HLS 23RS-2725 ORIGINAL 2023 Regular Session HOUSE RESOLUTION NO. 272 BY REPRESENTATIVE LYONS HEALTH CARE/PROVIDERS: Requests the Louisiana Department of Health to study and promulgate additional rules for single broker NEMT services relative to compliance and oversight 1 A RESOLUTION 2To urge and request the Louisiana Department of Health to study and promulgate additional 3 rules for single broker nonemergency medical transportation services relative to 4 compliance and oversight and to report its findings on or before September 8, 2023. 5 WHEREAS, Act No. 638 of the 2022 Regular Session, herein referred to as the Act, 6defines nonemergency medical transportation (NEMT) services as transportation services 7provided to a Medicaid beneficiary to or from a medically necessary Medicaid-covered 8service; and 9 WHEREAS, the provisions of the Act require the Louisiana Medicaid program to 10include NEMT services and establish that NEMT services shall be provided to a Medicaid 11beneficiary after all other reasonable means of free transportation for that person have been 12explored and found to be unavailable; and 13 WHEREAS, the Act also prohibits NEMT services from being utilized for 14transportation to or from a pharmacy, a nursing facility, hospice care, or Special 15Supplemental Nutrition Program for Women, Infants, and Children appointments at an office 16of public health location; and 17 WHEREAS, the current contractor for nonemergency medical transportation in this 18state is Southeastrans; and 19 WHEREAS, there are five health plans that are responsible for authorizing trips and 20processing claims for the medical transportation services provided to their members, which Page 1 of 3 HLS 23RS-2725 ORIGINAL HR NO. 272 1include Aetna Better Health, Amerigroup, AmeriHealth Caritas of Louisiana, Louisiana 2Healthcare Connections, and United Healthcare Community Plan; and 3 WHEREAS, the Southeastrans organization authorizes NEMT trips for Medicaid 4recipients who are not enrolled in a health plan, including those persons who regularly 5participate in Medicaid or fee for service; and 6 WHEREAS, the Medicaid fiscal intermediary will receive and process claims 7submitted by NEMT providers for these Medicaid recipients; and 8 WHEREAS, each health plan is responsible for establishing its own trip authorization 9and claims processes and is required to share this information with providers that contracted 10in that health plan; and 11 WHEREAS, the authorization and claims processes may differ from NEMT 12processes and reimbursement policies for recipients in traditional Medicaid; and 13 WHEREAS, there is a significant amount of variables involved in the provision of 14NEMT services, and one sole provider may not be sufficient to handle all of the state's 15NEMT services; and 16 WHEREAS, it is vital for the Louisiana Department of Health to study and examine 17its existing rules for single broker nonemergency medical transportation services and 18promulgate additional rules, if deemed necessary. 19 THEREFORE, BE IT RESOLVED that the House of Representatives of the 20Legislature of Louisiana does hereby urge and request the Louisiana Department of Health 21to study and promulgate additional rules for single broker nonemergency medical 22transportation services relative to compliance and oversight and to report its findings to the 23House Committee on Health and Welfare on or before September 8, 2023. 24 BE IT FURTHER RESOLVED that the information gathered from the study shall 25be submitted in the form of a written report and address the following topics: 26 (1) The performance of a single broker system in comparison to the multiple broker 27systems. 28 (2) The amount of guaranteed trips per vehicle for registered brokers. 29 (3) The amount of dollars paid per day per vehicle registered with the company. Page 2 of 3 HLS 23RS-2725 ORIGINAL HR NO. 272 1 (4) The penalties and oversight provisions for brokers who do not comply with the 2existing NEMT regulations, if any. 3 (5) The oversight provisions for disputes between brokers and the department. 4 (6) The ability of passengers to select their own means of transportation. 5 (7) The timeliness and method of delivery for cancellation information when drivers 6are unable to accommodate passengers. 7 (8) The disciplinary provisions for drivers who are unresponsive, if any. 8 (9) The disciplinary provisions for drivers who practice nepotism, if any. 9 (10) The disciplinary provisions for the untimely submission of driver credentials, 10if any. 11 (11) The disciplinary provisions for drivers who submit paper claims, if any. 12 (12) The continued use of MediRoutes NEMT software and the provider 13malfunctions associated with such use. 14 (13) The frequency of trip cancellations due to misinformation from the MediRoutes 15NEMT software. 16 (14) The continual changes in the dates of payment for NEMT services. 17 (15) The prohibition of incentives for after-hour trips and discharges. 18 (16) The current base and per-mile rates for NEMT services. 19 BE IT FURTHER RESOLVED that a copy of this Resolution be transmitted to the 20secretary of the Louisiana Department of Health. DIGEST The digest printed below was prepared by House Legislative Services. It constitutes no part of the legislative instrument. The keyword, one-liner, abstract, and digest do not constitute part of the law or proof or indicia of legislative intent. [R.S. 1:13(B) and 24:177(E)] HR 272 Original 2023 Regular Session Lyons Requests the La. Dept. of Health to study and promulgate additional rules for single broker nonemergency medical transportation services relative to compliance and oversight. Requests that the information gathered from the study be submitted to the House Committee on Health and Welfare in the form of a written report on or before Sept. 8, 2023. Page 3 of 3