NEMT Requirements: Understanding Insurance and Compliance

Non-emergency medical transportation (NEMT) is a vital service, helping to ensure individuals with medical conditions or disabilities have access to proper healthcare. Along with bridging the gap between patients and their need for safe transportation to and from appointments or procedures comes the immense responsibility of keeping vulnerable patients safe while in your care.

We’ll discuss NEMT requirements for someone starting their own NEMT business, including what they have to take care of for vehicles, equipment, and drivers, the types of insurance involved in running an NEMT operation, and the importance of providing travelers with a safe, comfortable experience.

Business Requirements

Just like forming any business, your NEMT business will require you to register to obtain a business license to operate in your state. There are both federal and state-by-state specifics for NEMT businesses, but the general process of applying for your NEMT license is the same as for other companies.

You will want to get a National Provider Identifier (NPI), which will help you contract with NEMT brokers. You will also have to get a Federal Tax Identification Number (FTIN) assigned for your business to provide necessary documentation and file taxes.

Be sure to check your state’s specific requirements for regulatory compliance. Some states may require you to get your NEMT license through the board of transportation for emergency or medical services, others require a specific NEMT permit that allows you to advertise your services, and states may have different requirements for vehicle inspections.

Always consult your local regulations for guidance.

Driver Requirements

It is crucial to hire trustworthy drivers who have the necessary credentials. This includes strict transportation guidelines set by Medicaid. Specific requirements vary from state to state but include details like:

Having a valid driver’s license with an acceptable number of points
Providing a certification of health
Passing a criminal background check
Following through with random drug screens
Having documented experience in assisting elders and individuals with disabilities

NEMT Vehicle Requirements

Operating your NEMT business in the United States involves navigating federal oversight from the Department of Transportation (DOT) and state-specific requirements. Because your NEMT business is designed around the needs of people relying on a third party for transportation, many of the requirements for the vehicles in your fleet center around the Americans with Disabilities Act (ADA).

The ADA is a federal law designed to protect the rights of people with disabilities, protecting these individuals from discrimination and providing them equal access and opportunities. In this case, access and opportunities involve the mobility services you provide so patients aren’t cut off from the healthcare they are entitled to.

Your NEMT business must accommodate individuals with disabilities without discrimination. This includes the following.

Vehicle accessibility

If you plan to provide transportation for non-ambulatory passengers (those who cannot walk), you must obtain a wheelchair-accessible vehicle. Your vehicles must be fitted with features like a wheelchair ramp or lift, a securement system, and proper room for mobility devices.

Accessible vehicles are available for purchase through companies like Braun Ability and Model 1. Used vans are also available. Check out local NEMT Facebook groups to see who is selling vans near you. When buying used, always have an experienced mechanic ensure the vehicles is in good working order.

Modifications

Accommodating the unique medical needs of your passengers includes adjusting to the required policies and procedures. This includes providing space and the safe transport of service animals, along with making modifications for communication accessibility.

A service dog next to a person in a wheelchair

For individuals with hearing or speech impairment, you may consider outfitting vehicles with text-based telecommunications equipment called a teletype and telecommunications device for those who are deaf or hard of hearing (TTY/TDD). This allows you to communicate with passengers with hearing or speech difficulties, including scheduling their transportation services.

Additionally, you will include clear, posted messages that assist passengers with instructions or details they may need to know.

Insurance Requirements

Choosing the right insurance policies with a trusted insurance provider is an important decision for your business’s well-being. You are trusted to protect the safety of elders, people with disabilities, and individuals with chronic medical conditions who will be relying on your attentive, responsible transportation. They will be wholly dependent on your vigilance in practicing safe and responsible processes.

NEMT insurance is not optional: It is mandatory for all vehicles and drivers, to safeguard your business against liability claims and accidents.

The following are the main types of NEMT insurance to be aware of:

General liability: This covers bodily injuries, property damage, and personal injury claims
Auto liability: This insurance is a subset of general liability that covers NEMT vehicle accidents, bodily injury, and property damage
Professional liability: This is malpractice insurance covering an NEMT service provider against claims of driver and staff negligence, errors, or omissions in the process of transportation
Commercial auto: This type of insurance is required for NEMT vehicles to cover liability for accidents, physical damage, medical payments, and uninsured or underinsured motorists
Workers’ compensation: This insurance protects the NEMT provider with coverage for medical expenses and lost wages for employees injured on the job
Hired and non-owned auto: This is for NEMT providers relying on contractors or employees; it covers liability for accidents

Always consult a professional insurance provider about what type of policies you need to consider and any specific features that are offered. NEMT insurance costs can vary greatly based on the model vehicles you purchase, the number of vehicles in your fleet, details about the drivers you hire, and numerous other details.

Once you are covered, remember to always maintain current, accurate records of your policies, policy numbers, types of coverage, and expirations.

If you are looking for an insurance agency that specializes in NEMT, consider S.W.A.N. Insurance.

Complying with HIPAA Guidelines

The Health Insurance Portability and Accountability Act (HIPAA) is a federal law designed to protect sensitive patient medical information. HIPAA was enacted to regulate how data is used and disclosed by healthcare providers, insurance companies, and related third-party businesses.

It’s critical to understand and comply with strict HIPAA rules. Since you will be handling patient paperwork and discussing patient details with healthcare facilities, you’ll want to ensure your drivers follow HIPAA as strictly as possible. Failure to do so can lead to severe and costly legal penalties and a loss of public trust.

Providing a Better NEMT Experience with the Traversa

As you finalize your NEMT business, consider the Traversa Transport Wheelchair for unmatched safety, comfort, and efficiency. Specifically designed for NEMT vehicles, the Traversa offers superior patient care with easy maneuverability. Choose the Traversa to elevate your service and exceed industry standards.

Once you’ve followed these steps to begin your NEMT business, you’ll want to carefully consider every investment you make, from the type of vehicles you choose to the drivers you hire. One way to stand apart from competitors in the field is to offer a level of comfort patients won’t find elsewhere. This is where Broda’s Traversa Transport Wheelchair comes in.

GIF of the Traversa Transport Wheelchair by Broda

The Traversa Transport Wheelchair (patent pending) is specifically designed to provide a better NEMT transportation experience. It is designed for comfort and, simultaneously, for the highest standards of WC19-compliant safety.

It is the first wheelchair solution solely designed for NEMT vehicles: an entirely new piece of equipment that combines the practicality of a stretcher with the comfort, convenience, and dignity of a Broda wheelchair.

Your Traversa Transport Wheelchair provides the following benefits:

An intuitive stretcher alternative
No manual lifting
Faster turnaround for higher-volume transports
Easily maneuvered in tight spaces
More comfortable ride
Adjustable from upright to reclined
Less wait time on ambulance transport
Fits passengers up to 450 lbs
Adjustable height using foot pump
Pivot Assist™ System swivels the wheelchair sideways and 360 degrees

Financing is Available!

Broda offers flexible financing and leasing options, which are especially helpful for newer NEMT businesses. If you have a business line of credit and a positive credit history, financing is an excellent way to start earning revenue now with the Traversa!