SF5070

Purpose

• Strengthen oversight and reduce fraud in nonemergency medical transportation (NEMT) by adding required safety equipment, data collection, and retention rules.
• Create clearer standards for how NEMT is provided, billed, and paid, and align them with state health programs.

What the bill would require and change

• Vehicle equipment and monitoring
  • NEMT vehicles must include a global positioning system (GPS) and a rear-facing camera to capture a view of the passenger area, with recordings kept for two years.
  • The GPS and video data are intended to verify trip details (origin, destination, times) and the safety of the transport.
• Documentation and recordkeeping
  • Providers must maintain detailed transportation trip records for each ride, including recipient name, driver (or provider number), pickup and dropoff times, origin/destination, mileage, vehicle and license plate, mode of transportation, and signatures from the driver and recipient or their representative.
  • Records must show the most direct route used and mileage; signatures may be required, and if signatures aren’t obtained, the provider must note why.
  • Records must include GPS data and rear-seat video recordings for each trip.
  • Records and recordings are subject to state recovery actions if not properly kept.
  • Documentation requirements apply to audit findings dating back to January 1, 2020; the camera-retention requirement is not retroactive.
• Modes of transportation and service levels
  • The state would use a standardized “level of service” process to determine the most appropriate transportation mode for each client.
  • Available modes include:
  • Client reimbursement (clients use their own or a family member’s transportation)
  • Volunteer transport (drivers using their own vehicles)
  • Unassisted transport (taxi or public transit)
  • Assisted transport (provider assistance during the ride)
  • Lift-equipped/ramp transport (vehicles with lifts or ramps)
  • Protected transport (special vehicles with safety features, video, and a partition)
  • Stretcher transport (for clients who need to lie down or be transported in a prone/supine position)
  • If no public transit or certified provider is available, clients may receive a one-time service upgrade.
• Scope and eligibility for NEMT
  • Applies to medical assistance (state health care programs) with definitions for rural/urban/super rural areas under RUCA classifications (expires July 1, 2026 for some programs and January 1, 2027 for prepaid programs).
  • Providers must meet operating standards in sections 174.29 to 174.30 and related Minnesota rules; publicly operated transit systems and not-for-hire vehicles are exempt from certain requirements.
• Transportation safeguards and restrictions
  • For trips to primary care, the distance is limited to 30 miles; for specialty care, up to 60 miles unless the client gets local authorization to exceed.
  • The local agency is the single administrative entity for administering and reimbursing NEMT modes, once a web-based, single administrative structure is in place.
• Reimbursement and rates
  • Payments are based on the client’s assessed mode, not the vehicle type.
  • Rates include base amounts and per-mile charges, with different structures for each mode (e.g., client reimbursement, volunteer, unassisted, assisted, liftequipped, protected, and stretcher transport). There are regional adjustments for RUCA areas (super rural and rural) and planned adjustments for inflation/fuel costs.
  • A fuel adjustment could be added for NEMT rates when fuel costs exceed a specified threshold; if federal approval for this provision isn’t obtained, capitation rates to managed care plans and similar entities may be adjusted accordingly. Any adjustments must be recoverable only to the extent they reflect the rate increase.
• Managed care and purchasing plans
  • The bill extends NEMT provisions to managed care plans and county-based purchasing plans.
  • It requires fuel-related rate adjustments and potential rate adjustments if federal approval is not granted; contracts must allow for recovery of payments if capitation rates are adjusted.

Implementation timeline and scope

• Central administration: Move toward a single, web-based administrative structure to manage NEMT modes, eligibility, and payments.
• Effective dates and expirations: Several provisions have specified expirations (e.g., July 1, 2026 or January 1, 2027) tied to medical assistance fee-for-service and prepaid programs, indicating a staged implementation and sunset on some rules unless renewed.

Impact on participants

• For beneficiaries: Enhanced verification and safety measures, more standardized ride options, potential limits on trip distance, and new documentation requirements. Some privacy considerations arise from video recordings.
• For providers: New equipment requirements (GPS, rear-facing camera), stricter documentation and signature requirements, and a more complex reimbursement structure with multiple modes and rates.
• For programs: A shift toward centralized administration of NEMT and tighter oversight to reduce fraud and improve accountability.

Notable changes to existing law

• Introduces mandatory GPS tracking and rear-facing cameras in NEMT vehicles.
• Requires comprehensive trip documentation and two-year retention of recordings.
• Establishes a single administrative structure for NEMT and specifies defined transport modes with corresponding reimbursement rates.
• Expands NEMT requirements to managed care and county-based purchasing plans, including a fuel-adjustment mechanism subject to federal approvals.
• Creates stricter rules around route distance, safety features for protected transport, and documentation retroactively applicable to audits (with some exceptions).

Potential considerations

• Privacy and data security: Handling GPS data and passenger video requires careful privacy protections and data management.
• Cost and compliance burden: Vehicle equipment, data systems, and detailed recordkeeping may increase costs for providers.
• Equity and access: Distance caps and mode options will shape how easily clients can access care, especially in rural areas.

Relevant Terms - nonemergency medical transportation (NEMT) - GPS (global positioning system) - rear-facing camera - transportation trip records - protected transport - lift-equipped/ramp transport - stretcher transport - wheelchair securement devices - RUCA (rural-urban commuting area) - medical assistance (state health care programs) - managed care plans - county-based purchasing plans - web-based single administrative structure - fuel adjustment - base rate and per-mile rate - signatures and documentation - audit findings and recovery - most direct route - service upgrade - license plate and vehicle identity - origin and destination - odometer readings - provider enrollment and background checks - retention of recordings (two years)