Capitol Correspondence - 07.01.19

CMS Possibly Delaying Publication of NEMT Rule

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ANCOR is sharing this article by InsideHealthPolicy because non-emergency medical transport (NEMT) is an important benefit for ensuring people with disabilities have proper access to health care. People with disabilities lag behind their peers without disabilities in terms of access to medical appointments, treatments and other health care. CMS had planned to release a proposed rule to make the benefit optional earlier this year but did not. It is important to note that while it appears publication of the rule will be delayed until 2021, the publication schedule is only tentative. As such, CMS could still publish at any time. ANCOR has been monitoring this issue as part of its work with the Consortium of Citizens with Disabilities (CCD) and will keep our members informed of opportunities for action should they arise.

As written in by InsideHealthPolicy:

“CMS appears to be postponing its plan to undo a longstanding regulation that requires state Medicaid programs to provide transportation for beneficiaries to travel to and from non-emergency medical appointments.

A proposed rule that would allow states to opt out of providing the benefit is now expected to be released in 2021, according to the agency’s regulatory agenda with the White House budget office. CMS had originally targeted the proposed rule for a release in the spring of this year, but it has garnered opposition from many stakeholders and members of Congress, including some Republicans.

Medicaid has covered non-emergency medical transportation services since the program’s inception—and in recent years, the NEMT benefit has been reshaped as ride-hailing companies like Uber and Lyft have entered the business. An estimated 10% of Medicaid beneficiaries rely on NEMT for rides to kidney dialysis appointments, substance abuse treatment programs, pharmacies and other routine care. The benefit is reserved for people who have no other access to reliable transportation.

NEMT is not a mandatory benefit under the Medicaid statute, but states are nonetheless required to cover it under a federal regulation that was originally codified in 1969.

The Trump administration supports revoking that regulation. President Trump’s budget proposals for fiscal 2019 and 2020 both called for making NEMT an optional benefit, and last fall, CMS added the idea to its regulatory agenda—a formal list of the agency’s regulatory goals published biannually by the Office of Management and Budget. The fall agenda said the agency was working on a proposed rule to roll back the requirement for states to cover NEMT, and the agenda’s timetable set the proposed rule’s release for May 2019.

The agency did not release the proposed rule last month, and its target date has now been pushed back by more than two years. On the agency’s spring regulatory agenda, the proposed rule has now been designated a “long term action” — a classification used for regulatory plans not expected to be finalized for at least a year — and the target date has been changed to December 2021.” [Emphasis in original.]