# How to Become a GRITS (Audubon Area) Medicaid Transportation Provider in 2027

Canonical URL: https://nemtguide.com/brokers/grits/ · Updated 2026-09-30

GRITS is the Green River Intra-county Transit System, run by Audubon Area Community Services. As of September 2026, it brokers Kentucky Medicaid rides in 22 counties in Regions 1, 3, and 4. To carry its riders, get Taxi or Disabled Persons Vehicle authority from the Division of Motor Carriers, call GRITS at 270-686-1651 to subcontract, and file a Medicaid application GRITS signs.

- GRITS brokers Medicaid rides in 22 counties: Region 1 around Paducah, Region 3 around Owensboro and Henderson, and Region 4 around Elizabethtown.
- Your subcontract is with GRITS, but the Transportation Cabinet approves you, inspects vehicles, and sets the rate for each service type.
- Every new provider must keep at least three approved drivers and three working vehicles in the program.
- GRITS must pay you within 3 business days after the Cabinet pays it, and every invoice is due within 6 months of the trip.
- House Bill 2 requires a broker-paid GPS device in every Medicaid vehicle and holds back 2% of each broker's capitation for performance.

GRITS, the Green River Intra-county Transit System, is the transportation program of Audubon Area Community Services, Inc. Audubon is an Owensboro nonprofit community action agency, formed in 1975 when two agencies founded in 1966 merged. GRITS has run nonemergency transportation for more than 30 years. As of September 2026, it is the Medicaid ride broker for three of the 15 regions in Kentucky's Human Service Transportation Delivery (HSTD) program.

Every Medicaid ride request in those 22 counties goes to GRITS. GRITS can send each trip to its own vehicles or to an approved subcontractor. If you want Medicaid trips there, you sign with GRITS, but the Kentucky Transportation Cabinet (KYTC) approves you, inspects your vehicles, and sets what each trip pays.

## Where GRITS runs Medicaid rides

KYTC lists these GRITS regions and counties as of September 2026. Riders book on their region's line, and GRITS keeps Region 4's hours on Eastern time and the other two on Central time.

| Region | Counties | Rider booking lines | Office time |
|---|---|---|---|
| 1 | Ballard, Calloway, Carlisle, Fulton, Graves, Hickman, Marshall, McCracken | 270-575-9119 or 844-575-9676 | Central |
| 3 | Daviess, Hancock, Henderson, McLean, Ohio, Union, Webster | 270-686-1651 or 800-816-3511 | Central |
| 4 | Breckinridge, Grayson, Hardin, LaRue, Marion, Meade, Nelson | 270-982-8220 or 844-870-4646 | Eastern |

Region 2, which lies between Regions 1 and 3, has its own broker, [PACS](https://nemtguide.com/brokers/pacs/). Check which region your garage and your likely riders sit in before you call. Rides stay inside the rider's home county and the counties that touch it, unless a clinician's referral is on file for a farther trip.

### How big GRITS is

Audubon's annual report for July 2023 through June 2024 counts 411,062 GRITS trips, 5,432,742 miles, and 8,890 riders, about 1,100 trips a day. GRITS also runs paratransit for the Owensboro Transit System and a fee-per-mile service open to the public. In its audited statements for the year ended June 30, 2025, Audubon reported $22,222,418 in transportation program costs, of which $14,401,129 was contracts and consultants.

### How GRITS is paid

Kentucky's Department for Medicaid Services (DMS) pays KYTC a monthly [capitation](https://nemtguide.com/glossary/capitation/) rate for each Medicaid member, and KYTC pays it out to each region's broker. These are the per-member monthly rates DMS and KYTC showed lawmakers on November 5, 2025:

| Region | Broker's rate per member per month |
|---|---|
| 1 | $8.33 |
| 3 | $7.87 |
| 4 | $9.12 |

That money pays GRITS to run the region. It is not what a provider earns per trip. KYTC sets provider rates separately, as shown below.

KYTC picks each region's broker through a request for proposals under KRS Chapter 45A. Under 603 KAR 7:080, a broker contract runs one year, July 1 to June 30, with up to four one-year renewals. Kentucky's federal waiver for the program, which runs from April 1, 2025 through March 31, 2027, says each region is on its own bidding timeline.

### Who rides

A Medicaid member qualifies for a ride to a medically necessary, Medicaid-covered service when the member has no working vehicle, or has one that cannot be used for the trip and sends the Cabinet a doctor's, mechanic's, employer's, or school's statement. Qualified Medicare Beneficiaries and KCHIP Phase III children are excluded. HSTD also carries Kentucky Works, vocational rehabilitation, and aging services riders. Stretcher rides are not part of the program. The [Kentucky state guide](https://nemtguide.com/states/kentucky/) covers eligibility in full.

## How to become a GRITS subcontractor

KYTC sets the same steps for every regional broker. Calling GRITS first tells you what it needs before you buy vehicles or insurance.

1. **Call GRITS first.** Ask the transportation office at 270-686-1651 which counties and service types it needs, and which insurance limits its subcontract requires.
2. **Form your company.** Depending on how you set it up (LLC, corporation, or sole proprietor), you may need to file with the Kentucky Secretary of State. Get your employer identification number from the IRS and an [NPI](https://nemtguide.com/guides/how-to-get-an-npi-number-for-nemt/).
3. **Get operating authority.** Apply to the Division of Motor Carriers (502-564-1257) for a Taxi or Disabled Persons Vehicle (DPV) certificate in its Motor Carrier Portal. Before you apply, your insurer files a Form E, you have at least one vehicle with a county clerk plate, and a technician inspection and nationwide background checks are done. Allow up to 14 business days.
4. **Qualify every vehicle.** Motor Carriers issues a license plate and a fee receipt card for each one.
5. **Meet with GRITS.** Tell GRITS you hold a certificate. It reviews the subcontract with you, inspects your vehicles, and copies your insurance, registrations, workers' compensation proof, certificate, and fee receipt cards.
6. **Set up testing and training.** Every employee and driver goes into the statewide random drug and alcohol pool. Safety-sensitive staff pass background checks and pre-employment drug and alcohol tests, and drivers finish the required training. GRITS walks you through it.
7. **Enroll with Kentucky Medicaid.** Fill out one MAP-811 for each service type, sign it, and give it to GRITS to sign page 12. Then submit it in the Kentucky Medicaid Partner Portal (KY MPPA) with the signed page, your operating certificate, and an IRS letter showing your employer identification number (a W-9 does not count).
8. **Hand GRITS your welcome letters.** Medicaid sends a welcome letter with a provider number for each approved type. GRITS forwards your file to the Office of Transportation Delivery and is told when you can start.
9. **Go to orientation.** GRITS must hold an orientation meeting with you before your first trip.

KYTC requires every new provider to keep at least three active, approved drivers and three operational passenger vehicles. A subcontractor cannot sign with a broker until the Cabinet approves it, and any rides before your Medicaid effective date are at your own financial risk.

### Which Medicaid numbers to apply for

Enter provider type 56 in box 7 of the MAP-811 and the specialty code in box 8. The MAP-811 checklist also asks for proof of your NPI and [taxonomy code](https://nemtguide.com/glossary/taxonomy-code/).

| Type | Riders | Specialty code | Who applies |
|---|---|---|---|
| 02 | Walk and need no special help | 263 | For-profit companies |
| 04 | Walk and need no special help (ambulatory bus) | 262 | Nonprofits |
| 07 | Walk but are disoriented and may need an escort | 264 | For-profit or nonprofit |
| 08 | Use a wheelchair | 265 | For-profit or nonprofit |

### What the state charges

| Item | Cost as of September 2026 | Rule |
|---|---|---|
| Taxi or DPV certificate application | $250 | KRS 281.630 |
| Certificate renewal | $250 every year | KRS 281.630 |
| Motor carrier vehicle license | $30 per vehicle a year | KRS 281.631 |
| City or county vehicle license, where charged | Up to $30 per vehicle a year | KRS 281.631 |
| Kentucky Medicaid enrollment, provider type 56 | No application fee | DMS application fee list |

Type 56 is not on DMS's list of provider types that pay the federal enrollment fee, which is $750 in 2026. A certificate not renewed within one calendar year of its renewal date is void.

## What GRITS checks: drivers, vehicles, and insurance

GRITS must remove any vehicle that fails licensing, operating authority, or safety rules. Get these right before the inspection.

### Drivers and escorts

Under 603 KAR 7:080 and KRS 281.6301, a person cannot drive or escort GRITS riders for you if they:

- Are under 18, or are not licensed in Kentucky for the vehicle they drive.
- Have more than two moving violation convictions in the last 3 years.
- Were ever convicted of a sexual crime, a crime of violence, or a Class A or B felony.
- Were ever convicted of leaving the scene of an accident, causing a death by negligent driving, or using a vehicle in a drug felony.
- In the last 3 years, were convicted of driving on a suspended license, going 26 mph or more over the limit, or racing, or have four speeding or points convictions.
- Have a misdemeanor or felony conviction in the last 5 years, unless GRITS, your company, and the Cabinet approve them first.

Run each nationwide background check before the person starts, through a company on the Division of Motor Carriers' approved list, and keep it at least 3 years. Repeat it every 3 years when you renew your certificate. Drivers also need a pre-employment drug test, random testing, orientation and safety training (first aid, bloodborne pathogens, passenger assistance), a name tag, and a company photo ID. Our [driver drug testing guide](https://nemtguide.com/guides/nemt-driver-drug-testing/) covers the written policy you need.

### Vehicles

Each vehicle passes a safety inspection by an automotive technician before its first HSTD rider and every year after, with written proof on file. Items that often decide an inspection under 603 KAR 7:080:

- A two-way link with dispatch, used in a way that keeps rider information private.
- Working heat and air conditioning. Without it, the vehicle is out of service until fixed.
- A clean seat belt for every seat, stored off the floor, two seat belt extensions, and a belt cutter above the driver's door.
- A fire extinguisher with a current tag, three reflective triangles, a first aid kit, and a spill kit.
- A retractable step or a metal step stool with nonskid tips when the floor sits more than 12 inches up. A milk crate never counts.
- Your legal company name on the driver and passenger side doors in 2-inch block letters, and inside, your name, the vehicle number, and the program's customer service number.

Wheelchair vehicles must meet the Americans with Disabilities Act rules. The [Kentucky state guide](https://nemtguide.com/states/kentucky/) has the full list, and our [vehicle inspection checklist](https://nemtguide.com/templates/nemt-vehicle-inspection-checklist/) helps you prepare.

### Insurance

Your insurer files proof with the Division of Motor Carriers, and the policy covers every vehicle under your certificate. KRS 281.655 sets these minimums per vehicle as of September 2026:

| Coverage | Up to 7 regular seats | 8 or more regular seats |
|---|---|---|
| Injury or death, one person | $100,000 | $100,000 |
| Injury or death, all people in one accident | $300,000 | $600,000 |
| Property damage | $50,000 | $50,000 |

GRITS also collects proof of Kentucky workers' compensation. Ask GRITS for its required limits and certificate wording in writing before you buy. See [NEMT insurance requirements](https://nemtguide.com/guides/nemt-insurance-requirements/).

## How GRITS books riders and sends trips

Riders call GRITS at least 72 hours before the appointment, weekends and holidays included. GRITS takes up to three trips per call. Booking runs 8 a.m. to 4:30 p.m. on weekdays and 8 a.m. to 1 p.m. on Saturday, and rides run 6 a.m. to 8 p.m. on weekdays and 8 a.m. to 1 p.m. on Saturday. Everything closes on New Year's Day, Memorial Day, July 4, Labor Day, Thanksgiving, and Christmas.

Some trips skip the 72 hours. Urgent care rides, for a rider who must be seen within 12 hours, run around the clock once a clinician verifies them. Hospital discharges run during ride hours without the 72-hour notice. GRITS may also schedule dialysis, chemotherapy, or radiation outside normal hours. Riders must be ready 15 minutes before pickup and cancel at least 24 hours ahead.

### Who gets each trip

- **Rider's choice.** A Type 07 or Type 08 rider may name any eligible subcontractor in the region, or GRITS, and still books through GRITS (KRS 281.874). GRITS may offer the same choice to Type 02 riders.
- **No preference.** 603 KAR 7:080 tells the broker to assign trips by coordination first, then cost, and then by rotating Type 07 and 08 trips among providers, GRITS included.
- **Shared rides.** Riders who need no special vehicle can be grouped, or sent by taxi, bus, or private auto.

Once a trip is yours, you drive it. You may not pass it to another provider, decide a rider's eligibility or type of transport, or solicit Medicaid trips.

GRITS also posts rules for every passenger: seat belts on, no smoking, eating, or drinking, no weapons or flammable liquids, and no pets except service animals unless they ride in a kennel. Your drivers should know them.

## Rates and how GRITS pays you

KYTC, not GRITS, sets one rate for each service type in each region, the same for every provider there, GRITS included. It weighs terrain, trip distance, population, medical and job sites, labor costs, and use of services, and gives brokers 45 days of notice before a change. Its report for state fiscal year 2023 says rates took effect July 1, 2022, were adjusted May 1, 2023 in six regions including all three GRITS regions, and are subject to quarterly review. For how Kentucky's approach compares with other states, see [NEMT reimbursement rates](https://nemtguide.com/guides/nemt-reimbursement-rates/).

| Step | When |
|---|---|
| You invoice GRITS | By the 1st of the month for that month's billing. A later invoice rolls to the next month |
| GRITS reports to KYTC | By the 7th |
| KYTC pays GRITS | By the 15th, once the reports and the Medicaid eligible count are in |
| GRITS pays you | Within 3 business days of being paid (KRS 281.875) |
| Last day to bill a trip | 6 months after the date of service |

For example, send March's invoice by April 1. If KYTC pays GRITS on April 15, GRITS owes you within 3 business days after that.

Under 603 KAR 7:080, the broker reports every broker and subcontractor trip to the Cabinet with the amount paid for each one-way trip, plus a monthly count of each provider's vehicles. Keep encounter data for every trip and all program records for 5 years. Report any moving violation or accident on a trip to GRITS at once, and the broker must tell the Cabinet within 24 hours. Clean [trip documentation](https://nemtguide.com/guides/nemt-trip-documentation/) protects your pay in an audit.

## What House Bill 2 changes for GRITS providers

Kentucky's HB 2 became Acts Chapter 179 on April 14, 2026, when the General Assembly overrode the governor's line-item vetoes. Section 14 sets new rules for every regional broker, GRITS included:

- **GPS in every vehicle.** Each vehicle used for Medicaid rides needs a GPS device that shows the broker its location during trips. The broker pays for it, not the state.
- **Pay tied to performance.** 2% of each broker's capitation is held back and earned back on measures that include trips completed, canceled or rescheduled, and delayed, average trip time and miles, time to schedule, and rider satisfaction.
- **Spending floors.** Each broker must reach a medical loss ratio, the share of capitation spent on services rather than administration and profit, of at least 85% in the state fiscal year that began July 1, 2026. The floor rises to 87% from July 1, 2027, 89% from July 1, 2028, and 90% from July 1, 2029, and a broker that misses it returns the excess capitation.
- **Facility rides.** A hospital or skilled nursing facility may drive its own patients or residents and be paid by the broker at the mileage rate the broker pays a contracted driver.

Section 29 directs the Medicaid Oversight and Advisory Board to review the regional broker system and other states' models and report by December 31, 2026. Starting in 2027, DMS must report on the program each year by July 1. If DMS finds that part of Section 14 needs federal approval, Section 27 lets it hold only that part until the approval comes. Ask GRITS which GPS device it will use and when. Our [HB 2 report](https://nemtguide.com/news/kentucky-hb2-nemt-changes/) covers the full law.

## Who to call

| For | Contact |
|---|---|
| GRITS transportation office (subcontracts, Medicaid signatures) | 270-686-1651, 222 St. Elizabeth Street, Owensboro, KY 42301 |
| Audubon Area Community Services main office | 270-686-1600, 1700 West 5th Street, Owensboro, KY 42301 |
| GRITS rider booking, Region 1 | 270-575-9119 or 844-575-9676 |
| GRITS rider booking, Region 3 | 270-686-1651 or 800-816-3511 |
| GRITS rider booking, Region 4 | 270-982-8220 or 844-870-4646 |
| Operating authority (Division of Motor Carriers) | 502-564-1257 |
| HSTD program (Office of Transportation Delivery) | 502-564-7433, weekdays 8 a.m. to 4:30 p.m. Eastern |
| HSTD customer service and complaints | 888-941-7433 |
| Kentucky Medicaid enrollment (KY MPPA contact center) | 877-838-5085 |

Before you call GRITS, have your certificate, vehicle list, insurance declarations, and driver roster ready. Our [credentialing checklist](https://nemtguide.com/templates/nemt-credentialing-checklist/) keeps the file in one place. To compare with the broker for Louisville, Lexington, and Northern Kentucky, see [FTSB](https://nemtguide.com/brokers/ftsb/), and for how other states buy rides, see [how states run NEMT](https://nemtguide.com/guides/how-states-run-nemt/).

## Frequently asked questions

### Which counties does GRITS cover for Medicaid rides?

As of September 2026, the Kentucky Transportation Cabinet lists GRITS as the broker for three regions. Region 1 is Ballard, Calloway, Carlisle, Fulton, Graves, Hickman, Marshall, and McCracken. Region 3 is Daviess, Hancock, Henderson, McLean, Ohio, Union, and Webster. Region 4 is Breckinridge, Grayson, Hardin, LaRue, Marion, Meade, and Nelson.

### Is GRITS the same as Audubon Area Community Services?

GRITS is a program of Audubon Area Community Services, Inc., a nonprofit community action agency based at 1700 West 5th Street in Owensboro. The Cabinet lists the broker as Audubon Area Community Services, Inc. (GRITS). The GRITS transportation office is at 222 St. Elizabeth Street in Owensboro, and its number, 270-686-1651, is the one the Cabinet lists for GRITS in all three regions.

### How much does GRITS pay per trip?

The Kentucky Transportation Cabinet sets the rate, not GRITS. Under 603 KAR 7:080, the Cabinet sets one rate for each service type in each region, the same for every provider there, GRITS included. It gives brokers 45 days of notice before a change. Your subcontract lists the current rates, so ask GRITS for them for each region you would serve.

### How fast does GRITS pay subcontractors?

KRS 281.875 requires a broker to pay subcontractors within 3 business days after the Cabinet pays the broker. The Cabinet pays brokers by the 15th of the month once their reports arrive by the 7th. Send your invoice by the 1st, because one dated later rolls into the next month, and bill every trip within 6 months of the date of service.

### Do I need a Kentucky Medicaid number to take GRITS trips?

Yes. You file a MAP-811 for each service type you will run, as provider type 56, and GRITS signs page 12 before you submit it in the Kentucky Medicaid Partner Portal (KY MPPA). A for-profit company applies for Types 02, 07, and 08, and a nonprofit for Types 04, 07, and 08. Type 56 is not on the list of provider types that pay an enrollment fee.

### Can a Medicaid rider ask GRITS to send my company?

Yes, when the rider is classified as Type 07 (walks but may need an escort) or Type 08 (wheelchair). KRS 281.874 lets those riders choose any eligible subcontractor in the region or GRITS itself, and they still book through GRITS. The broker may also offer that choice to Type 02 riders who walk. You may never solicit Medicaid trips.

### Can I run stretcher trips through GRITS?

No. Kentucky's NEMT waiver for April 1, 2025 through March 31, 2027 leaves stretcher rides out of the broker program. Members in a Medicaid health plan get them through the plan, and other members through fee-for-service Medicaid, as nonemergency ambulance service.

## Official resources

- [GRITS Transportation (Audubon Area Community Services)](https://www.audubon-area.com/services/transportation/)
- [KYTC: How to become a subcontract NEMT provider](https://transportation.ky.gov/TransportationDelivery/Pages/Non-Emergency-Medical-Transportation-Provider.aspx)
- [KYTC: Regional brokers and the counties they serve](https://transportation.ky.gov/TransportationDelivery/Pages/Human-Services-Transportation.aspx)
- [Kentucky Division of Motor Carriers: Passenger vehicle certificates](https://drive.ky.gov/Motor-Carriers/Pages/Passenger-Vehicle.aspx)
- [Kentucky Medicaid: MAP-811 Provider Application](https://chfs.ky.gov/agencies/dms/MAPForms/Map811.pdf)
- [Kentucky Medicaid Partner Portal (KY MPPA)](https://medicaidsystems.ky.gov/Partnerportal/home.aspx)
- [Kentucky Administrative Regulations: 603 KAR 7:080](https://apps.legislature.ky.gov/law/kar/titles/603/007/080/)
- [HHS OIG: List of Excluded Individuals and Entities](https://oig.hhs.gov/exclusions/)