Industry news
Louisiana Medicaid Lets Rideshare Companies Give NEMT Rides to Ambulatory Members
Since November 20, 2025, rideshare companies can give Louisiana Medicaid rides. CMS approved state plan amendment LA-25-0017 on December 12, 2025, effective November 20, the day the Louisiana Department of Health (LDH) adopted its matching rule. It adds transportation network companies (TNCs) as NEMT providers for ambulatory members only, ranked after public transit, gas reimbursement drivers, and traditional NEMT companies.
What changed
| Item | Detail |
|---|---|
| State law | Act 677 of 2024 (House Bill 80), signed June 19, 2024, added La. R.S. 40:1257.5. It lets TNCs give Medicaid rides once LDH writes rules for them |
| State rule | LDH amended LAC 50:XXVII, Chapter 5, and added section 519. The rule appeared in the Louisiana Register on November 20, 2025 (LR 51:1858) and took effect that day |
| Federal approval | CMS approved LA-25-0017 on December 12, 2025, effective November 20, 2025 |
| Who a TNC can carry | Ambulatory members only |
| Scheduling order | Public transit, gas reimbursement, traditional companies, then TNCs |
| Member choice | Members may pick their transportation company, but not a TNC, as long as it stays the least costly option |
| Who schedules | Every NEMT trip, including TNC trips, is paid only if a contracted broker scheduled it |
| Fees | LDH’s August 20, 2025 proposal expected no change in the number of trips or the fees paid for them |
Louisiana Medicaid now names four kinds of NEMT providers. Public transit is city and parish bus and train service. Gas reimbursement providers are friends or family paid to drive a member; each may carry up to five members, or one household, and may not live at the member’s address. Traditional providers are for-profit and nonprofit NEMT companies. TNCs are the fourth.
Where the trips come from
Healthy Louisiana health plan members get rides through the plan’s broker, which as of September 2026 is MediTrans for every plan. Members on fee-for-service Medicaid get rides through Verida. A TNC gets Medicaid trips only through a contract. Before its first trip, it must be under contract with a health plan or its broker, or with LDH or its broker.
LDH’s managed care manual, updated May 28, 2026, adds more for plans. A TNC must hold a permit under La. R.S. 48:2193, enroll in the Louisiana Medicaid Provider Enrollment Portal, and follow Louisiana’s TNC law. Its drivers use approved personal vehicles.
How rideshare rules compare with yours
The state plan sets different floors for the two groups.
| Requirement | Traditional NEMT company | Rideshare company (TNC) |
|---|---|---|
| Exclusion check | No company or driver on the HHS OIG exclusion list | Same |
| Driver’s license | Valid CDL or chauffeur license | Valid driver’s license |
| Background check | Criminal history check every year by the Louisiana State Police, an agency it authorizes, or the FBI, with results sent straight to the plan or broker | A criminal background check that meets La. R.S. 40:1203.1 or R.S. 48:2199, finished before the driver’s first Medicaid trip |
| Drug law violations | The company and the broker each keep a process | The broker and the TNC monitor under federal guidelines and the TNC’s policy |
| Driving history | The broker discloses it to Medicaid | The broker monitors and discloses it |
| Trips allowed | Every level of service the company is credentialed for | Ambulatory only |
Traditional companies also carry the state’s auto liability floor under LAC 50:XXVII.517: $25,000 per person, $50,000 per accident, and $25,000 property damage, or a $300,000 combined single limit. See the Louisiana state guide for each broker’s insurance and vehicle rules.
What it means for ambulatory NEMT companies
Rideshare competes only for ambulatory trips. Wheelchair trips never go to a TNC. Neither does ELOC, Louisiana’s door-through-door level of care for members who use a wheelchair and need hands-on help. ELOC trips go only to fully credentialed companies that meet LDH’s advanced training and insurance rules.
LDH has said how it expects TNCs to be used. Its August 2025 proposal said they can complete trips that traditional providers are unable to fulfill “in the case of vehicle malfunctions or other unforeseen emergencies.” Its April 2021 report to the House found that most states it reviewed use TNCs for short-notice requests or when other providers are unavailable. It concluded that TNCs work best as providers of last resort.
So the trips most likely to go to rideshare are the ones traditional companies cannot cover, such as short-notice requests and trips left open by a breakdown. For trips you can cover, the scheduling order puts your company ahead of rideshare.
What to do now
- Ask your broker how it uses rideshare. Ask MediTrans or Verida which trips it sends to TNCs and whether short-notice trips you decline go to one.
- Cover the trips you are offered. LDH expects TNCs to fill trips that traditional companies cannot, such as when a vehicle breaks down.
- Keep driver files current. Every driver needs a CDL or chauffeur license and a criminal history check each year, with the results sent by the checking agency to your plan or broker.
- Keep your daily trip log electronic and in time order. Under LDH’s managed care manual, plans match every traditional company claim to an entry in the log before paying.
- Look at wheelchair and ELOC work. TNCs cannot take it. See how to start a wheelchair transportation business.
- Bill only broker-scheduled trips. Since November 20, 2025, the state rule pays NEMT only when a contracted broker scheduled the trip.
For how rideshare fits in other states, see NEMT vs rideshare. For onboarding with the plans’ broker, see our MediTrans provider guide, and for fee-for-service rides, our Verida provider guide.
Key dates
| Date | What happened |
|---|---|
| April 2021 | LDH answers House Resolution 14 with a report on TNCs in NEMT |
| June 19, 2024 | Governor signs Act 677, effective August 1, 2024 |
| August 20, 2025 | LDH proposes the TNC rule in the Louisiana Register |
| October 1, 2025 | LDH submits LA-25-0017 to CMS |
| November 20, 2025 | The rule is adopted and the state plan change takes effect |
| December 12, 2025 | CMS approves LA-25-0017 |
Who to contact
- LDH Medicaid Transportation team: 225-342-9566 or 225-333-7473
- MediTrans, joining its network: providers@meditrans.com
- Verida Louisiana provider service line: 225-726-2800