# How to Hire NEMT Drivers in 2027: Where to Find Them and How to Screen

Canonical URL: https://nemtguide.com/guides/hire-nemt-drivers/ · Updated 2026-09-28

To hire NEMT drivers, post the pay, hours, and your broker's driver rules, then recruit through referrals, American Job Centers, and people who already drive or care for others. Screen in the order that costs least: knock-out questions, free exclusion searches, an interview and road test, then a conditional offer before you pay for the driving record, background check, and drug test.

- Your broker's driver rules are the hiring standard. Turn each one into a screening question before you post the job.
- Run the free checks and your interview first, and pay for the driving record, background check, and drug test only after a conditional offer.
- No medical or disability questions before the offer. A lift or wheelchair demo that every applicant takes is allowed.
- A check from a screening company needs a stand-alone disclosure, written consent, and a notice both before and after you turn someone down.
- Keep new drivers off broker trips until credentialing clears, or those trips can go unpaid.

Broker trips need drivers the broker has approved. MTM Health's Virginia handbook (May 2026) warns that trips done by drivers with expired documents, or drivers it never approved, can lose payment. So hiring is two jobs at once: finding people who are good with riders, and proving to the payer that they qualify.

The hiring never really stops. The Bureau of Labor Statistics projects about 35,500 openings a year from 2025 to 2035 for shuttle drivers and chauffeurs, the job group that includes NEMT drivers. Nearly all of them, about 33,700, replace drivers who stop working or move to another occupation. Only a small share are new positions.

## What a NEMT driver needs before you can hire them

Federal law sets a short floor. Section 1902(a)(87) of the Social Security Act, added by the Consolidated Appropriations Act, 2021, makes every state ensure that each NEMT provider and driver it pays meets four minimums:

- The driver is not excluded from federal health programs or listed on the HHS OIG exclusion list.
- The driver has a valid driver's license.
- Your company has a process to deal with any violation of a state drug law.
- Your company has a process to report each driver's driving history, including traffic violations, to the state Medicaid program.

CMS explained these rules in its Medicaid Transportation Coverage Guide on September 28, 2023. It added that states can set more standards, such as limits on license points or a health certification. Your broker's contract adds more on top. Here is how three payers compare: MTM Health's standard provider agreement (January 1, 2023 version), its Virginia handbook (May 2026), and the Texas rules for Medicaid health plans (Uniform Managed Care Manual chapter 16.4).

| Rule | MTM standard | MTM Virginia | Texas plans |
|---|---|---|---|
| Minimum age | 21 | 21, with two years of driving experience | 18 |
| Driving record | Fewer than 3 at-fault moving violations and fewer than 2 at-fault accidents in 36 months | No more than 2 chargeable accidents or moving violations in 3 years, and no suspension for moving violations in 5 years | No more than 1 moving violation in any 12 months, and no DWI in the 7 years before hire |
| Criminal history | No sexual or violent crime conviction. A felony in the last 7 years needs the client's approval. | No barrier crimes under Virginia law | No abuse, neglect, or exploitation conviction ever. No listed felony or misdemeanor in 7 years. |
| Checks | Criminal background check before hire and every year. Three-year driving record every year. | State Police or national criminal check and a sex offender registry check before the first ride | State and national criminal history checks and a DPS driving record. Sex offender registries and exclusion databases before hire and every year, with OIG and SAM every month. |
| Drug and alcohol | Tests before hire, after an accident, on suspicion, and at random. No positive test or treatment in 5 years. | No alcohol, illegal drugs, or misused prescriptions on duty | A testing program that follows 49 CFR parts 40 and 655 |
| Training | Fraud, waste, and abuse, and HIPAA | PASS, HIPAA, and defensive driving before the first ride, plus first aid and wheelchair securement where they apply | Passenger assistance, safety, lifts and tie-downs, and defensive driving within 30 days of hire |

Read your own broker's driver section before you write a job post, and turn every rule into a screening question. The state-by-state picture is in [NEMT driver requirements](https://nemtguide.com/guides/nemt-driver-requirements/), and MTM's full list is on our [MTM Health page](https://nemtguide.com/brokers/mtm-health/).

A commercial license is rarely part of it. Under 49 CFR 383.5, a CDL is needed for a vehicle designed to carry 16 or more people including the driver, or rated at 26,001 pounds or more. See do NEMT drivers need a CDL.

## Where to find good NEMT drivers

The best NEMT drivers are patient, on time, and careful with people who need help. Those traits matter more than years of commercial driving. BLS says the job typically needs no formal education and only short-term on-the-job training, so you can hire for character and teach the rest.

- **Your own drivers.** Ask them who they would want to work beside. Pay a referral bonus once the new driver finishes training and stays a set number of weeks.
- **American Job Centers.** There are about 2,300 of them nationwide, according to the Labor Department. Their staff help employers write job orders, match job seekers to openings, and run job fairs. Veterans get priority referrals. Find the nearest one through CareerOneStop or call 1-877-US-2JOBS (1-877-872-5627).
- **On-the-job training money.** Under a WIOA on-the-job training contract, your local workforce board can typically reimburse up to 50 percent of a trainee's wage while you train them, and up to 75 percent in some cases, with employer size one of the factors (20 CFR 680.700 and 680.730). The new hire must be a program participant first, so ask your American Job Center before you make the offer.
- **People who already drive or care for others.** Former school bus, paratransit, and shuttle drivers know the road side. Home health aides and nursing assistants know the rider side.
- **Retirees.** In 2025 the median age of employed shuttle drivers and chauffeurs was 47.6, and about one in five was 65 or older, according to the Current Population Survey. Part-time shifts, such as dialysis mornings, can reach them. See part-time NEMT drivers.
- **Local groups.** Churches, senior centers, and veterans' posts reach steady, service-minded people.

One tax break is on hold. The Work Opportunity Tax Credit, generally up to $2,400 per qualifying hire, covers only people who started work by December 31, 2025, and as of September 2026 Congress has not extended it. Washington's workforce agency says employers who apply on time for 2026 hires could still get the credit if Congress brings it back. The application, Form 8850, is due to your state workforce agency within 28 days of the start date, so ask your agency whether it still takes them.

### What to put in the job post

1. **The pay plan in dollars.** Say whether you pay by the hour, trip, or shift, and give the range. See [NEMT driver pay](https://nemtguide.com/guides/nemt-driver-pay/).
2. **The real schedule.** Early dialysis starts, split days, and weekends.
3. **The vehicle and the work.** Sedan, wheelchair van, or stretcher van, and whether drivers push wheelchairs or help riders to the door.
4. **The broker's rules in plain words.** Minimum age, years licensed, and driving record limits.
5. **The training you pay for.** PASS, first aid, and defensive driving.
6. **How to apply** and how fast you will answer.

Describe the job, not the person you picture in it. The EEOC warns that an ad seeking "recent college graduates" can discourage people over 40. In California, an ad that says "No felons" or "Must have clean record" breaks the Fair Chance Act.

## The screening order that saves money

Every paid check costs you for each person who reaches it, so put the paid checks last. Put the free checks and your own judgment first, and use a written conditional offer as the gate between them. This order also follows the law: medical questions, and in California any criminal history question, must wait until after a conditional offer.

| Step | What it costs you | Why it goes here |
|---|---|---|
| 1. Application with knock-out questions | Nothing | Filters out anyone your broker would reject |
| 2. Free exclusion searches | Nothing | An excluded driver cannot work any Medicaid trip |
| 3. Phone screen | About 10 minutes | Catches schedule and pay mismatches early |
| 4. Interview, road test, and assistance demo | An hour or so | Shows who is good with riders and safe in your van |
| 5. Conditional written offer | Nothing | Opens the door to medical and criminal history checks |
| 6. Driving record | Paid | A record outside the broker's limits ends the process before you pay for anything else |
| 7. Criminal background check, registry search, and drug and alcohol tests | Paid | Only for people you want to hire |
| 8. Hiring paperwork | Your time | Federal deadlines start on the first day of work |
| 9. Training and broker credentialing | Paid training | No broker trips until approval |

### 1. Ask knock-out questions on the application

Ask only what your broker's rules make decisive. Is the applicant at least the broker's minimum age? How many years have they held a license? Can they work the listed hours? Can they help a rider in and out of a wheelchair and lift a folded one, with or without a reasonable accommodation? Our [NEMT driver application form](https://nemtguide.com/templates/nemt-driver-application/) is built around these.

Leave criminal history off the application. The EEOC recommends that employers not ask about convictions on job applications, and California bars the question before an offer. In California, save questions about traffic convictions for the driving record step too.

### 2. Run the free exclusion searches yourself

Search each applicant on the [OIG exclusion list](https://nemtguide.com/glossary/oig-exclusion-list/) at oig.hhs.gov/exclusions and on the exclusions list at SAM.gov. Both are free. OIG says to check before you hire. Because it updates its list every month, it says monthly rechecks best limit your risk. Print or save the results page for the driver's file. Texas health plans must check both lists every month. See SAM exclusions.

### 3. Do a 10-minute phone screen

Confirm the hours, the pay plan, the vehicle, and the start date. Anyone who cannot work the schedule drops out here, before costing you anything.

### 4. Interview, road test, and assistance demo

Use the questions in the next section, and ask every candidate the same ones. Then ride along on a set route in your own van. Finish with the physical parts of the job: folding and lifting a wheelchair, working the lift, and helping someone step up.

The EEOC says a test where applicants show they can do real or simulated job tasks is not a medical exam, as long as you do not take blood pressure or heart rate. Give the same test to everyone applying for that job. If an applicant needs an accommodation for the demo, provide it or let them describe how they would do the task. The driver ride-along checklist keeps the scoring fair.

### 5. Make a conditional offer in writing

State the pay, the hours, the start date, and that the offer depends on passing the checks your broker requires. After the offer, you may ask medical questions or require an exam, but only if every new driver in the same job gets the same questions or exam.

### 6. Pull the driving record first

If a screening company pulls it, get the Fair Credit Reporting Act disclosure and consent first (see below). MTM's standard agreement asks for three years of history, renewed every year. Compare the record with the broker's limits before you order anything else. See what an MVR check shows.

### 7. Run the background check, registry search, and drug test

Match your broker's definition of a background check. MTM's standard agreement defines it as a federal and FBI check or the equivalent, including a national criminal record search, a Social Security number trace, a national database search, and county court searches for past addresses and names. Texas health plans need a state check through the Department of Public Safety plus a national check. Add the free Justice Department sex offender search at NSOPW.gov, which covers every state's public registry.

The ADA does not treat a test for illegal drugs as a medical exam, so it does not limit when you test. An alcohol test is different: the EEOC treats it as a medical exam, so it waits until after the offer. MTM's standard agreement requires drug and alcohol screening before hire. See NEMT driver background checks, NEMT driver drug testing, and marijuana and NEMT drivers.

### 8. Finish the hiring paperwork

- **Form I-9.** The new driver completes Section 1 by the first day of paid work. You complete Section 2 within 3 business days, so a Monday start means Thursday.
- **Form W-4** for federal tax withholding.
- **New hire report** to your state's new hire directory within 20 days of hire, or sooner if your state sets a shorter deadline.
- **Driver file.** Start it with the [driver qualification file checklist](https://nemtguide.com/templates/nemt-driver-file-checklist/), and follow the [onboarding checklist](https://nemtguide.com/templates/nemt-driver-onboarding-checklist/) for the first week.

### 9. Train and credential before the first broker trip

MTM Health in Virginia requires training before a driver carries any member. Texas health plans set a deadline of 30 days from hire. Book PASS, first aid, and defensive driving, and cover HIPAA and fraud, waste, and abuse yourself or through the broker. Upload every document to the broker and wait for approval before you schedule the driver. The full plan is in [NEMT driver training](https://nemtguide.com/guides/nemt-driver-training/).

## Interview questions for NEMT drivers

Ask the same questions of every candidate, in the same order, and score each answer from 1 to 3 right after the interview. Mix questions about what the person has actually done with situations from a real NEMT day.

| Ask | A strong answer shows |
|---|---|
| Tell me about a time you helped someone who was upset or confused. | Patience, a calm voice, and no arguing |
| Your rider is not at the door at pickup time. Walk me through what you do. | A process: knock, call dispatch, wait the required time, write it down |
| You are running 20 minutes late for a dialysis pickup. What do you do first? | Calling dispatch early, never speeding to catch up |
| A rider becomes short of breath in your van. What do you do? | Pull over safely, call 911, then dispatch |
| A rider offers you $20 for being so kind. What do you say? | Declines politely. MTM Health's Virginia handbook bars drivers from accepting money or goods from members. |
| How do you plan a day with eight pickups and a will-call return? | Thinking ahead about timing and staying in touch |
| What would a past supervisor say about your attendance? | Honest, specific reliability |
| How comfortable are you using a phone app to record trips and get signatures? | Willingness to learn the tools |

For the tipping rules, see can NEMT drivers accept tips.

## Legal limits on interview questions and background checks

### Which federal laws cover your company

The EEOC's rules depend on your size. The equal pay law covers employers with at least one employee. The laws against discrimination based on race, color, religion, sex, national origin, disability, and genetic information cover employers with 15 or more. The age law, which protects people 40 and older, starts at 20. State laws can reach smaller companies. California's Fair Chance Act covers employers with five or more employees. The Fair Credit Reporting Act applies whenever a screening company runs a check, whatever your size.

### Before the offer: no medical or disability questions

| Do not ask before the offer | Ask this instead |
|---|---|
| Do you have any health problems or disabilities? | Can you do the tasks in this job description, with or without a reasonable accommodation? |
| What medications do you take? | Nothing yet. After the offer, if you ask every new driver. |
| Have you ever filed a workers' comp claim? | Nothing. The EEOC bars this question before an offer. |
| Have you ever been addicted to drugs? | Do you currently use illegal drugs? |
| How old are you? | Are you at least 21? (when your broker requires it) |
| Are you married, or do you have children? | Can you work the schedule listed, including early mornings? |

The EEOC says asking about race, sex, national origin, age, or religion is not banned outright, but the answers can be used as evidence of discrimination. Leave those questions out.

### Criminal records: use the broker's list, then look at the person

The EEOC's guidance on arrest and conviction records, issued April 25, 2012 and still posted as of September 2026, recommends this approach:

- **An arrest alone proves nothing.** Excluding someone for an arrest, without more, is not job related. The conduct behind it can be.
- **Three factors decide whether a conviction matters:** how serious it was, how long ago it happened or the sentence ended, and what the job involves.
- **Let the person respond.** Tell them the record may exclude them, and consider what they show you before you decide.
- **Federal bars are a defense.** Refusing to hire someone a federal rule excludes, such as a person on the OIG list, is lawful.

Federal enforcement shifted in 2026. On June 9, 2026, the Justice Department concluded that the EEOC's disparate-impact guidelines under Title VII are unconstitutional, and it said employers only need to show a screening practice serves a valid business purpose. State fair chance laws, such as California's below, still apply.

Broker rules are contract terms, not federal law. Apply them the same way to everyone, and for a record the broker does not list, weigh the three factors. The EEOC's guidance discusses a court case about a paratransit driver trainee in which the court pointed to the job's unsupervised access to vulnerable adults. That is the kind of job link to write down. See can a felon be a NEMT driver.

California goes further, according to its Civil Rights Department (fact sheet, June 2025). Employers with five or more workers cannot ask about convictions or run a check until after a conditional offer. They cannot consider arrests that did not lead to a conviction, sealed or dismissed records, or conviction history more than seven years old. If a record raises a concern, the employer must do an individualized assessment. It must send a written notice listing the convictions, with a copy of the report, and give at least five business days to respond before a final decision, or at least 10 days if the person disputes the report. The act does not apply to jobs where a law requires a background check or limits hiring based on criminal history. Even then, California bars criminal history rules that screen out a protected group without a business need. Other states and cities have their own fair chance rules, so check yours before you write the application.

### The Fair Credit Reporting Act steps for any screening company check

The FTC treats driving records, criminal histories, and license checks that screening companies supply to employers as consumer reports. That puts four steps on you:

1. **Disclose.** Give a written notice that you may get a report, in a stand-alone document. It cannot be part of the application.
2. **Get written permission.** It can go on the disclosure form. If you plan to recheck during employment, the form must say so clearly.
3. **Warn before you reject.** Send a pre-adverse action notice with a copy of the report and the CFPB's "A Summary of Your Rights Under the Fair Credit Reporting Act," and give the person time to point out errors.
4. **Send the final notice.** The adverse action notice names the screening company with its address and phone number. It says the company did not make the decision, and it explains the right to dispute the report and to get a free copy within 60 days.

You also certify to the screening company that you followed these steps. Shred or securely destroy reports when you are done. The EEOC says to keep hiring records for one year after they are made or after the hiring decision, whichever is later. Skipping the steps is expensive: a willful violation can cost the person's actual damages or $100 to $1,000, plus punitive damages and lawyer's fees (15 U.S.C. 1681n).

## Hire drivers who stay

BLS expects about 13 percent of shuttle drivers and chauffeurs to leave the occupation every year from 2025 to 2035, before counting those who switch employers. Most of what keeps a driver starts at hiring:

- **Show the real job.** A paid ride-along before the offer lets candidates see dialysis mornings, waits, and wheelchair work.
- **Put the pay plan in writing,** including how waiting time is paid. See [NEMT driver pay](https://nemtguide.com/guides/nemt-driver-pay/).
- **Keep drivers with their regular riders.** MTM Health's Virginia handbook expects a best-faith effort to use the same driver for standing-order trips.
- **Be honest about split shifts** and early starts in the interview, not after the first week.
- **Check in at 30 and 90 days.** Ask what surprised them and what would make them stay.

The full playbook is in how to keep NEMT drivers.

## Frequently asked questions

### What does a NEMT driver need before I can hire them?

Federal law sets the floor. Every NEMT driver needs a valid license for the vehicle and must not be on a federal exclusion list, and your company needs processes for state drug law violations and for reporting each driver's driving history to Medicaid. Brokers add the rest. MTM Health's standard agreement (January 1, 2023) requires drivers to be at least 21, with a three-year driving record inside its limits and a criminal background check before hire and every year.

### Can I hire a NEMT driver with a criminal record?

Sometimes. Start with your broker's list. MTM Health's standard agreement bars any sexual or violent crime conviction and allows a felony from the last seven years only with its client's approval. Texas health plans bar listed offenses for seven years and abuse or neglect of vulnerable people for life. For records outside those lists, the EEOC says to weigh the offense, the time since, and the job, and to let the person explain before you decide.

### Can I drug test a NEMT driver before I make a job offer?

Yes, under federal law. The EEOC does not treat a test for illegal drugs as a medical exam, so the ADA allows it before an offer. An alcohol test counts as a medical exam, so give it only after a conditional offer. MTM Health's standard agreement requires drug and alcohol screening before hire, after an accident, on reasonable suspicion, and at random. Check your state's testing rules, especially for marijuana, before you write the policy.

### How often do I have to recheck NEMT drivers?

It depends on the payer. MTM Health's standard agreement wants a new criminal background check and driving record every year. Texas health plans recheck sex offender registries and several databases every year, and the OIG exclusion list and SAM.gov every month. OIG updates its exclusion list monthly and says monthly screening best limits your risk.

### Do I need a driver's permission to pull their driving record?

If a screening company pulls it, yes. The FTC treats driving records that screening companies supply to employers as consumer reports, so the Fair Credit Reporting Act applies: a stand-alone written disclosure, written permission, and notices before and after any decision based on it. If you get the record straight from your state's driver licensing agency, follow that agency's own request process.

### Do NEMT drivers need a CDL?

Usually not. Under 49 CFR 383.5, a CDL is needed for a vehicle designed to carry 16 or more people including the driver, a vehicle rated at 26,001 pounds or more, or a vehicle carrying placarded hazardous materials. Most sedans, minivans, and wheelchair vans fall below those lines. Your state may still require a chauffeur or for-hire license, and your broker may add its own license rules.

## Official resources

- [EEOC and FTC: Background Checks, What Employers Need to Know](https://www.eeoc.gov/laws/guidance/background-checks-what-employers-need-know)
- [FTC: Using Consumer Reports, What Employers Need to Know](https://www.ftc.gov/business-guidance/resources/using-consumer-reports-what-employers-need-know)
- [CFPB: A Summary of Your Rights Under the Fair Credit Reporting Act (model form, March 2023 version)](https://files.consumerfinance.gov/f/documents/bcfp_consumer-rights-summary_2018-09.pdf)
- [HHS OIG: Search the List of Excluded Individuals and Entities](https://oig.hhs.gov/exclusions/)
- [SAM.gov: Search exclusions](https://sam.gov/)
- [National Sex Offender Public Website](https://www.nsopw.gov/)
- [CareerOneStop: Find an American Job Center](https://www.careeronestop.org/LocalHelp/AmericanJobCenters/find-american-job-centers.aspx)
- [USCIS: Form I-9, Employment Eligibility Verification](https://www.uscis.gov/i-9)
- [California Civil Rights Department: Fair Chance Act](https://calcivilrights.ca.gov/fair-chance-act/)