How to Start a NEMT Business in Oklahoma (2027)

Oklahoma Medicaid, called SoonerCare, uses one broker for both of its ride systems as of September 2026. Modivcare arranges SoonerRide trips for members who stay in SoonerCare and the rides for all three SoonerSelect health plans. You contract with Modivcare, license your company with the Oklahoma Corporation Commission, and follow the SoonerRide rules in Part 32 of OHCA’s policy, with sections revised as recently as September 11, 2023. A new SoonerRide contract term begins October 1, 2026.

How Medicaid rides work in Oklahoma

The Oklahoma Health Care Authority (OHCA) runs SoonerCare. Since April 1, 2024, most members get their care through SoonerSelect, where OHCA pays a health plan capitation for each member. The rest stay in SoonerCare, and their rides go through SoonerRide, a statewide program OHCA pays a broker to run under a capitated method in its State Plan.

Program	Who is in it	Rides through
SoonerSelect	Non-disabled children, low-income parents, pregnant women, and non-disabled adults 19 to 64	Each plan’s ride vendor, Modivcare
SoonerCare	Aged, blind, and disabled members, Medicare dual eligibles, nursing facility residents, and tribal members who do not opt in	SoonerRide, run by Modivcare

The three SoonerSelect health plans are Aetna Better Health of Oklahoma, Humana Healthy Horizons in Oklahoma, and Oklahoma Complete Health, which also runs the Children’s Specialty Program for children in foster care. OHCA’s March 2024 SoonerSelect ride guide says all three use Modivcare, each with its own booking line.

For April to June 2026, OHCA reports $10,437,395 in SoonerRide spending, 208,846 trips, and an average of 312,789 eligible members a month, about 10,000 of whom rode each month.

Who qualifies and where rides go

SoonerRide covers medically necessary trips to SoonerCare services at the nearest appropriate facility. It does not serve members covered only as Qualified or Specified Low Income Medicare Beneficiaries, inpatients, or most waiver members, though ADvantage, Medically Fragile, In-Home Supports Waiver for Children, and Living Choice members qualify.

Care should be within 45 miles of home, and OHCA must approve anything farther. The 2023 SoonerRide program overview on OHCA’s provider training page sets the limits at under 45 miles for routine care and under 100 miles for specialists, and out-of-state trips need OHCA approval. American Indian and Alaska Native members going to a tribal or Indian Health Service facility may ride to any such facility that meets their needs.

How members book

Members and facilities book routine rides three to 14 business days ahead, and standing appointments such as dialysis further out. Urgent trips can be booked the same day when a doctor needs the member seen that day or the next, and hospitals schedule discharges.

The ride types are mass transit, paratransit, ambulatory, wheelchair, and stretcher, and SoonerRide may use an ambulance for scheduled stretcher trips. That overview lists bariatric wheelchair, bariatric stretcher, and advanced or basic life support as levels SoonerRide does not cover. Members bring their own wheelchair, car seats, and oxygen, and those near a bus stop may be moved to transit after their first 30 days.

From July 1, 2026, the SoonerSelect plan contracts require a reservation system by phone, email, website, and mobile app, and rides available at least 8 a.m. to 8 p.m. Central, Monday through Saturday. Plans may add extra rides as a value-added benefit. Oklahoma Complete Health’s 2026 provider manual lists 15 extra round trips a year for needs such as groceries and job interviews.

Rural and tribal coverage

Modivcare arranges SoonerRide trips in all 77 counties. At OHCA’s January 17, 2024 board meeting, the CEO reported that Modivcare had signed a Joplin-based provider for the northeast and a Dallas-based provider for the southeast, that a Texas provider agreed to bring 10 new wheelchair vehicles, and that contracts were changed to let taxis give rides. When you call Modivcare, ask which counties still need providers. See rural NEMT for how long trips pay.

OHCA’s SoonerRide one-pager gives tribes two ways to become a tribal transportation contractor: a contract, or mileage reimbursement. See tribal NEMT.

How to join Modivcare in Oklahoma

OHCA’s rules say it contracts with a broker to provide rides statewide, and every SoonerRide provider must meet the State Plan, the SoonerRide provider manual and contract, and all state and federal law. So you contract with Modivcare, not with OHCA. The steps:

1. Check who holds SoonerRide after October 1, 2026. OHCA awarded a new SoonerRide contract from its 2025 request for proposals (EV00000663). In June 2026, OHCA asked its board to extend the prior contract through September 30, 2026 for the transition and to fund the new contract’s first term, October 1, 2026 to June 30, 2027. Ask OHCA or Modivcare which company holds it. The SoonerSelect plans pick their own ride vendors.
2. Get your state registrations first. Form your company, get a USDOT number, buy insurance, and file for your Corporation Commission license.
3. Send Modivcare’s Become a Transportation Provider form. It asks for your owners, NPI and tax ID, service types, vehicles, hours, base county, and insurance amounts. Our Modivcare guide lists every field.
4. Send your credentialing documents. Modivcare’s requirements list names a PASS wheelchair certificate, first aid and CPR, and defensive driving for each driver, plus a drug screen, a motor vehicle report, and a background check. For each vehicle it wants current registration and proof of insurance. Use the credentialing checklist.
5. Pass the field visit. Modivcare makes field visits to confirm vehicles meet contract standards.
6. Keep up the yearly training. Owners and drivers review Modivcare’s compliance training when they contract and every year after, and someone with authority to sign for your company returns Modivcare’s compliance attestation.

OHCA adds its own screening. Under State Plan amendment 21-0043, approved by CMS on March 2, 2022 and effective December 27, 2021, OHCA attests that NEMT providers and drivers meet the federal minimums in section 1902(a)(87) of the Social Security Act. No provider or driver may be excluded from federal health programs, each driver needs a valid license, and each provider needs a process to address state drug law violations and to disclose each driver’s driving history, including traffic violations. Since June 2026, OHCA has been reviewing its processes and guardrails for broker-contracted NEMT providers. Screen your drivers against the OIG exclusion list.

Ask about your application through Modivcare’s Transportation Provider Support Form, and see the broker credentialing guide.

Licenses and registrations

Your company

Form an LLC with the Oklahoma Secretary of State. Articles of organization cost $100, and card payments carry a 4% charge. The state says online registration takes about 15 minutes. Every LLC files an annual certificate on the anniversary of its registration for $25, and one that files more than 60 days late loses its good standing. The state emails annual certificate notices to the address on file, so keep it current. A trade name costs $25 to register. See LLC for NEMT.

Get your employer identification number (EIN) from the IRS, which charges nothing. Once you have employees, open an income tax withholding account with the Oklahoma Tax Commission and an unemployment tax account with the Oklahoma Employment Security Commission. Ask your city and county which local licenses apply.

Oklahoma Corporation Commission

The Corporation Commission (OCC) requires an intrastate for-hire motor carrier license for anyone who carries passengers for hire inside Oklahoma. The only exceptions are city-licensed taxicabs that stay within one city and city-licensed buses that do not run between towns.

If you run	You need	From
Sedans, minivans, or wheelchair vans for pay inside Oklahoma	Intrastate for-hire license, passenger category	OCC
Stretcher vans	Stretcher van service license and a class S vehicle permit	State Department of Health
A vehicle built for 16 or more people, driver included	A commercial driver’s license	Service Oklahoma
Trips across state lines	Unified Carrier Registration for commercial vehicles	OCC and federal rules

To apply, file form TDF 1 with:

• An active USDOT number, or a copy of the MCS-150 you mailed the Federal Motor Carrier Safety Administration. See DOT numbers for NEMT.
• Your FEIN or Social Security number, and for an LLC or corporation, a copy of your Secretary of State filing.
• The passenger category that matches your largest vehicle: 6 or fewer, 7 to 9, 10 to 15, or 16 or more seats, driver included.
• A list of every vehicle with its make, model, and seating, and whether you own or lease it.
• An insurance filing, typically Form E, sent by your insurance company rather than your agent, matching your application exactly.
• The $100 filing fee, $7 for each vehicle’s identification stamp, and a Chapter 30 rule book for $10 or downloaded free.

You cannot operate until the license is issued, and the OCC dismisses an application if every requirement is not met within 30 days of receiving it. The license lasts one year. OCC rules ask for renewal at least 30 days before it expires, and the TDF 2 form, revised July 1, 2020, asks for 45 days and a $50 fee. Show your USDOT number in any advertising, and keep records for three years. For the layers that apply in every state, see NEMT license requirements.

Oklahoma State Department of Health

Stretcher vans need a stretcher van service license from the State Department of Health under its emergency medical services rules. The first application costs $600, plus $20 for each van over two and $150 for each substation. It needs a business plan showing you can run for a year, ownership disclosures down to 5%, a felony statement, a personnel roster, an equipment list, a policy for screening each request, a coverage area map, and proof of liability and workers’ compensation insurance.

Stretcher van services are approved only in emergency medical service regions, ambulance service districts, or counties with more than 500,000 people, though trips to and from any federal or state veterans facility are allowed. Applicants must also show they comply with any local “sole source” ambulance ordinance. The first license expires on the second June 30 after it is issued, and renewals run two years for $100, plus $50 for each substation and $20 for each van over two. See how to start a stretcher transportation business.

Vehicle rules

Modivcare checks vehicles on field visits against its contract standards. The OCC requires every vehicle to be safe and to carry the equipment state law and the US Department of Transportation require. Its application warns that vehicles for 15 or more passengers, or over 26,000 pounds, fall under the federal safety rules even inside Oklahoma, which require an inspection at least once a year.

The Department of Health inspects each stretcher van before permitting it, makes unannounced inspections after, and pulls a van with carbon monoxide above 50 parts per million.

For SoonerRide and SoonerSelect trips, keep these in every vehicle:

• A copy of your OCC license with that vehicle’s identification stamp on it.
• A SoonerRide sign inside, which OHCA tells members to look for.
• Safety restraints the driver fastens when a rider asks. With extra children on an urgent trip, no more than five people, driver included, may ride.
• For wheelchair riders, a lift van loaded by the protocols OHCA approves, with each wheelchair secured by the driver.

Stretcher vans carry more:

• An elevating gurney with a locking system that meets AMD 004, and a mount for portable oxygen.
• Two 5-pound fire extinguishers, isolation kits, gloves, and spare linens.
• An AED, with pediatric capability and a child restraint if you carry children.
• On newer vans, a mounted attendant seat, a way to call 911, and “stretcher van” and your business name in 6-inch letters on the rear and sides.

Stretcher vans must meet AMD standards 004, 012, and 013 and may not have working emergency lights or sirens. Walk each vehicle through the vehicle inspection checklist before a visit, and see NEMT vehicle requirements.

Driver rules and training

A driver cannot carry SoonerRide or SoonerSelect riders if:

• They are excluded from any federal health care program.
• They do not hold a valid driver’s license.
• Their driving record, background check, or drug screen does not pass Modivcare’s review.

Stretcher trips add a second person. Each stretcher van carries an attendant certified as an Oklahoma Emergency Medical Responder with current BLS, and a driver with a valid Oklahoma license, current BLS, and an agency defensive driving course in a vehicle like a stretcher van. The service orients both to the local emergency medical system and keeps training records for everyone before their first trip.

On the job, SoonerRide is curb-to-curb. Drivers wear a photo ID badge and show it to the rider before boarding. They open and close doors, help load adaptive equipment, and fasten seat belts when asked. They do not go into the home, lift riders, take wheelchairs up or down stairs, or help along walkways. They do not load personal belongings, and they cannot add a pharmacy stop unless Modivcare authorizes it. See curb-to-curb service and wheelchair securement.

Keep a file on each driver: license, a Service Oklahoma driving record, the background check, the drug screen, training certificates, and the yearly Modivcare attestation. A Service Oklahoma driving record covers three years and costs $25, and unless the driver holds a CDL, you need the driver’s written consent to get it. An OSBI name-based criminal history check costs $15, rising to $20 on November 1, 2026. Use the driver file checklist and a written drug and alcohol policy.

Trip rules and how you get paid

The service standards differ a little by program:

Rule	SoonerRide	SoonerSelect plans
On time	Arrive 15 minutes before to 15 minutes after pickup	Early is allowed, but the rider need not board before pickup
Waiting	Up to 15 minutes after the pickup time	No more than 15 minutes after pickup
Will-call returns	Within 60 minutes of the call	Within one hour of the call

The SoonerSelect contracts add two rules. When a pickup runs more than 15 minutes late, the plan or provider must tell the rider and offer other pickup arrangements when appropriate. On shared rides, no member rides more than 45 minutes longer than a direct trip. For hospital discharges, Modivcare’s Oklahoma page gives the provider up to three hours to arrive. See will-call trips and hospital discharges.

Nursing home residents ride with a facility attendant, one for up to three residents, including to dialysis, and you are not required to carry the attendant back without the member. See dialysis transportation.

Modivcare sets your rate in its provider agreement, and you bill through its Transportation Provider portal. OHCA pays the SoonerRide broker under a capitated method. In June 2026, OHCA asked its board to approve up to $48,034,497 for SoonerRide from July 1, 2026 to June 30, 2027, and the new contract also covers mileage reimbursement, public bus rides, and meals and lodging for qualifying trips. Record times and signatures on your trip log so each claim matches the trip. See how to bill NEMT brokers.

The broker may deny a ride when the member is not ready within 15 minutes after pickup, and three no-shows in 90 days can move a member to mileage reimbursement only. Denied members can appeal to OHCA, but not over shared rides or vehicle type. On the provider side, the 2023 SoonerRide overview says excessive grievances can cut the work Modivcare assigns you or lead it to stop using you.

Insurance requirements

Modivcare’s requirements list:

Coverage	What Modivcare asks for
General liability	Bodily injury, property damage, and personal injury, with limits that vary by state
Sexual abuse and molestation	Required, with higher limits if needed
Auto liability	Bodily injury and property damage at or above your state’s minimum
Workers’ compensation	Required in most states when you have employees

Ask Modivcare for its Oklahoma limits in writing before you buy. See abuse and molestation coverage and NEMT insurance requirements.

The OCC’s minimums are in OAC 165:30-3-11, as combined single limits that depend on each vehicle’s seats, driver included:

Seats	Minimum limit
6 or fewer	$100,000
7 to 9	$750,000
10 to 15	$1,000,000
16 or more	$5,000,000

Those limits are far above the 25/50/25 minimum for personal cars. The certificate must cover every vehicle you run, and it cannot be canceled without 30 days’ written notice to the OCC. A stretcher van can lose its permit on the spot if its liability or workers’ compensation coverage lapses.

Oklahoma’s Workers’ Compensation Act says every employer must secure compensation for its employees and post a notice that it has. Owners who run their own business, including LLC members and corporate officers, may exclude themselves by agreement. See workers’ comp for NEMT.

What it costs and how long it takes

These are the state fees as of September 2026. Vehicles and insurance premiums depend on your quotes. See what it costs to start a NEMT business.

Item	Cost	Paid to
EIN	Free	IRS
LLC articles of organization	$100	Secretary of State
LLC annual certificate	$25 a year	Secretary of State
OCC license application	$100	Corporation Commission
Vehicle identification stamp	$7 per vehicle a year	Corporation Commission
OCC license renewal	$50 a year	Corporation Commission
Stretcher van license	$600, plus $20 per van over two	State Department of Health
OSBI name-based check	$15, then $20 from November 1, 2026	OSBI
Driving record	$25	Service Oklahoma

A workable order, from first call to first trip:

1. Call Modivcare’s provider network team. Ask which counties and service levels need providers, and who holds SoonerRide from October 1, 2026.
2. Form your LLC and get your EIN. Both can be done online.
3. Get a USDOT number and buy insurance at the OCC limit for your largest vehicle. Ask your insurer to file Form E.
4. File TDF 1 with the OCC. Meet every requirement within 30 days of filing.
5. Hire drivers and run their checks. An OSBI check takes 10 to 15 minutes in person and two to five business days by fax.
6. Send Modivcare’s provider form and documents, then pass the field visit and complete the compliance training.

For the same steps in any state, see how to start a NEMT business and how long it takes to start NEMT.

Work beyond Medicaid

• Developmental disabilities waiver rides. Oklahoma Human Services Developmental Disabilities Services certifies transportation providers for its waiver programs, and OHCA contracts with them. Under OAC 317:40-5-103, drivers need a valid Oklahoma license, and each trip record shows the date, miles, member, and purpose. See becoming a waiver transportation provider.
• Transit grants. ODOT has run the federal Section 5310 program for seniors and people with disabilities since July 1, 2019. It pays 80% of eligible costs, and buying transportation services under a contract is an eligible expense, so a grantee can pay a contractor to run rides.
• Veterans. VA pays for special mode transportation, an ambulance or specially equipped vehicle, when a VA provider decides it is needed and the trip is approved in advance. Ask the travel office at your nearest VA facility how it books rides. See VA beneficiary travel.
• Facilities and private pay. A nursing home that does not book a ride through SoonerRide pays for it itself and cannot bill the member, so a facility may hire a provider for those trips directly. Nursing facilities that drive their own residents can claim mileage through Modivcare’s voucher form. See how to get NEMT facility contracts and private pay NEMT.