MEDICAID: Requires the Louisiana Department of Health to increase the reimbursement rates for nonemergency medical transportation providers (EN +$2,601,174 GF EX See Note)
Summary
HB 1028 requires the Louisiana Department of Health to adopt rules establishing a new Medicaid reimbursement methodology for nonemergency medical transportation (NEMT) providers. The bill sets a minimum payment of $14.50 per trip and $2.10 per mile for NEMT services, including wheelchair-accessible transportation, and directs the department to create a separate methodology for multiple-passenger trips based on the number of riders being transported.
The bill also limits Medicaid transportation to services within a recipient’s parish of residence or contiguous parishes unless the Medicaid managed care organization or the department determines that travel farther away is medically necessary. In addition, the department must take the steps needed to implement the law, including filing a Medicaid state plan amendment, within 90 days after the act becomes effective. The act does not take effect until a separate appropriation is enacted to fund implementation.
Impact
HB 1028 amends Louisiana law governing nonemergency medical transportation under Medicaid by creating statutory reimbursement floors and directing the Louisiana Department of Health to formalize a rate methodology. It affects NEMT providers, including wheelchair-accessible transportation providers, and may influence how Medicaid managed care organizations authorize and pay for rides to covered services. The bill also imposes a geographic restriction on transportation outside a recipient’s parish or contiguous parishes unless medical necessity is shown, which could affect beneficiary access to distant providers and the scope of reimbursable trips.
Sentiment
The bill appears to have received broad legislative support, passing the House 75-16 and the Senate 30-2. The final votes suggest general agreement that NEMT reimbursement rates needed to be increased and standardized, likely reflecting concern about provider costs and service availability. The fact that it became law without the governor’s signature also indicates it ultimately advanced without a major public veto fight.
Contention
The main points of contention likely centered on the cost of the reimbursement increase and the access limits tied to parish-based travel. Supporters would view the higher minimum trip and mileage rates as necessary to sustain NEMT providers and preserve transportation access for Medicaid recipients, while critics may have been concerned about the estimated fiscal impact, noted in the caption as additional general fund expenditures, and about whether the new geographic restriction could make it harder for some beneficiaries to reach needed care outside their local area. The multiple-passenger methodology and medical-necessity exception suggest the bill tried to balance provider payment concerns with program controls and utilization management.
Requests the La. Dept. of Health modify regulations related to the nonemergency, non-ambulance medical transportation component of the Medicaid manged care program
Modifies the Louisiana Doula Registry Board within the Louisiana Department of Health and provides for respective regulatory authority (EN +$2,495 FF EX See Note)