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