{"id":358955,"date":"2026-09-28T17:02:09","date_gmt":"2026-09-28T17:02:09","guid":{"rendered":"https:\/\/www.newsbeep.com\/us-ny\/358955\/"},"modified":"2026-09-28T17:02:09","modified_gmt":"2026-09-28T17:02:09","slug":"op-ed-leveraging-technology-to-reduce-non-emergency-medical-transportation-fraud","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/us-ny\/358955\/","title":{"rendered":"Op-ed | Leveraging technology to reduce non-emergency medical transportation fraud"},"content":{"rendered":"

Hundreds of thousands of New Yorkers with medical needs, such as dialysis patients, wheelchair users, and post-surgical patients, use non-emergency medical transportation (NEMT) services<\/a> to get to their medical appointments. NEMT is part of our health care system and is administered through Medicaid to ensure enrollees of that program have access to routine and life-sustaining care.\u00a0<\/p>\n

New York City\u2019s 3.6 million Medicaid enrollees \u2013 nearly the population of Los Angeles \u2013 are eligible for transportation to routine Medicaid-eligible medical services if they have transportation needs. The transportation is provided by small businesses that serve members of their own community, mostly in sedans, as well as vans for people who use wheelchairs and ambulettes who require that service.\u00a0<\/p>\n

Nationally, Medicaid provides over 100 million NEMT trips annually, at a cost of approximately $3 billion annually. Amazingly, the program nets Medicaid $4 billion in savings. That is because people who are undergoing chemotherapy or dialysis treatment could get severely sick, or worse, if they miss an appointment.<\/p>\n

NEMT is only 1% of the Medicaid budget, and the academic research indicates that expanding the program further could produce even more significant savings, because access to reliable transportation is one of the more significant barriers to obtaining care. \u00a0<\/p>\n

Recent policy shifts in Washington, DC, such as the federal One Big Beautiful Bill Act<\/a>, set a target of over $900 billion in Medicaid savings over the coming ten years. As pandemic-era federal funding expires, state governments face severe budget gaps. <\/p>\n

Given the facts cited above, one response would be for the federal government to promote the expansion of NEMT, by reducing bureaucracy and unnecessary regulations.\u00a0<\/p>\n

Instead, given the increased scrutiny from some publicized day care fraud cases, the focus has shifted to identifying and stopping fraud, waste, and abuse in Medicaid generally \u2013 and NEMT is a top target.<\/p>\n

\"\"Matthew Daus<\/p>\n

Joint teams of federal and state auditors, investigators and prosecutors are turning to advanced data analytics, cross-agency data matching, and algorithmic billing reviews to find discrepancies. The U.S. Department of Health and Human Services (HHS) is pushing for stricter enforcement from state Attorneys General. The U.S. Department of Justice has reported to have uncovered NEMT fraud schemes in New Mexico, Ohio and upstate New York. Congress is now conducting separate investigations as part of its legislative oversight. <\/p>\n

State Attorney General Letitia James has charged New York City NEMT providers with fraud<\/a>, including one driver who allegedly charged Medicaid for over 2,100 miles of driving in a single day.<\/p>\n

To be clear, the overwhelming majority of NEMT businesses and drivers are following the rules, and it is certainly a benefit to everyone if the fraudsters and scammers are excluded from the industry. However, NEMT businesses face unprecedented compliance risk. A routine paperwork error, or false flags raised by algorithms, can cause an investigation. The legal fees, reputational damage, and business consequences of an audit or investigation of this nature could prove ruinous.\u00a0\u00a0<\/p>\n

The federal government could take a different approach to eliminate fraud, waste, and abuse. HHS could mandate \u2013 and even fund \u2013 technology upgrades for NEMT driver vehicles and dispatching programs that simultaneously assist in providing clear billing records and reduce paperwork burdens on providers.\u00a0 <\/p>\n

The federal government could also require states to adopt New York State\u2019s approach and hire a single, accountable private entity to manage the administration of the NEMT program. New York\u2019s broker, Medical Answering Service (MAS), manages the program. Importantly, as part of its contract with the State, MAS has a \u201crisk-sharing\u201d profit incentive, which gives MAS a portion of savings that the company returns to the State by efficiently running the program.\u00a0<\/p>\n

Additionally, the federal and state government could eliminate enormous waste by addressing NEMT companies\u2019 eye-wateringly expensive insurance costs. NEMT passengers, generally speaking, are especially vulnerable to injury in crashes \u2013 a fender bender that causes a young and healthy person a stiff neck could result in serious injuries for an older or more vulnerable person. Even though NEMT drivers are regulated in NYC and are generally very safe, when crashes occur, they can be very expensive. Nationally, the rate of jury verdicts in transportation personal injury cases in excess of $10 million \u2013 often called \u201cnuclear verdicts\u201d \u2013 have more than doubled in recent years. This legal environment has pushed standard commercial auto insurers out of the NEMT market, driving providers into specialized insurance markets with premiums 60% to 70% higher than regular commercial fleets.\u00a0<\/p>\n

The federal and state governments can reduce NEMT insurance costs, and protect enrollees by incentivizing concrete safety upgrades. The state could require insurers to provide \u201csafe driving discounts\u201d to NEMT companies that use driver monitoring technologies like telematics and smart dashcams to monitor driver behavior in real time and record footage that protects against false injury claims, or utilize active intelligent speed assistance devices, which prevent drivers from unsafely exceeding the speed limit. The federal government could offer NEMT providers bonuses for adopting this technology.\u00a0<\/p>\n

The NEMT program is a lifeline for New Yorkers. Federal and state regulators are correct to pursue fraudulent NEMT providers ripping off the taxpayer.\u00a0 This is always unacceptable. <\/p>\n

But because NEMT reduces barriers to accessing medical care and saves Medicaid money, regulators should look beyond simply cracking down on fraud and adopt reforms that enable the program to be expanded by introducing programmatic efficiencies and reducing NEMT providers\u2019 costs.\u00a0<\/p>\n

Matthew Daus\u00a0is the transportation technology chair for the University Transportation Research Center, Region 2 (NY\/NJ) at the City University of New York<\/p>\n","protected":false},"excerpt":{"rendered":"Hundreds of thousands of New Yorkers with medical needs, such as dialysis patients, wheelchair users, and post-surgical patients,…\n","protected":false},"author":2,"featured_media":358956,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[6],"tags":[48730,107007,75696,7050,46833,133596,133597,133598,133599,133600,9,133601,11,10,133602,32799,133603],"class_list":["post-358955","post","type-post","status-publish","format-standard","has-post-thumbnail","category-new-york","tag-health-care-access","tag-health-care-policy","tag-insurance-costs","tag-medicaid","tag-medicaid-fraud","tag-medicaid-reform","tag-medical-answering-service","tag-medical-transportation","tag-medical-transportation-providers","tag-nemt","tag-new-york","tag-new-york-city-medicaid","tag-new-york-headlines","tag-new-york-news","tag-non-emergency-medical-transportation","tag-transportation-policy","tag-transportation-technology"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/us-ny\/wp-json\/wp\/v2\/posts\/358955","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/us-ny\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/us-ny\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ny\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ny\/wp-json\/wp\/v2\/comments?post=358955"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/us-ny\/wp-json\/wp\/v2\/posts\/358955\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ny\/wp-json\/wp\/v2\/media\/358956"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/us-ny\/wp-json\/wp\/v2\/media?parent=358955"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ny\/wp-json\/wp\/v2\/categories?post=358955"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ny\/wp-json\/wp\/v2\/tags?post=358955"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}