain from obtaining information regarding the ARPA program from sources outside of LDH and the MCOs/brokers.
NEMT providers should reference the table below titled, “Contact Information for the ARPA NEMT Program” when and/or if the NEMT provider requires assistance with the ARPA program. NEMT providers should refrain from contacting the broker call centers or other NEMT providers for questions regarding ARPA policies, payments, and/or distribution lists.
There are several factors which may attribute to a delay in LDH assigning a NEMT provider to a MCO to begin receiving the ARPA bonus payment.
- The date in which the transportation broker completes the onboarding process for a new NEMT provider will directly impact the first month that the NEMT provider is eligible for the ARPA bonus payment. If there are less than 20 calendar days left in the month, the NEMT provider will not be eligible for the bonus payment.
- LDH composes each MCO’s ARPA distribution list using documentation submitted by the MCOs on the 15th of each month. If a provider is not active or is removed from service prior to the submission of the MCO’s report, that provider may not be eligible for payments immediately.
Contact Information for the ARPA NEMT Program:
| MCO | All ARPA Requests including: Submission of invoices and required documentation, general questions and/or concerns | Escalation Contacts for ARPA Concerns |
| Aetna Better Health of Louisiana (ABHLA) |
||
| AmeriHealth Caritas of Louisiana (ACLA) |
Kenya Foster – Kfoster@amerihealthcaritasla.com Javier Muniz – |
|
| Healthy Blue (HBL) |
arpa@meditrans.com |
director@meditrans.com and/or David Ealy Jr. (Program Manager) |
| Humana Healthy Horizons (HHH) |
Alicia Coleman (Associate Director Provider Contracting) - acoleman9@humana.com |
|
| Louisiana Healthcare Connections (LHCC) |
Candace H. Kliesch (Director, Compliance) - Candace.H.Kliesch@louisianahealthconnect.com |
|
| United Healthcare Community Plan (UHC) |
and/or |
NEMT providers should use the escalation process above for all APRA related issues. If the MCO and/or the respective broker unable to assist, the provider may contact LDH using the following contact information. Failure to use the information below when contacting LDH may cause a delay in response time.
ARPA NEMT Provider Assignments:
The NEMT provider assignment is used for the NEMT ARPA monthly bonus payments. Each month, LDH will distribute an updated list to each MCO for the following billing period. Each link below will be updated monthly. LDH advises each NEMT provider to remain with their assigned MCO throughout the duration of the ARPA program to decrease confusion.
- Aetna Better Health of Louisiana (ABHLA)
- AmeriHealth Caritas of Louisiana (ACLA)
- Healthy Blue (HBL)
- Humana Healthy Horizons (HHH)
- Louisiana Healthcare Connections (LHCC)
- United Healthcare Community Plan (UHC)
MCO ARPA Overview PowerPoint Presentation:
The PowerPoint presentation linked above represents all six (6) MCO presentations.
The required documentation for monthly ARPA submissions:
ARPA Bonus Payment Attestation
ARPA Bonus Payment Schedule
| NEMT Provider Submission Due Date(s)* | MCO Payment Schedule | ||
| Q2 – May & Jun 2024 |
May - due Jun 5 Jun - due Jul 5 |
July 31, 2024 | |
|
Jul - due Aug 5 Aug - due Sept 5 Sept - due Oct 5 |
October 31, 2024 | |
| Q4 – Oct, Nov, & Dec 2024 |
Oct - due Nov 5 Nov - due Dec 5 Dec - due Jan 5 |
January 31, 2025 | |
| Q1 – Jan, Feb, & Mar 2025 |
Jan - due Feb 5 Feb - due Mar 5 Mar - due Apr 5 |
April 30, 2025 |
*Late submission may result in loss of payment
LDH Contact Information:
ARPA Contact: MedicaidTransportation@la.gov and/or 225.219.3125
NEMT Inquiries:
Melanie Doucet
225.333.7473