# Medicaid Surety Bond for NEMT: Which States Require One, How Much, and How to Get It

Canonical URL: https://nemtguide.com/glossary/medicaid-surety-bond/ · Updated 2026-10-02

A Medicaid surety bond is a surety company's promise to your state Medicaid agency that it will repay what you owe the program, such as payments on duplicate or false claims, up to the bond amount. Each state sets its own rule. As of October 2026, Indiana requires at least $50,000 for three years from taxi and common carrier companies, and Minnesota, Florida, and New York require bonds too.

- The bond protects the state Medicaid program, not you. Your liability insurance is a separate thing.
- Indiana asks taxi, common carrier, TNC, and broker fleet providers for at least $50,000 lasting at least three years, on State Form 55382.
- A Minnesota law signed May 27, 2026 makes DHS require a $50,000 or $100,000 bond, bought new each year.
- New York asks ambulette companies in six counties, and new owners there and in New York City, for up to $100,000 a year.
- Put the bond's end date on your calendar. A lapsed bond can end your enrollment.

## How a Medicaid surety bond works

A Medicaid surety bond has three parties. You are the principal, the state Medicaid agency is the obligee, and a surety company backs your promise. If the state finds you were paid for claims you should not have been, it can collect from the surety up to the bond amount.

The requirement is a state rule. The federal screening and enrollment rules every state follows, 42 CFR part 455, contain no bond requirement. That is why the amount, the form, and who must post one change from state to state.

The bond is not your insurance. Your auto and liability policies pay people who make claims against you. The Medicaid bond pays the state. It is also different from a [performance bond](https://nemtguide.com/glossary/performance-bond/), which backs a single county, school, or transit contract.

## Which states require one for NEMT

As of October 2026, these state Medicaid programs require a bond from some ride or medical transportation companies:

| State | Who must post one | Amount and term |
|---|---|---|
| Indiana | Taxi, common carrier (ambulatory and nonambulatory), TNC, and broker fleet providers | At least $50,000, lasting at least three years |
| Minnesota | Providers enrolling, revalidating, reinstating, or staying enrolled, under the 2026 law | $50,000, or $100,000 after a year over $300,000 in Medicaid revenue; bought new yearly |
| Florida | Non-emergency, multi-load, and taxicab providers, unless contracted through the transportation coordinator | Up to the greater of $50,000 or the year's billing |
| New York | New ambulette companies in six counties, new owners there and in New York City, and high billers statewide | $100,000 a year, or $25,000 per ambulette if lower; renewed yearly |
| Texas | Durable medical equipment suppliers and private ambulance companies, not ride companies | At least $50,000 per location, as a continuous bond with 12-month terms |

Check your own state's enrollment manual for the specialty you will enroll under. Florida's policy also lets AHCA ask a bond of moderate and high risk providers, so see [provider risk levels](https://nemtguide.com/glossary/provider-risk-levels/) and [how to become a Medicaid transportation provider](https://nemtguide.com/guides/how-to-become-a-medicaid-transportation-provider/).

## Indiana's bond in practice

Indiana's rule comes from IC 12-15-11-2.5 and applies to provider type 26, Transportation, in specialties 263 (taxi), 264 (common carrier, ambulatory), 265 (common carrier, nonambulatory), 267 (TNC), and 269 (broker fleet), per the September 8, 2026 enrollment module. Bus companies (262) and family member drivers (266) are not on the list. Say you are opening a wheelchair van company in Indianapolis and enrolling as specialty 265:

1. **Check the exemptions.** A 501(c)(3) nonprofit, or a company owned or controlled by a licensed hospital, a licensed pharmacy, or a person licensed or certified by the Indiana Professional Licensing Agency, needs no bond.
2. **Ask for a waiver if it fits.** FSSA may waive the bond in a federal or state underserved area, or when it finds you a low fraud risk. Send a written request with your IHCP Portal application or paper packet saying why you qualify. Indiana holds the application until it decides, and if it says no, you have 30 days from the notice to send the bond.
3. **Give your insurance broker Indiana's terms.** The bond goes on State Form 55382. It names your company as principal and the Office of Medicaid Policy and Planning as obligee, covers at least $50,000, and stays in force at least three years after you apply.
4. **Send proof with your application.** Proof of the bond is a required document for specialties 263, 264, 265, 267, and 269, along with your Motor Carrier Services certificate or USDOT registration if you are a for-profit common carrier.

Here is what the bond does later. Say Indiana finds it paid you $8,000 for duplicate trips. It sends the surety written notice with its evidence, and the surety must pay within 30 days: the $8,000, accrued interest, and any assessment the state imposed, up to the bond amount. One recovery does not end the bond, so the state can claim again until the bond amount is used up. The bond also stays in force to the end of its term even if your provider agreement ends. The [Indiana state guide](https://nemtguide.com/states/indiana/) covers the rest of the enrollment.

## Minnesota's 2026 bond

Minnesota's chapter 121, signed May 27, 2026, adds a new section 256B.044 to state law. Subdivision 6 says DHS must require a provider to buy a surety bond as a condition of enrollment, reenrollment, revalidation, reinstatement, or continued enrollment. A new provider, or one with $300,000 or less in Medical Assistance revenue the year before, buys a $50,000 bond. Above $300,000, it is $100,000. The same law strikes the older rule that let DHS ask for a bond only from providers that failed financial checks, showed signs of fraud, or were rated high risk.

The bond names DHS as obligee, is bought new each year, and must cover the costs of pursuing a claim on it. DHS has six years from a final agency decision on a debt to recover from it. Providers that already carry a bond as personal care assistance, recuperative care, or community first services and supports agencies are exempt.

The bond section carries no start date of its own, and the House's summary of the law says it takes effect July 1, 2026, unless noted otherwise. Ask MHCP provider enrollment how and when it is collecting the bond from transportation providers before you apply or revalidate. The [Minnesota state guide](https://nemtguide.com/states/minnesota/) covers the rest of the 2026 changes.

## Florida and New York

**Florida.** Section 409.907(7) of the Florida Statutes lets AHCA require a bond from providers paid fee for service or on a fee schedule that is not cost based, before signing the provider agreement or to keep it. The cap is $50,000 or your billing in the current or most recent calendar year, whichever is greater. A new provider's amount is set from its own estimate of first-year billing, and AHCA can ask for an added bond if billing runs higher. The bond goes on AHCA Form 5000-1064. See the [Florida state guide](https://nemtguide.com/states/florida/).

**New York.** OMIG asks for a bond from new ambulette companies with service addresses in Nassau, Westchester, Monroe, Erie, Orange, and Suffolk counties, and from a new entity buying an ambulette company there or in New York City. OMIG contacts you once you are otherwise eligible, and you have 90 days to post the bond or the application is denied. If you expect less than $500,000 in ambulette billing in your first full year, you can send a letter with your application asking for an exception, with your billing estimate and the number of ambulettes you own, lease, or plan to add. Anywhere in the state, an ambulette company that applied on or after March 1, 2011 and bills over $500,000 a year or $42,000 in a month must post one within 90 days. See the [New York state guide](https://nemtguide.com/states/new-york/).

## Other bonds a ride company may need

- **State carrier bonds.** Virginia DMV requires a $25,000 surety bond or letter of credit for a non-emergency medical transportation carrier certificate, kept on file for three years from the date the certificate is issued. It is a DMV rule, not a Medicaid one. See the [Virginia state guide](https://nemtguide.com/states/virginia/).
- **Interstate trips.** A for-hire passenger carrier crossing state lines needs at least $1.5 million in public liability for a vehicle seating 15 or fewer, driver included (49 CFR 387.33T). It proves this with an [MCS-90B](https://nemtguide.com/glossary/mcs-90b/) insurance endorsement or an MCS-82B surety bond kept at its main office (49 CFR 387.31). See [NEMT insurance requirements](https://nemtguide.com/guides/nemt-insurance-requirements/).
- **Contract bonds.** Some county and school ride contracts ask for bid and performance bonds. See [performance bond](https://nemtguide.com/glossary/performance-bond/).

For the licenses and permits that come before Medicaid enrollment, see [NEMT license requirements](https://nemtguide.com/guides/nemt-license-requirements/).

## Frequently asked questions

### How much does a Medicaid surety bond cost?

The surety sets your premium, and you pay a fraction of the bond amount. New York's Medicaid transportation manual (effective August 25, 2023) tells ambulette applicants that sureties are insurance companies and that the bond amount is much higher than what the bond actually costs the applicant. Indiana tells providers to get the bond through a licensed insurance broker and to hand the broker the state's exact bond terms, so ask two or three for quotes on those terms.

### Is a Medicaid surety bond the same as insurance?

No. Your auto and liability policies pay claims made against you. A Medicaid surety bond pays the state. Indiana's bond, for example, makes the surety liable for duplicate, erroneous, or false Medicaid claims paid to you during the bond's term, and the surety must pay within 30 days of the state's written notice, up to the bond amount.

### Do I need a Medicaid surety bond to work only for a broker?

It depends on the state. Florida's enrollment policy (February 2026) lists the bond for non-emergency, multi-load, and taxicab transportation providers but says it is not required if you are contracted through the transportation coordinator. Indiana ties its bond to Medicaid enrollment in the listed specialties, so read your state's enrollment manual for the specialty you will enroll under.

### What happens if my Medicaid surety bond lapses?

You can lose your enrollment. New York ends an ambulette provider's enrollment if it does not renew the bond by its expiration date, and it sends a renewal notice at least 60 days before. Florida may end your provider agreement as of the date your required bond was no longer in place, and it can require you to replace an expired bond within 30 days of its expiration date.

### Are nonprofit ride companies exempt from Indiana's bond?

Yes. Indiana exempts 501(c)(3) nonprofits, along with companies owned or controlled by a hospital licensed by the Indiana Department of Health, a pharmacy with an Indiana Board of Pharmacy permit, or a person licensed or certified by the Indiana Professional Licensing Agency. FSSA can also waive the bond in an underserved area or for a provider it finds low risk.

## Official resources

- [Indiana Medicaid: Surety Bond Requirements to hand your surety agent](https://www.in.gov/medicaid/providers/files/indiana-medicaid-surety-bond-requirements.pdf)
- [Indiana Health Coverage Programs: Provider Enrollment module](https://www.in.gov/medicaid/providers/files/modules/provider-enrollment.pdf)
- [Florida AHCA: Florida Medicaid Provider Enrollment Policy](https://ahca.myflorida.com/content/download/28712/file/Provider%20Enrollment%20Policy.pdf)
- [New York eMedNY: Medicaid Transportation Policy Manual](https://www.emedny.org/ProviderManuals/Transportation/PDFS/Transportation_Manual_Policy_Section.pdf)