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In 2009, CMTA has helped more then 80 NEMT providers to settle their
monetary re-payment cases with DHCS. After mass audits of NEMT industry providers,
Medi-Cal Audits and Investigation Department has discovered that more then
40% of NEMT providers were out of compliance with Vehicle and Drivers reporting
regulations. CMTA was working closely with Medi-Cal to bring all NEMT providers
into compliance and to settle their penalty cases with DHCS.
JOIN NOW TO STAY INFORMED OF THE NEMT LEGAL ADVOCACY EFFORTS!!!
w In 2008, CMTA formed a Legal Defense Fund, with fundraising spearheaded
by long-time CMTA member Marat Sheynkman. Led by CMTA President Steve Horne,
CMTA retained the successful Legal Advocacy team of Lynn Carman and Stanley Friedman
from the Medicaid Defense Fund to argue that Non-Emergency Medical Transportation
(NEMT) should be spared the 10% Medi-Cal rate cut many providers have been experiencing.
The separate CMTA complaint was heard in federal court in November 2008.
JOIN NOW TO STAY INFORMED OF THE NEMT LEGAL ADVOCACY
EFFORTS!!!
w In 2007, when
many other optional benefits were slated for elimination (NEMT is the second largest
“optional” (meaning the State does not have to provide the service under the Medicaid
program) service (adult dental is the most expensive)) the Medi-Cal program did
NOT target NEMT. Medi-Cal Director Stan Rosenstein told CMTA that Bill Barnaby
Sr. & Jr. had made such a good case that NEMT was “in essence” required by federal
law that Medi-Cal was not going to target NEMT for elimination under his watch.
JOIN NOW TO STAY INFORMED OF THE NEMT LEGISLATIVE ADVOCACY
EFFORTS!!!
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In 2006, CMTA gained an 8% rate increase from the legislature.
While the increase was vetoed by the Governor, NEMT was the only provider category
to garner any type of rate increase. Additionally in 2006, CMTA fought with
a coalition of Medi-Cal providers to overturn a 5% rate cut that had been enacted
in 2003, but stopped by court action. The cut was only in place for only 63
days until CMTA and the provider coalition were able to pass legislation ending
the cut.
JOIN NOW TO SUPPORT THE EFFORT FOR BETTER MEDI-CAL RATES!!!
w In 2004 –
05, CMTA worked with the California Medical Association (CMA) – led coalition on
fighting a rate decrease effort proposed by Governors Shwarzenegger and Davis.
Before Governor Davis was recalled in 2003 he was facing an approximately $34 billion
deficit. He first proposed eliminating NEMT and then fell back upon a 10%
cut. In the end CMTA and coalition was able to defeat the cut, only to have
a 5% cut forced upon all Medi-Cal providers by a last-minute, back-room deal.
However, the cut was stopped by court action that remained in place until overturned
in late 2005. JOIN NOW TO SUPPORT THE
NEMT INDUSTRY’S ADVOCACY EFFORTS!!!
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In 2002, due to a budget deficit in excess of $23 billion,
severe Medi-Cal provider rate cuts were proposed, including a reimbursement reduction
of 20% for NEMT. CMTA, as the only organized voice for NEMT in California,
aggressively fought against the Medi-Cal rate cuts. We prevailed, and were
one of the first provider categories exempted from a rate cut. In signing
the 2002-03 State Budget, Governor Davis made special note of full funding for NEMT.
A month later, the Governor signed another bill that attempted to preserve Medi-Cal
patient access by not cutting rates for most other providers, as well. But CMTA
led the way and the example it set for NEMT encouraged others to seek and win retention
of their payment rates.
IN SHORT, CMTA HAS KEPT NEMT IN THE MEDI-CAL PROGRAM AND
PREVENTED SEVERE RATE CUTS.
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During 2001, CMTA sponsored legislation (Assembly Bill (AB)
915 by former Assembly Majority Leader Dario Frommer, D - Glendale) to streamline
the Treatment Authorization Request (TAR) process and make it more user-friendly
for both Medi-Cal beneficiaries and NEMT providers. CMTA was able to drop
sponsorship of AB 915 because the then-Department of Health Services (DHS), now
the Department of Health Care Services (DHCS), administratively remedied many of
the TAR problems facing NEMT. Several CMTA companies have reported their TAR
processing situation has improved since the introduction of AB 915 and the increased
dialogue with the DHCS. CMTA had a meeting with then-DHS officials on October
26, 2001 in the San Diego Field Office and continues to work on the TAR issue.
JOIN CMTA AND BE KEPT UP TO DATE ON TAR ISSUES!
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During 2000, CMTA fought for, and obtained, a twenty percent
(20%) Medi-Cal rate reimbursement increase for the NEMT industry. While the
entire industry received this payment increase – it was the CMTA dues-paying members
who financed this successful effort!
JOIN NOW – HELP YOUR INDUSTRY AND YOUR BUSINESS!!!
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During 2000, then-DHS also proposed changes in the Manual
of Criteria (MOC). The MOC directly affects your patients’ ability to access
NEMT. These proposed changes have also been put on hold pending further comments
from CMTA. Again, the MOC update project remains on hold but could be revived.
JOIN NOW TO HAVE INPUT ON THESE CRITICAL RULES!!!
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During 1998-2000, then-DHS proposed changes in equipment
regulations set forth in California Code of Regulations, Title 22, which would have
been costly for NEMT providers. CMTA successfully argued that implementation
of these changes be put on hold until more comments were received from CMTA.
At the moment, proposed regulations are still on hold but subject to being revived.
JOIN NOW TO HAVE INPUT ON THESE REGULATIONS!!!
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For many years, during the Deukmejian and Wilson administrations
(1983 – 1999), the NEMT industry was targeted for elimination from the Medi-Cal
program due to State budgetary problems. CMTA successfully fought to keep
the NEMT industry in the Medi-Cal program.
CMTA HAS KEPT YOU IN BUSINESS!!!