HF 4684

Introduction - 94th Legislature (2025 - 2026)

Posted on 03/26/2026 05:28 p.m.

A bill for an act
relating to fraud; requiring nonemergency medical transportation providers to
operate vehicles equipped with a global positioning system and rear-facing camera,
compile certain information for each trip, and retain recordings for two years;
amending Minnesota Statutes 2024, section 256B.0625, subdivisions 17b, 18h;
Minnesota Statutes 2025 Supplement, sections 174.30, subdivision 3; 256B.0625,
subdivision 17.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

Minnesota Statutes 2025 Supplement, section 174.30, subdivision 3, is amended
to read:

Subd. 3.

Other standards; wheelchair securement; protected transport.

(a) A special
transportation service that transports individuals occupying wheelchairs is subject to the
provisions of sections 299A.11 to 299A.17 concerning wheelchair securement devices. The
commissioners of transportation and public safety shall cooperate in the enforcement of
this section and sections 299A.11 to 299A.17 so that a single inspection is sufficient to
ascertain compliance with sections 299A.11 to 299A.17 and with the standards adopted
under this section. Representatives of the Department of Transportation may inspect
wheelchair securement devices in vehicles operated by special transportation service
providers to determine compliance with sections 299A.11 to 299A.17 and to issue certificates
under section 299A.14, subdivision 4.

(b) In place of a certificate issued under section 299A.14, the commissioner may issue
a decal under subdivision 4 for a vehicle equipped with a wheelchair securement device if
the device complies with sections 299A.11 to 299A.17 and the decal displays the information
in section 299A.14, subdivision 4.

(c) For vehicles designated as protected transport under section 256B.0625, subdivision
17, paragraph deleted text begin (n) deleted text end new text begin (o) new text end , the commissioner of transportation, during the commissioner's
inspection, shall check to ensure the safety provisions contained in that paragraph are in
working order.

Sec. 2.

Minnesota Statutes 2025 Supplement, section 256B.0625, subdivision 17, is
amended to read:

Subd. 17.

Transportation costs.

(a) "Nonemergency medical transportation service"
means motor vehicle transportation provided by a public or private person that serves
Minnesota health care program beneficiaries who do not require emergency ambulance
service, as defined in section 144E.001, subdivision 3, to obtain covered medical services.

(b) For purposes of this subdivision, "rural urban commuting area" or "RUCA" means
a census-tract based classification system under which a geographical area is determined
to be urban, rural, or super rural. This paragraph expires July 1, 2026, for medical assistance
fee-for-service and January 1, 2027, for prepaid medical assistance.

(c) Medical assistance covers medical transportation costs incurred solely for obtaining
emergency medical care or transportation costs incurred by eligible persons in obtaining
emergency or nonemergency medical care when paid directly to an ambulance company,
nonemergency medical transportation company, or other recognized providers of
transportation services. Medical transportation must be provided by:

(1) nonemergency medical transportation providers who meet the requirements of this
subdivision;

(2) ambulances, as defined in section 144E.001, subdivision 2;

(3) taxicabs that meet the requirements of this subdivision;

(4) public transportation, within the meaning of "public transportation" as defined in
section 174.22, subdivision 7; or

(5) not-for-hire vehicles, including volunteer drivers, as defined in section 65B.472,
subdivision 1, paragraph (p).

(d) Medical assistance covers nonemergency medical transportation provided by
nonemergency medical transportation providers enrolled in the Minnesota health care
programs. All nonemergency medical transportation providers must comply with the
operating standards for special transportation service as defined in sections 174.29 to 174.30
and Minnesota Rules, chapter 8840, and all drivers must be individually enrolled with the
commissioner and reported on the claim as the individual who provided the service. All
nonemergency medical transportation providers shall bill for nonemergency medical
transportation services in accordance with Minnesota health care programs criteria. Publicly
operated transit systems, volunteers, and not-for-hire vehicles are exempt from the
requirements outlined in this paragraph.

(e) An organization may be terminated, denied, or suspended from enrollment if:

(1) the provider has not initiated background studies on the individuals specified in
section 174.30, subdivision 10, paragraph (a), clauses (1) to (3); or

(2) the provider has initiated background studies on the individuals specified in section
174.30, subdivision 10, paragraph (a), clauses (1) to (3), and:

(i) the commissioner has sent the provider a notice that the individual has been
disqualified under section 245C.14; and

(ii) the individual has not received a disqualification set-aside specific to the special
transportation services provider under sections 245C.22 and 245C.23.

(f) The administrative agency of nonemergency medical transportation must:

(1) adhere to the policies defined by the commissioner;

(2) pay nonemergency medical transportation providers for services provided to
Minnesota health care programs beneficiaries to obtain covered medical services;

(3) provide data monthly to the commissioner on appeals, complaints, no-shows, canceled
trips, and number of trips by mode; and

(4) by July 1, 2016, in accordance with subdivision 18e, utilize a web-based single
administrative structure assessment tool that meets the technical requirements established
by the commissioner, reconciles trip information with claims being submitted by providers,
and ensures prompt payment for nonemergency medical transportation services. This
paragraph expires July 1, 2026, for medical assistance fee-for-service and January 1, 2027,
for prepaid medical assistance.

(g) Effective July 1, 2026, for medical fee-for-service and January 1, 2027, for prepaid
medical assistance, the administrative agency of nonemergency medical transportation must:

(1) adhere to the policies defined by the commissioner;

(2) pay nonemergency medical transportation providers for services provided to
Minnesota health care program beneficiaries to obtain covered medical services; and

(3) provide data monthly to the commissioner on appeals, complaints, no-shows, canceled
trips, and number of trips by mode.

(h) Until the commissioner implements the single administrative structure and delivery
system under subdivision 18e, clients shall obtain their level-of-service certificate from the
commissioner or an entity approved by the commissioner that does not dispatch rides for
clients using modes of transportation under paragraph deleted text begin (n) deleted text end new text begin (o) new text end , clauses (4), (5), (6), and (7).
This paragraph expires July 1, 2026, for medical assistance fee-for-service and January 1,
2027, for prepaid medical assistance.

(i) The commissioner may use an order by the recipient's attending physician, advanced
practice registered nurse, physician assistant, or a medical or mental health professional to
certify that the recipient requires nonemergency medical transportation services.
Nonemergency medical transportation providers shall perform driver-assisted services for
eligible individuals, when appropriate. Driver-assisted service includes passenger pickup
at and return to the individual's residence or place of business, assistance with admittance
of the individual to the medical facility, and assistance in passenger securement or in securing
of wheelchairs, child seats, or stretchers in the vehicle.

(j) Nonemergency medical transportation providers must take clients to the health care
provider using the most direct route, and must not exceed 30 miles for a trip to a primary
care provider or 60 miles for a trip to a specialty care provider, unless the client receives
authorization from the local agency. This paragraph expires July 1, 2026, for medical
assistance fee-for-service and January 1, 2027, for prepaid medical assistance.

(k) Effective July 1, 2026, for medical assistance fee-for-service and January 1, 2027,
for prepaid medical assistance, nonemergency medical transportation providers must take
clients to the health care provider using the most direct route and must not exceed 30 miles
for a trip to a primary care provider or 60 miles for a trip to a specialty care provider, unless
the client receives authorization from the administrator.

(l) Nonemergency medical transportation providers may not bill for separate base rates
for the continuation of a trip beyond the original destination. Nonemergency medical
transportation providers must maintain trip logs, which include pickup and drop-off times,
signed by the medical provider or client, whichever is deemed most appropriate, attesting
to mileage traveled to obtain covered medical services. Clients requesting client mileage
reimbursement must sign the trip log attesting mileage traveled to obtain covered medical
services.

new text begin (m) A vehicle operated by a nonemergency medical transportation provider must be
equipped with a global positioning system capable of tracking the route taken by the vehicle
and a rear-facing camera capable of recording a sufficient area of the passenger compartment
to identify the recipient of the service and the date and time when the recording was made.
new text end

deleted text begin (m) deleted text end new text begin (n) new text end The administrative agency shall use the level of service process established by
the commissioner to determine the client's most appropriate mode of transportation. If public
transit or a certified transportation provider is not available to provide the appropriate service
mode for the client, the client may receive a onetime service upgrade.

deleted text begin (n) deleted text end new text begin (o) new text end The covered modes of transportation are:

(1) client reimbursement, which includes client mileage reimbursement provided to
clients who have their own transportation, or to family or an acquaintance who provides
transportation to the client;

(2) volunteer transport, which includes transportation by volunteers using their own
vehicle;

(3) unassisted transport, which includes transportation provided to a client by a taxicab
or public transit. If a taxicab or public transit is not available, the client can receive
transportation from another nonemergency medical transportation provider;

(4) assisted transport, which includes transport provided to clients who require assistance
by a nonemergency medical transportation provider;

(5) lift-equipped/ramp transport, which includes transport provided to a client who is
dependent on a device and requires a nonemergency medical transportation provider with
a vehicle containing a lift or ramp;

(6) protected transport, which includes transport provided to a client who has received
a prescreening that has deemed other forms of transportation inappropriate and who requires
a provider: (i) with a protected vehicle that is not an ambulance or police car and has safety
locks, a video recorder, and a transparent thermoplastic partition between the passenger and
the vehicle driver; and (ii) who is certified as a protected transport provider; and

(7) stretcher transport, which includes transport for a client in a prone or supine position
and requires a nonemergency medical transportation provider with a vehicle that can transport
a client in a prone or supine position.

deleted text begin (o) deleted text end new text begin (p) new text end The local agency shall be the single administrative agency and shall administer
and reimburse for modes defined in paragraph deleted text begin (n) deleted text end new text begin (o) new text end according to paragraphs deleted text begin (r) deleted text end new text begin (s) new text end to deleted text begin (t) deleted text end new text begin
(u) new text end when the commissioner has developed, made available, and funded the web-based single
administrative structure, assessment tool, and level of need assessment under subdivision
18e. The local agency's financial obligation is limited to funds provided by the state or
federal government. This paragraph expires July 1, 2026, for medical assistance
fee-for-service and January 1, 2027, for prepaid medical assistance.

deleted text begin (p) deleted text end new text begin (q) new text end The commissioner shall:

(1) verify that the mode and use of nonemergency medical transportation is appropriate;

(2) verify that the client is going to an approved medical appointment; and

(3) investigate all complaints and appeals.

deleted text begin (q) deleted text end new text begin (r) new text end The administrative agency shall pay for the services provided in this subdivision
and seek reimbursement from the commissioner, if appropriate. As vendors of medical care,
local agencies are subject to the provisions in section 256B.041, the sanctions and monetary
recovery actions in section 256B.064, and Minnesota Rules, parts 9505.2160 to 9505.2245.
This paragraph expires July 1, 2026, for medical assistance fee-for-service and January 1,
2027, for prepaid medical assistance.

deleted text begin (r) deleted text end new text begin (s) new text end Payments for nonemergency medical transportation must be paid based on the
client's assessed mode under paragraph deleted text begin (m) deleted text end new text begin (n) new text end , not the type of vehicle used to provide the
service. The medical assistance reimbursement rates for nonemergency medical transportation
services that are payable by or on behalf of the commissioner for nonemergency medical
transportation services are:

(1) $0.22 per mile for client reimbursement;

(2) up to 100 percent of the Internal Revenue Service business deduction rate for volunteer
transport;

(3) equivalent to the standard fare for unassisted transport when provided by public
transit, and $12.10 for the base rate and $1.43 per mile when provided by a nonemergency
medical transportation provider;

(4) $14.30 for the base rate and $1.43 per mile for assisted transport;

(5) $19.80 for the base rate and $1.70 per mile for lift-equipped/ramp transport;

(6) $75 for the base rate and $2.40 per mile for protected transport; and

(7) $60 for the base rate and $2.40 per mile for stretcher transport, and $9 per trip for
an additional attendant if deemed medically necessary. This paragraph expires July 1, 2026,
for medical assistance fee-for-service and January 1, 2027, for prepaid medical assistance.

deleted text begin (s) deleted text end new text begin (t) new text end Effective July 1, 2026, for medical assistance fee-for-service and January 1, 2027,
for prepaid medical assistance, payments for nonemergency medical transportation must
be paid based on the client's assessed mode under paragraph deleted text begin (m) deleted text end new text begin (n) new text end , not the type of vehicle
used to provide the service.

deleted text begin (t) deleted text end new text begin (u) new text end The base rate for nonemergency medical transportation services in areas defined
under RUCA to be super rural is equal to 111.3 percent of the respective base rate in
paragraph deleted text begin (r) deleted text end new text begin (s) new text end , clauses (1) to (7). The mileage rate for nonemergency medical transportation
services in areas defined under RUCA to be rural or super rural areas is:

(1) for a trip equal to 17 miles or less, equal to 125 percent of the respective mileage
rate in paragraph deleted text begin (r) deleted text end new text begin (s) new text end , clauses (1) to (7); and

(2) for a trip between 18 and 50 miles, equal to 112.5 percent of the respective mileage
rate in paragraph deleted text begin (r) deleted text end new text begin (s) new text end , clauses (1) to (7). This paragraph expires July 1, 2026, for medical
assistance fee-for-service and January 1, 2027, for prepaid medical assistance.

deleted text begin (u) deleted text end new text begin (v) new text end For purposes of reimbursement rates for nonemergency medical transportation
services under paragraphs deleted text begin (r) deleted text end new text begin (s) new text end to deleted text begin (t) deleted text end new text begin (u) new text end , the zip code of the recipient's place of residence
shall determine whether the urban, rural, or super rural reimbursement rate applies. This
paragraph expires July 1, 2026, for medical assistance fee-for-service and January 1, 2027,
for prepaid medical assistance.

deleted text begin (v) deleted text end new text begin (w) new text end The commissioner, when determining reimbursement rates for nonemergency
medical transportation, shall exempt all modes of transportation listed under paragraph deleted text begin (n) deleted text end new text begin
(o) new text end from Minnesota Rules, part 9505.0445, item R, subitem (2).

deleted text begin (w) deleted text end new text begin (x) new text end Effective for the first day of each calendar quarter in which the price of gasoline
as posted publicly by the United States Energy Information Administration exceeds $3.00
per gallon, the commissioner shall adjust the rate paid per mile in paragraph deleted text begin (r) deleted text end new text begin (s) new text end by one
percent up or down for every increase or decrease of ten cents for the price of gasoline. The
increase or decrease must be calculated using a base gasoline price of $3.00. The percentage
increase or decrease must be calculated using the average of the most recently available
price of all grades of gasoline for Minnesota as posted publicly by the United States Energy
Information Administration. This paragraph expires July 1, 2026, for medical assistance
fee-for-service and January 1, 2027, for prepaid medical assistance.

Sec. 3.

Minnesota Statutes 2024, section 256B.0625, subdivision 17b, is amended to read:

Subd. 17b.

Documentation required.

(a) As a condition for payment, nonemergency
medical transportation providers must document each occurrence of a service provided to
a recipient according to this subdivision. Providers must maintain records sufficient to
distinguish individual trips with specific vehicles and drivers. The documentation may be
collected and maintained using electronic systems or software or in paper form but must be
made available and produced upon request. Program funds paid for transportation that is
not documented according to this subdivision may be subject to recovery by the commissioner
pursuant to section 256B.064.

(b) A nonemergency medical transportation provider must compile transportation trip
records that are written in English and legible according to the standard of a reasonable
person and that include each of the following elements:

(1) the recipient's name;

(2) the date or dates the service is provided, if different than the date the entry was made;

(3) either the printed name of the driver sufficient to distinguish the driver of service or
the driver's provider number;

(4) the date and the signature of the driver attesting that the record accurately represents
the services provided and the actual miles driven, and acknowledging that misreporting
information that results in ineligible or excessive payments may result in civil or criminal
action;

(5) the date and the signature of the recipient or authorized party attesting that
transportation services were provided as indicated on the transportation trip record, or the
signature of the medical services provider certifying that the recipient was transported to
the medical services provider destination. In the event that both the medical services provider
and the recipient or authorized party refuse or are unable to provide signatures, the driver
must document on the transportation trip record that signatures were requested and not
provided;

(6) the address, or the description if the address is not available, of both the origin and
destination, and the mileage for the most direct route from the origin to the destination;

(7) the name or number of the mode of transportation in which the service is provided;

(8) the license plate number of the vehicle used to transport the recipient;

(9) the time of the recipient pickup;

(10) the time of the recipient drop-off;

(11) the odometer reading of the vehicle used to transport the recipient taken at the time
of pickup;

(12) the odometer reading of the vehicle used to transport the recipient taken at the time
of drop-off;

(13) the name of the extra attendant when an extra attendant is used to provide special
transportation service; and

(14) the documentation indicating the method that was used to determine the most direct
route.

new text begin (c) In addition to the requirements under paragraph (a), a nonemergency medical
transportation provider must compile transportation trip records that include:
new text end

new text begin (1) global positioning system data showing the origin and destination of each trip; and
new text end

new text begin (2) a recording of the passenger compartment of the vehicle taken from a rear-facing
camera that shows the recipient of the service and the date and time when the recording
was made.
new text end

deleted text begin (c) deleted text end new text begin (d) new text end In determining whether the commissioner will seek recovery, the documentation
requirements in this section apply retroactively to audit findings beginning January 1, 2020,
and to all audit findings thereafter new text begin , except that the documentation requirements in paragraph
(c) do not apply retroactively new text end .

new text begin (e) Notwithstanding any other law or rule to the contrary, recordings of the passenger
compartment of a vehicle must be retained for two years.
new text end

Sec. 4.

Minnesota Statutes 2024, section 256B.0625, subdivision 18h, is amended to read:

Subd. 18h.

Nonemergency medical transportation provisions related to managed
care.

(a) The following nonemergency medical transportation (NEMT) subdivisions apply
to managed care plans and county-based purchasing plans:

(1) subdivision 17, paragraphs (a), (b), (i), new text begin (m), new text end and deleted text begin (n) deleted text end new text begin (o) new text end ;

new text begin (2) subdivision 17b;
new text end

deleted text begin (2) deleted text end new text begin (3) new text end subdivision 18; and

deleted text begin (3) deleted text end new text begin (4) new text end subdivision 18a.

(b) A nonemergency medical transportation provider must comply with the operating
standards for special transportation service specified in sections 174.29 to 174.30 and
Minnesota Rules, chapter 8840. Publicly operated transit systems, volunteers, and not-for-hire
vehicles are exempt from the requirements in this paragraph.

(c) Managed care plans and county-based purchasing plans must provide a fuel adjustment
for NEMT rates when fuel exceeds $3 per gallon. If, for any contract year, federal approval
is not received for this paragraph, the commissioner must adjust the capitation rates paid to
managed care plans and county-based purchasing plans for that contract year to reflect the
removal of this provision. Contracts between managed care plans and county-based
purchasing plans and providers to whom this paragraph applies must allow recovery of
payments from those providers if capitation rates are adjusted in accordance with this
paragraph. Payment recoveries must not exceed the amount equal to any increase in rates
that results from this paragraph. This paragraph expires if federal approval is not received
for this paragraph at any time.