The Medicaid program pays for nonemergency medical transportation (NEMT) services that a State determines to be necessary for beneficiaries to obtain care. Prior OIG audit reports have consistently identified NEMT services as vulnerable to fraud, waste, and abuse.Our objectives were to determine whether Massachusetts: (1) claimed Federal Medicaid reimbursement for NEMT service claims in accordance with Federal and State requirements and (2) ensured that NEMT providers adequately documented driver qualifications and maintained vehicle records.We reviewed Massachusetts’s monitoring and oversight of its NEMT brokerage program, including compliance with certain Federal and State requirements to determine whether: (1) the beneficiary received a qualifying medical service on the date of transportation, (2) there was adequate documentation supporting the NEMT service, (3) the NEMT service was provided, and (4) driver and vehicle qualifications complied with State regulations. We reviewed 100 randomly sampled claim lines of service from the 896,792 lines of service between January 1, 2016, to December 31, 2017, for which Massachusetts paid $17.3 million.
MA,
United States
