Authorized by Title XIX of the Social Security Act, both Medicare and Medicaid were passed by both houses of Congress and signed into law by President Johnson in 1965. While Non-Emergency Medical Transportation (NEMT) benefits were not included in this initial rollout, it did not take long for necessary transportation services to be added to the program.
In 1966, the first mentions of NEMT can be found in the “Handbook of Public Assistance” and as part of the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit. This benefit mandated that states offer children from birth to age 21 and their families the necessary transportation assistance to and from healthcare providers. This narrow allotment for transportation services would stay in place for almost ten years until a landmark court case in the mid 1970’s.
The United States District Court case, Smith vs. Vowell, set the foundation for the NEMT benefits that are in place today in a ruling passed down in 1974. In this case, a Medicaid recipient testified that the state of Texas refused to provide him with transportation access, which restricted him from being able to attend rehabilitation appointments for his chronic health conditions. Without the capacity to transport himself to appointments or the means to hire livery services, he needed the state to provide access to attend necessary medical treatments. Senior District Judge Thomas Clary ruled in favor of the plaintiff, affirming that states had a responsibility to provide adequate access to transportation resources to Medicaid recipients.
Coordinated Transportation Solutions, Inc. was founded In 1997 as an efficient and effective way to manage transportation benefits and began offering NEMT services to eligible Medicaid members in Connecticut. CTS has grown to become a respected industry expert, supporting state departments of Medicaid services, managed care organizations, with customized transportation programs for vulnerable populations throughout the Northeast and Mid-Atlantic regions. By establishing a network of safe and reliable local transportation providers and integrating the latest technology, we have offered easy access to our customers and have been connecting people with care for over 24 years.
Near the end of 2020, NEMT benefits were officially mandated as essential benefits of Medicaid with the passing of The Consolidated Appropriations Act (H.R. 133). Prior to this change, NEMT benefits were subject to interpretation at the state level and were not applied uniformly across the country. This change helped to ensure that Medicaid recipients in need of transportation resources would be entitled to those services as an essential benefit under the law.
As benefit designs provided for Seniors through Medicare Advantage Plans begin to include transportation services to medical and non-medical appointments and studies begin to connect positive health outcomes with greater access to friends, family, and other non-medical destinations, we recognize that the need for cost-effective and reliable transportation will only grow in the future. As such, CTS will continue to be here to provide transportation access to all the activities needed for a rich and fulfilling life, to our partners and the members they serve.