Rachel Scholler - NEMT Growth Consultants

10/21/2026

What NEMT Operators should be watching this week:

COLORADO — Statewide broker transition approaching

Colorado continues preparing for MediDrive to take over statewide NEMT brokerage January 1, 2027.

Provider enrollment reopened October 1 following the moratorium.

Operators should be reviewing network requirements, reimbursement and contracting as the transition approaches.

NEW MEXICO — November 1 broker change

Blue Cross and Blue Shield of New Mexico Medicaid transportation is transitioning from Modivcare to MTM Health November 1.

Providers should confirm their network status and understand how the transition could affect their existing trips.

WISCONSIN — Still watching the broker transition

Verida remains the intended next statewide NEMT vendor, but no confirmed transition date has been announced.

For Wisconsin providers, preparation makes sense. Acting on rumors doesn't.

My takeaway this week?

Whether it's a new broker, expanded coverage, additional funding or increased oversight, these changes can have a significant impact on transportation businesses.

And not every change is a negative one. Some create opportunities for operators who are paying attention.

I've always believed that understanding what's happening beyond your own service area is part of running a stronger business.

Because what we're seeing in one state today may be what operators in another state are dealing with tomorrow.

10/19/2026

What NEMT Operators Should Be Watching This Week

A new state audit, a $3 million transportation grant opportunity, and several important Medicaid transportation changes are on the radar this week.

Heres whats happening across the country.

MICHIGAN — NEMT oversight concerns identified

A new state audit found continuing weaknesses in Michigans oversight of Medicaid transportation, including provider-record reviews and verification of broker-reported performance.

Michigan is also accepting proposals for its next fee-for-service NEMT broker, with the possibility of expanding brokerage statewide.

No statewide expansion decision has been announced.

For operators, this is another reminder of how important accurate records, credentialing and accountability have become.

KANSAS — $3 million rural transportation grant opportunity
Kansas opened applications October 16 for grants supporting rural non-emergency transportation.

Funding could help expand transportation capacity, purchase vehicles and improve scheduling and coordination.

Applications are due November 18, with funding contingent on CMS approval.

This could be a meaningful opportunity for rural transportation providers and healthcare organizations looking to improve access to care.

IOWA — Medicaid transportation coverage could expand
Iowa has proposed extending NEMT coverage to its Iowa Health and Wellness Plan population beginning January 1, 2027.

If approved, this could create additional transportation demand and new opportunities for providers.

Final approval and implementation still need to be confirmed.

I've always believed that understanding what's happening beyond your own service area is part of running a stronger business.

What changes are you seeing in your state that other NEMT operators should be aware of?

I'll be back Thursday with a look at several upcoming broker transitions we're continuing to watch.

10/14/2026

What NEMT Operators Should Be Watching This Week

More changes across Medicaid transportation this week, from broker transitions to reimbursement and provider compliance.

Here's what's happening:

MICHIGAN — Another transportation vendor change

Molina Healthcare of Michigan transitioned to SafeRide Health on October 1.

This isn't a statewide broker change, but it's an important reminder that individual health plans can change transportation vendors, potentially affecting where your trips come from.

MINNESOTA — NEMT mileage rates increased

Effective October 1, Minnesota increased several state-administered NEMT mileage rates.

Wheelchair transportation went from $1.80 to $1.92 per mile, while protected and stretcher transportation increased from $2.54 to $2.71.

Keep in mind, state reimbursement rates aren't necessarily what you're receiving under your broker contract. Know your actual numbers!

NORTH CAROLINA — Medicaid compliance updates

NC Medicaid began conducting certain provider site visits without advance scheduling on October 1.

The state is also reminding providers to stay current with reverification requirements to avoid potential suspension or termination.

These aren't NEMT-specific changes, but transportation providers subject to these requirements should be paying attention.

NEW MEXICO — Broker transition coming November 1

Blue Cross and Blue Shield of New Mexico Medicaid transportation is moving from Modivcare to MTM Health.

Operators should confirm their network status and understand how the transition may affect their business.

Here's what I want operators to think about this week:

You can have vehicles running all day, a full dispatch board and plenty of trips coming in.

But how much of that business depends on one payer, one broker or one contract?

And do you really know what you're making on those trips?

Being busy and being financially secure aren't necessarily the same thing.

Understanding your numbers and where your business comes from is just as important as keeping your vehicles on the road.

10/13/2026

In 2008, a transportation company told me 18 miles was too far to drive my grandfather to dialysis.

I hung up the phone angry.

Then I bought two vans.

I certainly didn’t know that decision would turn into the next 17 years of my life.

My grandfather was like a father to me. I wasn’t trying to become an entrepreneur or build something I could eventually sell. I saw a problem affecting someone I loved and decided to fix it.

Those two vans eventually became Lakeshore Transportation, a company providing more than 100 trips a day, with a team I was incredibly proud of and a business that became worth far more than I ever imagined when I started it.

But there was another side to that growth.

The business ran on a whole lot of my stubbornness.

In the beginning, that’s almost a superpower. You figure things out. You solve the problem. You do whatever needs to be done because nobody cares about the business quite like you do.

That works for a long time.

Until you want the business to work without you.

One of the biggest lessons I learned preparing for my own exit was that the things that make you a successful founder aren’t always the same things that make your company transferable.

Eventually, your job has to change from being the person who makes everything work to building a business that can work without you.

For the business owners who have been at this for a while, what’s something you still do simply because you’ve always been the one to do it?

10/08/2026

Ohio NEMT is changing — and this one is bigger than GPS.

Ohio Senate Bill 315 takes effect October 6, 2026, bringing new attention to how non-emergency medical transportation is documented and verified.

There's been a lot of discussion about GPS requirements, but I think the bigger story is accountability.

The legislation addresses GPS coordinates, timestamps, and the documentation needed to connect transportation services with Medicaid payments.

Why does this matter?

Because GPS can tell us where a vehicle traveled. It doesn't necessarily tell us whether the patient had a scheduled appointment, whether that appointment was canceled, or whether the transportation was medically necessary.

Those are important distinctions when we're talking about fraud, waste, and abuse.

**One clarification for Ohio providers:** The October 6 effective date does not mean every transportation provider must immediately purchase or implement a new GPS system. Implementation requirements and timelines matter.

My advice to providers is simple: Understand the legislation, review your documentation practices, and pay attention to guidance from Ohio Medicaid.

Prepare now. Don't panic-buy technology.

The NEMT industry is moving toward greater verification and accountability. Providers who understand where these changes are headed will be better positioned for what's next.

10/07/2026

Growth doesn't silence fear and doubt. Sometimes it turns up the volume.

When you're building a transportation business, every new milestone brings another level of responsibility.

More vehicles. More drivers. More patients depending on you. More decisions that ultimately land on your desk.

I experienced this firsthand during my 17 years building Lakeshore Transportation.

There were times when growth was exciting and exhausting at the same time. The business was succeeding, but that didn't mean the uncertainty disappeared.

I learned that perseverance isn't about eliminating fear or having every answer. It's about trusting your experience, making difficult decisions, and continuing forward even when things feel uncomfortable.

If you're growing your NEMT business right now, give yourself some credit for how far you've come.

And remember, you don't have to have everything figured out to take the next step.

The climb continues anyway.

10/05/2026

What NEMT Operators Should Be Watching This Week

October started with several important NEMT changes — particularly around broker transitions, provider networks and Medicaid transportation management.

MONTANA — Modivcare is now live statewide
As of October 1, Modivcare is managing Montana Medicaid NEMT statewide.

This goes beyond changing where members call for a ride. Provider enrollment and NEMT billing administration are also moving under Modivcare.

Montana operators should make sure their enrollment, network status, billing and recurring-trip processes are clear.

VIRGINIA — MTM is now managing fee-for-service NEMT

Virginia's Cardinal Care fee-for-service transportation transitioned to MTM October 1.

Important distinction: this does NOT apply to all Cardinal Care managed-care transportation.

The transition also includes digital tools allowing FFS members to schedule or cancel transportation, track rides and view trip information.

TEXAS & ILLINOIS — BCBS Medicaid transportation moved to MTM

Blue Cross and Blue Shield Medicaid transportation in Texas and Illinois transitioned from Modivcare to MTM Health October 1.

This is an important reminder:

A statewide Medicaid broker doesn't have to change for YOUR trip volume to change.

Individual health plans can change transportation vendors independently.

If you don't know which payer or MCO is generating your trips, you may not understand your exposure until something changes.

COLORADO — Provider enrollment is open again

Colorado's NEMT provider enrollment moratorium ended September 30, reopening enrollment October 1 as the state continues its transition toward statewide brokerage under MediDrive.

For startups:
Enrollment being open does not automatically mean there is demand for another provider.

Understand the market, reimbursement, network needs and realistic trip volume before buying vehicles or committing significant money.

And then there's OHIO

A significant NEMT law takes effect tomorrow involving electronic trip verification, GPS data, payment integrity and fraud/waste/abuse prevention.

There's enough happening that I don't want to reduce it to one paragraph here.

I'll break Ohio down separately later this week — including what the law requires, what it DOESN'T require yet and what operators should be doing now.

The takeaway this week?
Know your payer.
Know your broker.
Know your network status.
Know where your trips actually come from.

Better to prepare than react.

10/05/2026

Thinking about starting an NEMT business? Save this article.

James O’Donnell and the team at Duet put together an incredible resource that breaks down much more than the cost of buying a van. It covers insurance, startup expenses, and the cash you’ll need while working toward steady revenue.

These are the details new owners need to understand before committing their money. I’m glad to see such a practical resource available—and thank you, James, for including lessons from my experience operating Lakeshore Transportation.

Read the full article here:

What it costs to start a NEMT business in 2026: a line-by-line budget for one wheelchair van, state fees, insurance down payments and a free spreadsheet.

10/01/2026

What NEMT Operators Should Be Watching Next

October 1 isn't the only thing happening in NEMT. There are several developments operators should have on their radar.

OHIO
Montgomery County recently released an RFP for NEMT services for Stillwater Center residents, including wheelchair and stretcher transportation. Proposals are due October 28.

At the same time, Ohio Medicaid recently closed an RFI exploring GPS, electronic trip verification, fraud/waste/abuse detection and audit support.

An RFI does NOT mean these requirements have been implemented.

But it does tell us what the state is exploring.

Ohio is interesting right now because we're seeing both traditional transportation opportunities and movement toward more technology-driven verification.

MICHIGAN
Michigan's NEMT broker procurement remains open through October 30.

The current model covers fee-for-service transportation in Wayne, Oakland and Macomb counties, but bidders are also being asked to address a potential statewide model.

Michigan has not decided to move statewide.

But operators should understand what a change like that could mean for their businesses — especially if they're heavily dependent on one payer or source of trips.

SOUTH CAROLINA
South Carolina's procurement for a statewide NEMT coordinator has closed.

The state is seeking a single contractor to manage a risk-based, capitated statewide NEMT program.

No award has been announced, so for now, this is one to watch rather than react to.

The bigger trend?

NEMT is becoming increasingly data-driven.

GPS. Timestamps. Eligibility. Appointment verification. Documentation. Audit trails.

Good systems and clean data are becoming just as important as vehicles and drivers.

The operators who understand that shift now will be much better prepared for where NEMT is going.

09/29/2026

A higher NEMT rate doesn't automatically mean higher profit.

Louisiana's new legislation establishes a minimum Medicaid NEMT reimbursement methodology of $14.50 per trip + $2.10 per mile.

That's encouraging for providers.

But whenever rates increase, there's another question operators should be asking:

Is the rate actually profitable for MY operation?

Revenue per trip doesn't tell you that.

You need to know your driver cost, loaded AND unloaded miles, insurance, fuel, maintenance, vehicle replacement, dispatch/admin overhead, wait time and deadhead between trips.

Two transportation companies can receive the exact same reimbursement and have completely different margins.

Don't build your business around what a trip pays.

Build it around what you KEEP after providing it.