Non-emergency medical transport, NET, providers are expressing frustration with the Alabama Medicaid Agency following the announcement of new reimbursement rates which have made it more difficult for some providers to transport Medicaid recipients.
Previously, different transporters had negotiated different rates through Medicaid, but the agency recently established a universal flat rate for all providers which went into effect last month. According to a notice the agency sent to providers in July, the new rate for transportation services within a 25-mile radius is $35 for ambulatory patients and $70 for wheelchair patients. For transportation services beyond a 25-mile radius, those rates increase by $0.70 and $1.05, respectively, per additional mile.
APR recently spoke with several transporters from around the state who say they have long experienced difficulties transporting Medicaid recipients to doctor’s appointments, dialysis treatments, or other hospital visits due to Medicaid’s low reimbursement rates and inconsistent billing process. Multiple providers, like Baldwin County Non-Emergency Medical Transport in Daphne, Alabama, informed APR that they simply do not transport Medicaid recipients whatsoever because it is “impossible” to bill through the agency.
Meanwhile, several of the transporters that do accept Medicaid told APR that the new rates set by the agency are negatively impacting their ability to continue transporting Medicaid recipients. Among those providers is Choice Transport, an NET transporter that serves the Montgomery area.
Eddie and Kara Harris, the couple who own and operate Choice Transport, met with representatives of the Alabama Medicaid Agency in August to express their concerns over the new rates and lack of consistent billing. According to the Harrises, they have experienced a dramatic decrease in compensation for their transportation of Medicaid recipients under the new rates and have lost “upward of one million dollars” since founding Choice Transport in 2009 due to Medicaid’s repeated failure to properly reimburse their services.
Despite the Harrises’ complaints, the Alabama Medicaid Agency stood by the new rates during their meeting, reportedly telling the Harrises that Choice Transport had been “grossly” overpaid prior to the institution of the new rates.
In a written statement to APR, a spokesperson for the Alabama Medicaid Agency reaffirmed the agency’s commitment to its updated NET rates and policies.
“The Alabama Medicaid Agency recently implemented updated rules and rates for all Non-Emergency Transportation (NET) transporters to strengthen accuracy and consistency with program requirements. These updates ensure that transporters are compensated fairly, while also maintaining Medicaid’s responsibility to safeguard taxpayer dollars and the integrity of the program,” the Medicaid representative told APR.
“The updated rules require verification that the transport occurred and documentation of the type of transport used, to ensure the agency pays the correct rate for the correct type of transportation. For example, wheelchair or ambulatory rate, or personal or non-personal vehicle,” they continued. “This ensures, and documents, that Medicaid is paying for the appropriate services at the appropriate rate.”
The representative also claimed that the new rates would actually mark an increase in reimbursement for most transporters, a claim that APR has been unable to verify.
“Overall, most current NET transporters will see a positive outcome with these changes due to a higher reimbursement rate for the services rendered,” the representative stated. “Additionally, we have seen increased interest from potential transporters since this change. We remain committed to increasing access to reliable transportation for Medicaid recipients while applying consistent standards across all providers.”
“While we acknowledge that changes to procedures will not always make everyone happy, we are confident these changes will result in overall improved health of the NET program and an increased reimbursement to a vast majority of NET providers,” they concluded.
For Choice Transport, the new rates have rendered them unable to continue transporting Medicaid recipients, leaving clients who had previously relied on their service without reliable transportation to their medical appointments.
Other transporters, like Mobile-based Premier Transit Inc., informed APR that they have also seen their compensation decrease as a result of the new rates, which has made it increasingly difficult to provide their services to Medicaid recipients.
Even for transporters whose rates have improved under the new policy, working with the Alabama Medicaid Agency remains a challenge.
A representative for Loving Care Group & Transportation Services, an NET provider in Birmingham, informed APR that although the new Medicaid rates mark a slight increase in their reimbursement, it still remains “way under” the payment the company receives through private insurance. Additionally, it remains difficult for transporters like Loving Care to service Medicaid recipients who may live beyond a certain proximity, as Medicaid does not cover “dead miles” –the distance traveled without a client onboard–making farther trips more costly for providers.
Unfortunately for NET providers in Alabama, it appears unlikely that the Alabama Medicaid Agency will be able to provide more adequate reimbursement rates any time soon as the Trump administration’s massive federal Medicaid spending cuts go into effect over the next decade.
