Rockland County Medicaid Transportation: MAS Rides, the County Livery Law, Town Taxi Licenses, and Rates

Rockland County is in the middle of two changes. Rides for Fidelis Care members, most of the county’s Medicaid managed care enrollees, moved to the state broker on April 1, 2026. The county also passed its own livery licensing law in 2023, but that law sits idle until a county board’s rules take effect. Until then, a Rockland ride company answers to the state, the broker, and the town or village where its cars work.

Who books Medicaid rides in Rockland County

Across New York, Medical Answering Services (MAS) approves Medicaid trips and assigns them to companies in its network, and eMedNY has returned new transportation applications that lack a MAS letter of support since April 15, 2024. The New York guide and the MAS guide cover how to enroll and sign the network contract.

Rockland is one of the counties closest to New York City, yet MAS puts it on its Upstate contact center, 866-932-7740. Westchester, across the Hudson, uses the Downstate line. When you print a number for Rockland clinics and riders, use the Upstate one.

The Fidelis Care switch on April 1, 2026

The state Department of Health posted that MAS took over transportation for Fidelis Care members in Rockland on April 1, 2026, and members book on the Upstate line from that date. Fidelis’s April 2026 transportation provider manual says its Medicaid members’ rides now run through fee-for-service Medicaid in all counties, with Rockland’s switch effective April 1, 2026.

The change was large. The state’s August 2026 managed care report counts 89,840 Fidelis members among the 120,961 people in Rockland’s mainstream Medicaid managed care plans, about three in four. Their rides now come through MAS and are billed to eMedNY, not Fidelis. The Fidelis Rockland news report covers what that means for old Fidelis claims.

The Rockland County livery law: passed, not yet in force

State law gave Rockland the power to license livery cars and taxis in 2012, through Chapter 385 of the Laws of 2012, and Vehicle and Traffic Law 498 names Rockland among the counties that may license prearranged rides. The County Legislature used that power on September 6, 2023, passing the Rockland Livery Licensing Law of 2023 (Local Law 5 of 2023) by a vote of 13 to 1. It was filed with the Secretary of State on October 10, 2023, and took effect 270 days later, in July 2024.

The law created a Division of Livery Regulation in the Office of Consumer Protection and a seven-member Rockland County Livery Board: the office’s director or a designee as chair, three people from the livery industry, and three members of the public, with the Sheriff or a designee sitting in without a vote. The board issues the licenses, but its rules must be adopted by the board and ratified by the County Legislature before they apply.

In 2024 the Legislature added a condition. Local Law 7 of 2024, adopted July 9, 2024, added section 375-36: if the rules and regulations are not in effect, no part of the livery law can be enforced in any manner. As of October 2026, the Office of Consumer Protection takes license applications for contractors, electricians, plumbers, tow companies, and a few other trades, and none for livery drivers, vehicles, or bases. Call the office at 845-364-3901 to learn whether the rules have taken effect before you buy plates or sign up drivers.

The code on eCode360, current to September 1, 2026, files the law as Chapter 375, Article III, sections 375-19 to 375-36. The copy on the county website numbers the same sections 375-30 to 375-46, so quote the eCode360 numbers in any letter.

What the law will ask for once its rules apply

The law calls a car that carries riders for pay on trips booked ahead a livery vehicle, so cars on Medicaid trips would fall under it. Its text already lists the minimum for each license, so you can prepare:

• Livery driver license: a New York Class A, B, or C commercial license or a Class E license (or the equivalent from your home state, never a foreign license), a photo, county fingerprints with a state criminal history check, an affidavit of convictions, a drug test for amphetamines, cocaine, opiates, and PCP within 30 days before you apply, and a state defensive driving course within six months before a first application or three months before a renewal.
• Livery vehicle permit: proof that you own or lease the vehicle, its title or lease and registration, its make, model, plate, and VIN, every holder of more than 10% traced to a person, three or more doors, room for 20 or fewer passengers, and an inspection by whoever the board names.
• Base station license: the owners, the location by town and village, a list of affiliated drivers and vehicles with their license numbers, and a $5,000 surety bond for the benefit of Rockland County. The board tells the town or village supervisor or mayor within five business days, and the municipality has 20 business days to comment.

Every license lasts at most a year, and the board sets the fees. Drivers write each trip in a log before it starts and keep it for a year. Once the law can be enforced, fines run up to $2,000 per violation, with each day a separate violation, and willfully defying a board order is a misdemeanor carrying up to $1,000 and a year in jail.

Ambulances, rideshare companies, school district contract vehicles, transit buses, and funeral cars are exempt. The text does not list ambulettes or wheelchair vans among the exemptions, so ask the office in writing how its rules will treat them.

Town and village taxi licenses in Rockland

The county law defines a taxi as a car that picks up riders without a booking, and it leaves taxis to the towns and villages. A taxi licensed by a Rockland town or village may run without county limits while it stays inside that town or village, and it may carry a passenger from there to another point in Rockland under the rules of the places it touches.

Town of Ramapo. On August 10, 2026, the Ramapo Town Board repealed its old taxi chapter and adopted a new Chapter 255 (Local Law 2 of 2026), which takes effect when filed with the Secretary of State. It covers the part of the town outside its incorporated villages and treats any vehicle carrying passengers for hire as a taxicab, apart from rideshare cars and vehicles state law exempts. It requires:

• A registration for the taxi business, a license for each vehicle, and a license for each driver, each good for one year.
• Liability coverage of at least $100,000 for one person, $300,000 per accident, and $50,000 for property damage.
• A driver roster, a vehicle roster, proof of insurance, and dispatch records, kept for three years.

Fees and inspections are set by the town’s Taxi and Limousine Commission. Fines run up to $500 for a first offense, $1,000 for a second within 24 months, and $2,000 for a third, with each day counted separately. The town’s 2025 application packet charged a $200 business fee and a $150 background screening fee under the old chapter, so confirm the new fees at Town Hall, 237 Route 59, Suffern, 845-357-5100.

Villages. Rockland’s villages keep their own taxi laws. In the Village of Nyack, whose code was current to June 11, 2026, the Parking Authority licenses taxis and vehicles for hire at $200 per vehicle a year, with $50 to swap a vehicle, and caps the village at 35 licenses. Spring Valley’s taxi chapter, in the code copy current to February 23, 2017, has a fleet license for a company whose vehicles carry riders only to and from doctors, hospitals, clinics, and other medical providers without charging the riders. One fleet license covers up to 25 vehicles, each marked with the fleet’s name, and the village does not license or inspect them one by one. A 2022 amendment set the fine for a first conviction under the chapter at $2,500 to $7,500. Call the village clerk wherever your cars pick up.

What Medicaid enrollment asks of a Rockland company

eMedNY’s enrollment chart asks taxi companies outside New York City (category 0603) for a local TLC base in only two places, Westchester and Nassau. A Rockland taxi company enrolls without a county license, and keeps records that each driver holds a valid Class E license and each car has livery plates. See livery vehicle and the Class E license guide.

The state Medicaid manual still ties enrollment to local law. It says enrollment never replaces local licensing, such as a town taxi license, and that breaking local rules can end your Medicaid enrollment.

Trips into Westchester add a layer. Westchester’s commission, under its rules version 4.4 of June 29, 2026, requires a $300 Out-of-County permit on any vehicle tied to a base outside Westchester before it does business there. That permit covers only trips between Westchester and the area where the base is licensed, and each driver needs a WCTLC driver permit or a permit from a licensing jurisdiction under Vehicle and Traffic Law 498. Rockland issues no county permits yet, so plan on WCTLC driver permits and ask the commission what it accepts for your base. Some Rockland companies hold a Westchester base permit instead: the commission’s February 6, 2026 list includes bases at addresses in Nanuet, New City, and Suffern. eMedNY also asks for a Westchester TLC base from taxi companies carrying Medicaid riders in Westchester, so confirm with MAS which papers your Westchester trips need. The Westchester County page has the details.

For wheelchair and stretcher vans, an ambulette company files NYSDOT operating authority and an Article 19-A compliance letter with its application. Rockland is not one of the six counties, Westchester and Orange among them, where OMIG requires a new ambulette company to post a Medicaid surety bond before it enrolls. The statewide rule still applies once you are billing: pass $500,000 in a year or $42,000 in a month, and OMIG asks for a bond within 90 days.

What Medicaid pays in Rockland County

Rockland’s base rows in the eMedNY fee schedule file dated April 5, 2026 sit close to Westchester’s, but they split differently between the trip and the mile. The schedule’s own header says its fees apply to the broker and may reflect network negotiations, and MAS sets each company’s final rate in its contract.

Service	Code	Rockland	Westchester
Wheelchair van trip	A0130	$45.00	$47.00
Wheelchair van loaded mile	S0209	$3.75	$3.50
Stretcher van trip	T2005	$200.00	$200.00
Stretcher van loaded mile	T2049	No row	$2.323
Taxi trip	A0100	$9.39	$7.41
Taxi loaded mile	S0215	$2.05	$2.34

Rockland’s wheelchair rates took effect September 6, 2024, its stretcher trip rate August 1, 2024, and its taxi rates December 31, 2022. With no stretcher mileage row, a Rockland stretcher trip pays $200.00 however far it goes. Rockland’s taxi base is $1.98 higher and its mile 29 cents lower, so taxi trips under about 7 miles pay more in Rockland. Its wheelchair base is $2.00 lower and its mile 25 cents higher, so wheelchair trips over 8 miles pay more in Rockland.

Worked out, a 5-mile Rockland taxi trip pays $9.39 plus $10.25, or $19.64. A 12-mile wheelchair trip pays $45.00 plus $45.00, or $90.00. The New York fee schedule guide lists every county.

Payroll runs lower than across the river. Rockland’s minimum wage is $16.00 an hour, and the state Department of Labor says it stays $16.00 on January 1, 2027, while Westchester stays at $17.00.

Steps to start Medicaid trips in Rockland County

1. Pick your service. Taxi (category 0603) pays $9.39 plus $2.05 a mile for riders who walk. Ambulette (0602) pays $45.00 plus $3.75 a mile for wheelchair riders and $200.00 a stretcher trip.
2. License locally. Get the taxi license of each town or village where your cars work, such as Ramapo’s business registration, vehicle licenses, and driver licenses outside its villages.
3. Check the county law. Call the Office of Consumer Protection to learn whether the Livery Board’s rules are in effect yet, and keep a $5,000 bond and fingerprints in your plans for when they are.
4. Set up wheelchair vans with the state. File for NYSDOT authority and qualify drivers under Article 19-A. Rockland adds no OMIG bond at enrollment.
5. Join MAS, then Medicaid. Ask MAS for a letter of support, enroll with eMedNY, and sign the MAS contract, as the New York guide explains.
6. Plan for Westchester trips. Before your cars carry riders across the river, ask the Westchester commission whether you need an Out-of-County permit or a Westchester base permit, and get WCTLC driver permits for the drivers who go.