HF 4684

03/19/26   REVISOR  AGW/EI  26-07796
This Document can be made available
in alternative formats upon request  State of Minnesota
  HOUSE OF REPRESENTATIVES
  NINETY-FOURTH SESSION
  H. F. No.     4684
03/25/2026     Authored by Robbins, Scott, Mekeland, Dotseth, Rymer and others
  The bill was read for the first time and referred to the Committee on Human Services Finance and Policy
1.1A bill for an act
1.2relating to fraud; requiring nonemergency medical transportation providers to
1.3operate vehicles equipped with a global positioning system and rear-facing camera,
1.4compile certain information for each trip, and retain recordings for two years;
1.5amending Minnesota Statutes 2024, section 256B.0625, subdivisions 17b, 18h;
1.6Minnesota Statutes 2025 Supplement, sections 174.30, subdivision 3; 256B.0625,
1.7subdivision 17.
1.8BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.9Section 1. Minnesota Statutes 2025 Supplement, section 174.30, subdivision 3, is amended
1.10to read:
1.11Subd. 3. Other standards; wheelchair securement; protected transport. (a) A special
1.12transportation service that transports individuals occupying wheelchairs is subject to the
1.13provisions of sections 299A.11 to 299A.17 concerning wheelchair securement devices. The
1.14commissioners of transportation and public safety shall cooperate in the enforcement of
1.15this section and sections 299A.11 to 299A.17 so that a single inspection is sufficient to
1.16ascertain compliance with sections 299A.11 to 299A.17 and with the standards adopted
1.17under this section. Representatives of the Department of Transportation may inspect
1.18wheelchair securement devices in vehicles operated by special transportation service
1.19providers to determine compliance with sections 299A.11 to 299A.17 and to issue certificates
1.20under section 299A.14, subdivision 4.
1.21(b) In place of a certificate issued under section 299A.14, the commissioner may issue
1.22a decal under subdivision 4 for a vehicle equipped with a wheelchair securement device if
1.23the device complies with sections 299A.11 to 299A.17 and the decal displays the information
1.24in section 299A.14, subdivision 4.
Section 1.  1
03/19/26   REVISOR  AGW/EI  26-07796
2.1      (c) For vehicles designated as protected transport under section 256B.0625, subdivision
2.2  17, paragraph (n) (o), the commissioner of transportation, during the commissioner's
2.3  inspection, shall check to ensure the safety provisions contained in that paragraph are in
2.4  working order.
2.5    Sec. 2. Minnesota Statutes 2025 Supplement, section 256B.0625, subdivision 17, is
2.6  amended to read:
2.7      Subd. 17. Transportation costs. (a) "Nonemergency medical transportation service"
2.8  means motor vehicle transportation provided by a public or private person that serves
2.9  Minnesota health care program beneficiaries who do not require emergency ambulance
2.10 service, as defined in section 144E.001, subdivision 3, to obtain covered medical services.
2.11     (b) For purposes of this subdivision, "rural urban commuting area" or "RUCA" means
2.12 a census-tract based classification system under which a geographical area is determined
2.13 to be urban, rural, or super rural. This paragraph expires July 1, 2026, for medical assistance
2.14 fee-for-service and January 1, 2027, for prepaid medical assistance.
2.15     (c) Medical assistance covers medical transportation costs incurred solely for obtaining
2.16 emergency medical care or transportation costs incurred by eligible persons in obtaining
2.17 emergency or nonemergency medical care when paid directly to an ambulance company,
2.18 nonemergency medical transportation company, or other recognized providers of
2.19 transportation services. Medical transportation must be provided by:
2.20     (1) nonemergency medical transportation providers who meet the requirements of this
2.21 subdivision;
2.22     (2) ambulances, as defined in section 144E.001, subdivision 2;
2.23     (3) taxicabs that meet the requirements of this subdivision;
2.24     (4) public transportation, within the meaning of "public transportation" as defined in
2.25 section 174.22, subdivision 7; or
2.26     (5) not-for-hire vehicles, including volunteer drivers, as defined in section 65B.472,
2.27 subdivision 1, paragraph (p).
2.28     (d) Medical assistance covers nonemergency medical transportation provided by
2.29 nonemergency medical transportation providers enrolled in the Minnesota health care
2.30 programs. All nonemergency medical transportation providers must comply with the
2.31 operating standards for special transportation service as defined in sections 174.29 to 174.30
2.32 and Minnesota Rules, chapter 8840, and all drivers must be individually enrolled with the
Sec. 2.  2
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3.1  commissioner and reported on the claim as the individual who provided the service. All
3.2  nonemergency medical transportation providers shall bill for nonemergency medical
3.3  transportation services in accordance with Minnesota health care programs criteria. Publicly
3.4  operated transit systems, volunteers, and not-for-hire vehicles are exempt from the
3.5  requirements outlined in this paragraph.
3.6      (e) An organization may be terminated, denied, or suspended from enrollment if:
3.7      (1) the provider has not initiated background studies on the individuals specified in
3.8  section 174.30, subdivision 10, paragraph (a), clauses (1) to (3); or
3.9      (2) the provider has initiated background studies on the individuals specified in section
3.10 174.30, subdivision 10, paragraph (a), clauses (1) to (3), and:
3.11     (i) the commissioner has sent the provider a notice that the individual has been
3.12 disqualified under section 245C.14; and
3.13     (ii) the individual has not received a disqualification set-aside specific to the special
3.14 transportation services provider under sections 245C.22 and 245C.23.
3.15     (f) The administrative agency of nonemergency medical transportation must:
3.16     (1) adhere to the policies defined by the commissioner;
3.17     (2) pay nonemergency medical transportation providers for services provided to
3.18 Minnesota health care programs beneficiaries to obtain covered medical services;
3.19     (3) provide data monthly to the commissioner on appeals, complaints, no-shows, canceled
3.20 trips, and number of trips by mode; and
3.21     (4) by July 1, 2016, in accordance with subdivision 18e, utilize a web-based single
3.22 administrative structure assessment tool that meets the technical requirements established
3.23 by the commissioner, reconciles trip information with claims being submitted by providers,
3.24 and ensures prompt payment for nonemergency medical transportation services. This
3.25 paragraph expires July 1, 2026, for medical assistance fee-for-service and January 1, 2027,
3.26 for prepaid medical assistance.
3.27     (g) Effective July 1, 2026, for medical fee-for-service and January 1, 2027, for prepaid
3.28 medical assistance, the administrative agency of nonemergency medical transportation must:
3.29     (1) adhere to the policies defined by the commissioner;
3.30     (2) pay nonemergency medical transportation providers for services provided to
3.31 Minnesota health care program beneficiaries to obtain covered medical services; and
Sec. 2.  3
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4.1      (3) provide data monthly to the commissioner on appeals, complaints, no-shows, canceled
4.2  trips, and number of trips by mode.
4.3      (h) Until the commissioner implements the single administrative structure and delivery
4.4  system under subdivision 18e, clients shall obtain their level-of-service certificate from the
4.5  commissioner or an entity approved by the commissioner that does not dispatch rides for
4.6  clients using modes of transportation under paragraph (n) (o), clauses (4), (5), (6), and (7).
4.7  This paragraph expires July 1, 2026, for medical assistance fee-for-service and January 1,
4.8  2027, for prepaid medical assistance.
4.9      (i) The commissioner may use an order by the recipient's attending physician, advanced
4.10 practice registered nurse, physician assistant, or a medical or mental health professional to
4.11 certify that the recipient requires nonemergency medical transportation services.
4.12 Nonemergency medical transportation providers shall perform driver-assisted services for
4.13 eligible individuals, when appropriate. Driver-assisted service includes passenger pickup
4.14 at and return to the individual's residence or place of business, assistance with admittance
4.15 of the individual to the medical facility, and assistance in passenger securement or in securing
4.16 of wheelchairs, child seats, or stretchers in the vehicle.
4.17     (j) Nonemergency medical transportation providers must take clients to the health care
4.18 provider using the most direct route, and must not exceed 30 miles for a trip to a primary
4.19 care provider or 60 miles for a trip to a specialty care provider, unless the client receives
4.20 authorization from the local agency. This paragraph expires July 1, 2026, for medical
4.21 assistance fee-for-service and January 1, 2027, for prepaid medical assistance.
4.22     (k) Effective July 1, 2026, for medical assistance fee-for-service and January 1, 2027,
4.23 for prepaid medical assistance, nonemergency medical transportation providers must take
4.24 clients to the health care provider using the most direct route and must not exceed 30 miles
4.25 for a trip to a primary care provider or 60 miles for a trip to a specialty care provider, unless
4.26 the client receives authorization from the administrator.
4.27     (l) Nonemergency medical transportation providers may not bill for separate base rates
4.28 for the continuation of a trip beyond the original destination. Nonemergency medical
4.29 transportation providers must maintain trip logs, which include pickup and drop-off times,
4.30 signed by the medical provider or client, whichever is deemed most appropriate, attesting
4.31 to mileage traveled to obtain covered medical services. Clients requesting client mileage
4.32 reimbursement must sign the trip log attesting mileage traveled to obtain covered medical
4.33 services.
Sec. 2.  4
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5.1      (m) A vehicle operated by a nonemergency medical transportation provider must be
5.2  equipped with a global positioning system capable of tracking the route taken by the vehicle
5.3  and a rear-facing camera capable of recording a sufficient area of the passenger compartment
5.4  to identify the recipient of the service and the date and time when the recording was made.
5.5      (m) (n) The administrative agency shall use the level of service process established by
5.6  the commissioner to determine the client's most appropriate mode of transportation. If public
5.7  transit or a certified transportation provider is not available to provide the appropriate service
5.8  mode for the client, the client may receive a onetime service upgrade.
5.9      (n) (o) The covered modes of transportation are:
5.10     (1) client reimbursement, which includes client mileage reimbursement provided to
5.11 clients who have their own transportation, or to family or an acquaintance who provides
5.12 transportation to the client;
5.13     (2) volunteer transport, which includes transportation by volunteers using their own
5.14 vehicle;
5.15     (3) unassisted transport, which includes transportation provided to a client by a taxicab
5.16 or public transit. If a taxicab or public transit is not available, the client can receive
5.17 transportation from another nonemergency medical transportation provider;
5.18     (4) assisted transport, which includes transport provided to clients who require assistance
5.19 by a nonemergency medical transportation provider;
5.20     (5) lift-equipped/ramp transport, which includes transport provided to a client who is
5.21 dependent on a device and requires a nonemergency medical transportation provider with
5.22 a vehicle containing a lift or ramp;
5.23     (6) protected transport, which includes transport provided to a client who has received
5.24 a prescreening that has deemed other forms of transportation inappropriate and who requires
5.25 a provider: (i) with a protected vehicle that is not an ambulance or police car and has safety
5.26 locks, a video recorder, and a transparent thermoplastic partition between the passenger and
5.27 the vehicle driver; and (ii) who is certified as a protected transport provider; and
5.28     (7) stretcher transport, which includes transport for a client in a prone or supine position
5.29 and requires a nonemergency medical transportation provider with a vehicle that can transport
5.30 a client in a prone or supine position.
5.31     (o) (p) The local agency shall be the single administrative agency and shall administer
5.32 and reimburse for modes defined in paragraph (n) (o) according to paragraphs (r) (s) to (t)
5.33 (u) when the commissioner has developed, made available, and funded the web-based single
Sec. 2.  5
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6.1  administrative structure, assessment tool, and level of need assessment under subdivision
6.2  18e. The local agency's financial obligation is limited to funds provided by the state or
6.3  federal government. This paragraph expires July 1, 2026, for medical assistance
6.4  fee-for-service and January 1, 2027, for prepaid medical assistance.
6.5      (p) (q) The commissioner shall:
6.6      (1) verify that the mode and use of nonemergency medical transportation is appropriate;
6.7      (2) verify that the client is going to an approved medical appointment; and
6.8      (3) investigate all complaints and appeals.
6.9      (q) (r) The administrative agency shall pay for the services provided in this subdivision
6.10 and seek reimbursement from the commissioner, if appropriate. As vendors of medical care,
6.11 local agencies are subject to the provisions in section 256B.041, the sanctions and monetary
6.12 recovery actions in section 256B.064, and Minnesota Rules, parts 9505.2160 to 9505.2245.
6.13 This paragraph expires July 1, 2026, for medical assistance fee-for-service and January 1,
6.14 2027, for prepaid medical assistance.
6.15     (r) (s) Payments for nonemergency medical transportation must be paid based on the
6.16 client's assessed mode under paragraph (m) (n), not the type of vehicle used to provide the
6.17 service. The medical assistance reimbursement rates for nonemergency medical transportation
6.18 services that are payable by or on behalf of the commissioner for nonemergency medical
6.19 transportation services are:
6.20     (1) $0.22 per mile for client reimbursement;
6.21     (2) up to 100 percent of the Internal Revenue Service business deduction rate for volunteer
6.22 transport;
6.23     (3) equivalent to the standard fare for unassisted transport when provided by public
6.24 transit, and $12.10 for the base rate and $1.43 per mile when provided by a nonemergency
6.25 medical transportation provider;
6.26     (4) $14.30 for the base rate and $1.43 per mile for assisted transport;
6.27     (5) $19.80 for the base rate and $1.70 per mile for lift-equipped/ramp transport;
6.28     (6) $75 for the base rate and $2.40 per mile for protected transport; and
6.29     (7) $60 for the base rate and $2.40 per mile for stretcher transport, and $9 per trip for
6.30 an additional attendant if deemed medically necessary. This paragraph expires July 1, 2026,
6.31 for medical assistance fee-for-service and January 1, 2027, for prepaid medical assistance.
Sec. 2.  6
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7.1      (s) (t) Effective July 1, 2026, for medical assistance fee-for-service and January 1, 2027,
7.2  for prepaid medical assistance, payments for nonemergency medical transportation must
7.3  be paid based on the client's assessed mode under paragraph (m) (n), not the type of vehicle
7.4  used to provide the service.
7.5      (t) (u) The base rate for nonemergency medical transportation services in areas defined
7.6  under RUCA to be super rural is equal to 111.3 percent of the respective base rate in
7.7  paragraph (r) (s), clauses (1) to (7). The mileage rate for nonemergency medical transportation
7.8  services in areas defined under RUCA to be rural or super rural areas is:
7.9      (1) for a trip equal to 17 miles or less, equal to 125 percent of the respective mileage
7.10 rate in paragraph (r) (s), clauses (1) to (7); and
7.11     (2) for a trip between 18 and 50 miles, equal to 112.5 percent of the respective mileage
7.12 rate in paragraph (r) (s), clauses (1) to (7). This paragraph expires July 1, 2026, for medical
7.13 assistance fee-for-service and January 1, 2027, for prepaid medical assistance.
7.14     (u) (v) For purposes of reimbursement rates for nonemergency medical transportation
7.15 services under paragraphs (r) (s) to (t) (u), the zip code of the recipient's place of residence
7.16 shall determine whether the urban, rural, or super rural reimbursement rate applies. This
7.17 paragraph expires July 1, 2026, for medical assistance fee-for-service and January 1, 2027,
7.18 for prepaid medical assistance.
7.19     (v) (w) The commissioner, when determining reimbursement rates for nonemergency
7.20 medical transportation, shall exempt all modes of transportation listed under paragraph (n)
7.21 (o) from Minnesota Rules, part 9505.0445, item R, subitem (2).
7.22     (w) (x) Effective for the first day of each calendar quarter in which the price of gasoline
7.23 as posted publicly by the United States Energy Information Administration exceeds $3.00
7.24 per gallon, the commissioner shall adjust the rate paid per mile in paragraph (r) (s) by one
7.25 percent up or down for every increase or decrease of ten cents for the price of gasoline. The
7.26 increase or decrease must be calculated using a base gasoline price of $3.00. The percentage
7.27 increase or decrease must be calculated using the average of the most recently available
7.28 price of all grades of gasoline for Minnesota as posted publicly by the United States Energy
7.29 Information Administration. This paragraph expires July 1, 2026, for medical assistance
7.30 fee-for-service and January 1, 2027, for prepaid medical assistance.
7.31   Sec. 3. Minnesota Statutes 2024, section 256B.0625, subdivision 17b, is amended to read:
7.32     Subd. 17b. Documentation required. (a) As a condition for payment, nonemergency
7.33 medical transportation providers must document each occurrence of a service provided to
Sec. 3.  7
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8.1  a recipient according to this subdivision. Providers must maintain records sufficient to
8.2  distinguish individual trips with specific vehicles and drivers. The documentation may be
8.3  collected and maintained using electronic systems or software or in paper form but must be
8.4  made available and produced upon request. Program funds paid for transportation that is
8.5  not documented according to this subdivision may be subject to recovery by the commissioner
8.6  pursuant to section 256B.064.
8.7      (b) A nonemergency medical transportation provider must compile transportation trip
8.8  records that are written in English and legible according to the standard of a reasonable
8.9  person and that include each of the following elements:
8.10     (1) the recipient's name;
8.11     (2) the date or dates the service is provided, if different than the date the entry was made;
8.12     (3) either the printed name of the driver sufficient to distinguish the driver of service or
8.13 the driver's provider number;
8.14     (4) the date and the signature of the driver attesting that the record accurately represents
8.15 the services provided and the actual miles driven, and acknowledging that misreporting
8.16 information that results in ineligible or excessive payments may result in civil or criminal
8.17 action;
8.18     (5) the date and the signature of the recipient or authorized party attesting that
8.19 transportation services were provided as indicated on the transportation trip record, or the
8.20 signature of the medical services provider certifying that the recipient was transported to
8.21 the medical services provider destination. In the event that both the medical services provider
8.22 and the recipient or authorized party refuse or are unable to provide signatures, the driver
8.23 must document on the transportation trip record that signatures were requested and not
8.24 provided;
8.25     (6) the address, or the description if the address is not available, of both the origin and
8.26 destination, and the mileage for the most direct route from the origin to the destination;
8.27     (7) the name or number of the mode of transportation in which the service is provided;
8.28     (8) the license plate number of the vehicle used to transport the recipient;
8.29     (9) the time of the recipient pickup;
8.30     (10) the time of the recipient drop-off;
8.31     (11) the odometer reading of the vehicle used to transport the recipient taken at the time
8.32 of pickup;
Sec. 3.  8
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9.1      (12) the odometer reading of the vehicle used to transport the recipient taken at the time
9.2  of drop-off;
9.3      (13) the name of the extra attendant when an extra attendant is used to provide special
9.4  transportation service; and
9.5      (14) the documentation indicating the method that was used to determine the most direct
9.6  route.
9.7      (c) In addition to the requirements under paragraph (a), a nonemergency medical
9.8  transportation provider must compile transportation trip records that include:
9.9      (1) global positioning system data showing the origin and destination of each trip; and
9.10     (2) a recording of the passenger compartment of the vehicle taken from a rear-facing
9.11 camera that shows the recipient of the service and the date and time when the recording
9.12 was made.
9.13     (c) (d) In determining whether the commissioner will seek recovery, the documentation
9.14 requirements in this section apply retroactively to audit findings beginning January 1, 2020,
9.15 and to all audit findings thereafter, except that the documentation requirements in paragraph
9.16 (c) do not apply retroactively.
9.17     (e) Notwithstanding any other law or rule to the contrary, recordings of the passenger
9.18 compartment of a vehicle must be retained for two years.
9.19   Sec. 4. Minnesota Statutes 2024, section 256B.0625, subdivision 18h, is amended to read:
9.20     Subd. 18h. Nonemergency medical transportation provisions related to managed
9.21 care. (a) The following nonemergency medical transportation (NEMT) subdivisions apply
9.22 to managed care plans and county-based purchasing plans:
9.23     (1) subdivision 17, paragraphs (a), (b), (i), (m), and (n) (o);
9.24     (2) subdivision 17b;
9.25     (2) (3) subdivision 18; and
9.26     (3) (4) subdivision 18a.
9.27     (b) A nonemergency medical transportation provider must comply with the operating
9.28 standards for special transportation service specified in sections 174.29 to 174.30 and
9.29 Minnesota Rules, chapter 8840. Publicly operated transit systems, volunteers, and not-for-hire
9.30 vehicles are exempt from the requirements in this paragraph.
Sec. 4.  9
 03/19/26   REVISOR  AGW/EI  26-07796
10.1      (c) Managed care plans and county-based purchasing plans must provide a fuel adjustment
10.2  for NEMT rates when fuel exceeds $3 per gallon. If, for any contract year, federal approval
10.3  is not received for this paragraph, the commissioner must adjust the capitation rates paid to
10.4  managed care plans and county-based purchasing plans for that contract year to reflect the
10.5  removal of this provision. Contracts between managed care plans and county-based
10.6  purchasing plans and providers to whom this paragraph applies must allow recovery of
10.7  payments from those providers if capitation rates are adjusted in accordance with this
10.8  paragraph. Payment recoveries must not exceed the amount equal to any increase in rates
10.9  that results from this paragraph. This paragraph expires if federal approval is not received
10.10 for this paragraph at any time.
 Sec. 4.  10