NEMT Broker for Medicaid FFS Beneficiaries

Background
The Michigan Department of Health and Human Services (MDHHS) administers the Michigan Medicaid program, which includes the Non-Emergency Medical Transportation (NEMT) benefit. This benefit ensures necessary transportation for Medicaid beneficiaries to access covered services. The goal of this contract is to establish a comprehensive NEMT program for eligible fee-for-service (FFS) Medicaid beneficiaries residing in Wayne, Oakland, and Macomb Counties, with potential expansion to all Michigan Counties.

Work Details
The Contractor will serve as the designated NEMT broker for eligible FFS beneficiaries, responsible for:

1. Fielding beneficiary calls and verifying eligibility.
2. Scheduling transportation that meets medical needs while being cost-effective.
3. Determining reimbursement rates for NEMT providers and managing a network of subcontracted transportation providers.
4. Recruiting and managing volunteer drivers.
5. Submitting prior authorization requests via CHAMPS as required.
6. Ensuring compliance with MDHHS policies and federal regulations regarding NEMT services, including tracking service utilization and providing necessary reports.

Period of Performance
The contract is effective from August 1, 2027, until July 31, 2030, with an option for up to five additional one-year renewals at the State's discretion.

Place of Performance
Services will be performed primarily in Wayne, Oakland, and Macomb Counties, with potential expansion to all counties in Michigan.

Bidder Requirements
Bidders must comply with various requirements including maintaining licenses and permits necessary for service provision. They must ensure compliance with state and federal regulations regarding transportation services and provide proof of financial resources sufficient to ensure contract performance.