Compliance Guidelines from MAS — What New York State NEMT Providers Need to Know

On August 1, 2023, The New York State Department of Health (NYSDOH) made a noteworthy decision in favor of Medicaid-eligible individuals. They entered into a contract with MAS, transitioning the Syracuse-based corporation as the central transportation manager for each of the ten distinct regions of New York State.

As of 2024, even Managed Care, MLTC, and Medicaid Advantage Plus members are required to rely on private contractors (MAS) for transportation for medical care.

What does this change mean for transportation providers (TPs)? RouteGenie gives you the lay of the land of New York MAS compliance.

Contents:

• MAS in Transportation: What Does it Stand for?
• Key Changes in MAS Requirements for NEMT Providers 
• Impact of MAS Guidelines on NY State NEMT Operations 
• Looking to the Future with RouteGenie 
• Frequently Asked Questions 

MAS in Transportation: What Does it Stand for?

In the realm of transportation, MAS stands for Medical Answering Services, LLC. MAS plays a role of a figurative bridge between NYSDOH and TPs, providing coverage to an estimated 7.5 million locals.

From scheduling trips to maintaining compliance, they regulate non-emergency medical transportation (NEMT) providers. The goal is to provide beneficiaries with safe and reliable passage to and from appointments.

To this end, MAS has made some much-needed changes in contracts. 

Key Changes in MAS Requirements for NEMT Providers 

Let’s take a look at some of the changes in requirements for MAS guideline compliance that are focused on improving the passenger’s experience and safety:

Focus on Credentialing 

The quality of passenger care provided by NEMT drivers is paramount and must be enhanced whenever possible. It's essential to periodically review and validate the certifications of your NEMT drivers. If they’re found without credentials, the provider’s operating license may be suspended or revoked. 

Follow Trip Requests

Passengers for NEMT provide their addresses and scheduled pickup or appointment times on trip reservations. If they make changes to the assignment, MAS transportation providers will receive a revised manifest. If they cannot accommodate it due to inclement weather conditions or accidents, they’re obligated to inform MAS.

TPs are obligated to ensure that the trip is strictly medical-based but not emergent enough to warrant an ambulance. Schedule the least costly mode of transportation based on the patient's condition to ensure timely and accurate reimbursement.

High Levels of Safety 

Patient safety is a top priority for non-emergency medical transportation. To ensure this, new MAS contracts have set up specific guidelines:

• An NEMT driver can’t drop off a passenger at their medical appointment more than 15 minutes before the facility's opening time.
• For “will call” return pick-ups, the driver must arrive within one hour after they’re notified.
• Passengers under 18 years of age must be accompanied by a parent/guardian.

MAS also monitors traffic violations as a means to achieve passenger safety.

Keep up with Local Requirements

There’s a variability in requirements for NEMT services across jurisdictions. 

From the issuance of the license to criminal background checks on administrative and direct service providers like drivers, you must perform due diligence on all the required touchpoints. This is vital to ensure you meet the rules, regulations, and standards enforced in the administrative division you apply for.

Timely Appointments  

Time is of the essence to NEMT transport providers. They must ensure passengers have timely access to essential medical appointments. In addition to picking them up at the pre-arranged time, TPs must also keep up with return trip authorizations. 

If they encounter any issues meeting the scheduled time, whether for pick-up or drop-off, they must notify MAS authorities.

Update Transportation Provider Profile (TPP)

To plan capacity accurately, providers must maintain the accuracy of their TPP. It must be frequently updated to increase visibility into their ability to participate in the NEMT ecosystem. This reduces the risk of a trip invoice being refused, whether through provider no-show or vehicle breakdown, ensuring timely intervention. 

Impact of MAS Guidelines on NY State NEMT Operations 

Passengers in need of NEMT have medical conditions and disabilities that require frequent intervention. Their healthcare issues are not emergent enough to warrant an ambulance. But they depend on these appointments to keep complications at bay.

MAS adopts a patient-first philosophy to ensure there’s little room for error. It enforces regulations, with severe consequences for TPS who don't keep up. Here’s a look into it:

Non-Compliance

Adherence to rules and regulations dictates the efficiency of medically necessary trips. Compliance is central to MAS, and its updated requirements reflect that.

The ramifications of non-compliance result in a loss of reimbursement for services rendered. If the appropriate level of service is not administered, MAS could implement a Corrective Action Plan, a type of disciplinary action that allows TPs to improve performance before they’re removed from the network.

If the infraction is too severe, TPs may face hefty penalties, fines, and loss of contract. If a patient is harmed, the company may also be subject to a lawsuit.

Trip Refusals 

TPs can refuse trips if they don’t have drivers servicing the pick-up ZIP code, expect poor weather conditions, or are dealing with vehicular breakdowns. However, if they adopt a pattern of canceling trips without a legitimate reason, MAS will start to pre-verify all transportation requests for the TP.

Catering to All

NEMT is focused on helping Medicaid beneficiaries with special needs. If you serve passengers on the Exclusion List, you will not be reimbursed for furnishing them with medical care, services, or supplies. 

To avoid the financial implications of this, check passenger eligibility before obtaining authorization for the ride.

Looking to the Future with RouteGenie 

The Census Bureau estimates that the current population of New York has exceeded the 20 million people mark and 4-5% of this population will use NEMT services in a given year. To claim the lion's share of these profits, transport providers need to ensure New York MAS compliance, improve safety, and deliver the highest quality services. 

Since MAS requires TPs to submit GPS coordinates along the trip, it's crucial to leverage groundbreaking technology like RouteGenie for efficient processes. This software can help you manage scheduling and routing based on real-time data on traffic, weather, and road conditions. It also enables you to track all user activity and adds a layer of protection to protect sensitive data from falling into the wrong hands.

Our NEMT broker management software helps automate data for brokers. This makes claim reimbursement and other processes convenient and efficient.

Get a demo today to see how it can help your business.

Frequently Asked Questions 

How to start an NEMT business in NY?

To become a Medicaid NEMT provider in New York State, you must first look into the local regulations and licensing requirements. Once you’ve crafted a business plan, you can register your company and get approval to operate from NYSDOH through MAS.

Do passengers have to pay for NEMT services?

NYSDOH provides transportation to Medicaid-eligible beneficiaries at no extra cost