The Maryland Department of Health (MDH) released a request for proposals (RFP) this month for a non-emergency medical transportation (NEMT) contractor for the state’s Medicaid population. MDH intends to award a single contract award for a maximum period of 7 years.
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The contract will fulfill requirements under the Code of Federal Regulations, which mandates that states provide NEMT to Medicaid-covered services as a last resort when the participant has no other means of transport.
“The contractor is to assure access to transportation for eligible and qualified participants to and from non-emergency Medicaid covered services rendered by Medicaid providers in the most cost effective and efficient clinically appropriate transportation mode,” the RFP said.
For the past 2 decades, Maryland has administered NEMT through the local health departments in each of its 23 counties (with the addition of Baltimore City), totaling 24 jurisdictions. MDH pays for NEMT services through pass-through grants. Federal funding also supports the NEMT program, with a 50% match of state funds.
The RFP lists the progression of transportation types the program would use, based on patients’ clinical needs. These include a shared ride ambulatory vehicle, shared ADA-accessible vehicle, ambulance, interfacility transfer for tertiary care, and air ambulance service transport.
Over 946,000 NEMT trips occurred in fiscal year 2019, according to the RFP. MDH typically spends $50 million annually on the NEMT program. The COVID-19 pandemic significantly impacted operation numbers (there were about 814,000 trips in FY 2020 and only 104,000 trips in FY 2021, mostly due to the increased use of telemedicine). However, the RFP notes that restrictions on in-person medical appointments have been lifted since July 1st, 2021.
“Accordingly, for FY 2022 and beyond, it is expected that transports will return to the pre-FY20 levels,” the RFP said.
The awarded contractor will work with MDH’s Medicaid Modular Transformation (MMT) Project to design and develop the procedures and information technology needed to provide NEMT services. During the first phase of the operations and maintenance (OM) stage, which is estimated to last a maximum of 18 months from the contract start date, the contractor must inaugurate NEMT services in at least 9 of the 24 jurisdictions. During the second phase, covering the 6 months following the completion of the first phase, the contractor must onboard the remaining jurisdictions.
The NEMT contract is also part of the Maryland Medicaid Enterprise Systems Modular Transformation (MMT) Program Management Office (PMO), which works to redesign and modernize Maryland’s Medicaid Management Information system (MMIS). MMT PMO is a multi-year project expected to be fully implemented in 2029.
“To successfully administer the NEMT … the Contractor must seamlessly integrate with the legacy MMIS,” the RFP said. “To ensure that NEMT aspects are properly accounted for in MMT, the Contractor must have continual representation on MMT workgroups, steering committees, etc. And as the MMIS transitions under MMT, the Contractor must, in lockstep, transition its interfaces and connectivity.”
A pre-proposal conference is scheduled for Sept. 15th at 1 p. Eastern Time. Participants must register via Attachment A of the RFP. Questions about the RFP may be sent through the Non-Emergency Medical Transportation RFP Inquiry Form.
Proposals are due on Nov. 1st at 4 pm Eastern Time via the eMaryland Marketplace Advantage (eMMA). The contract is expected to begin on Feb. 1st, 2023.