WASHINGTON, D.C. – Reps. Earl L. “Buddy” Carter (R-GA), Tony Cárdenas (D-CA) and Sanford D. Bishop, Jr. (D-GA) today introduced The Access to Critical Non-Emergency Transportation Services Act, which expands access to non-emergency medical transportation (NEMT) for vulnerable dual-eligible Medicare and Medicaid patients.
Currently, Medicare beneficiaries must obtain prior authorization before accessing ambulance rides to dialysis or diabetes wound care services, threatening patients’ access to regularly scheduled health care services critical to their health. This bill will require the Secretary of Health and Human Services to coordinate with states to ensure low-income Medicare patients dually enrolled in Medicaid and Medicare who are denied ambulance NEMT are able to access Medicaid NEMT with appropriate modes of transportation. It would also make sure Medicare beneficiaries that qualify as partial dual-eligible beneficiaries are given assistance to enroll in Medicaid and have access to Medicaid transportation benefits.
“This is a common-sense move that will increase patients’ access to health care, particularly for elderly, low-income, and diabetic patients,” said Congressman Carter. “This bipartisan bill will ease the burden of transportation for the most vulnerable Americans nationwide. I thank my Democrat colleagues for supporting this legislation. Unnecessary bureaucracy should never be a barrier to high-quality medical care.”
"No one on Medicare and Medicaid should be forced to wait just to access lifesaving healthcare," said Congressman Cárdenas. "Our bill will help vulnerable individuals who need recurring care like dialysis or wound treatment by making non-emergency medical transportation services more widely available to those who need it most. Part of our job as Members of Congress is to ensure that no one is harmed by unintended negative consequences from legislation, and that's what we've done with the Access to Critical Non-Emergency Transportation Services Act."
“Providing access to nonemergency medical transportation for dual eligible individuals will make a significant difference in improving health outcomes and reducing avoidable hospitalizations. These benefits will be especially welcome for those with end-stage renal disease that struggle now to get transportation to life-saving dialysis treatment,” said Congressman Bishop.
Read more in Medpage Today.
Read the full bill text here.
BACKGROUND: This bill adjusts the Repetitive, Scheduled, Non-Emergent Ambulance Transport (RSNAT) model originally developed by the CMS Centers for Program Integrity and for Medicare and Medicaid Innovation and expanded nationally as part of the Medicare Access and CHIP Reauthorization Act. The RSNAT model is an important program integrity initiative that uses prior authorization to ensure appropriate use of ambulance services in Medicare. However, the evaluation of the RSNAT model expansion showed that nearly half of the beneficiaries who lose their ambulance service are disproportionately low-income, frail, disabled, and elderly. The overwhelming majority are accessing kidney dialysis or diabetes-related wound care.
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