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Non-Emergency Medical Transportation Provider Requirements

MB#
21-015

The South Carolina Department of Health and Human Services (SCDHHS) is updating requirements for agencies and drivers that provide non-emergency medical transportation (NEMT) services to South Carolina Healthy Connections Medicaid members. The updated requirements listed below will go into effect on Dec. 15, 2021.

The requirements described in this bulletin will bring SCDHHS’ State Plan into compliance with new Centers for Medicare and Medicaid Services (CMS) requirements. The Consolidated Appropriations Act, 2021, Division CC, Title II, Section 209, added provisions that codify in statute longstanding regulatory requirements for states to assure necessary transportation for beneficiaries to and from covered services, and added driver and provider requirements for state Medicaid transportation programs. The requirements include:

  1. Each provider and individual driver is not excluded from participation in any federal health care program (as defined in section 1128B(f) of the Act) and is not listed on the exclusion list of the Inspector General of the U.S. Department of Health and Human Services;
  2. Each such individual driver has a valid driver’s license;
  3. Each such provider has in place a process to address any violation of a state drug law; and,
  4. Each such provider has in place a process to disclose to the state Medicaid program the driving history, including any traffic violations, of each such individual driver employed by such provider, including any traffic violations.

The updated requirements apply to existing and new NEMT providers for Healthy Connections Medicaid, including those contracted through a transportation network company (e.g. Uber, Lyft, etc.).

Providers should direct any questions related to this bulletin to the Provider Service Center at (888) 289-0709. The Provider Service Center’s hours of operations are 7:30 a.m.-5 p.m. Monday-Thursday and 8:30 a.m.-5 p.m. Friday.

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