Medicaid Non-Emergency Medical Transportation (NEMT) Services

What is changing?

Under a new law (LB1126), anyone who wants to provide Medicaid NEMT services in Nebraska must have a Medicaid NEMT License issued by the Public Service Commission (PSC). This replaces the old system where carriers used a DHHS designation attached to a Certificate or Permit.

Why is this change happening?

The goal is to make regulation simpler and more efficient. Under the old system, carriers had to go through a lengthy approval process, including proving public need and waiting through protest periods. The new system removes those steps and focuses on whether a carrier is fit and able to provide Medicaid NEMT services. 

What is the Medicaid NEMT License?

The Medicaid NEMT License is a stand‑alone authority that allows you to provide Medicaid NEMT transportation statewide.

Key points:

• Valid for one year and must be renewed annually
• $250 application fee
• Requires a background check
• Requires insurance documentation (a Form E)
• Requires a list of vehicles used (but no PSC vehicle plates will be issued)
• No public notice, protests, or hearings required for issuance
• The license remains a perquisite to contracting with the appropriate designated agent for DHHS

How is this different from the old DHHS designation?

Old System:

• DHHS designation attached to a Certificate or Permit
• Required proving public need
• Required 30‑day notice and potential hearings
• Authority remained valid indefinitely unless cancelled or revoked

New System:

• Separate Medicaid NEMT License
• No hearings or public‑need requirement
• Must be renewed every year
• Carriers offering additional (non‑Medicaid) services may need multiple authorities

What do current carriers need to do?

If you currently hold a DHHS designation, you must notify the PSC in writing by December 9, 2026 that you want your designation converted into a Medicaid NEMT License.

Written confirmation can be done by emailing psc.motorfilings@nebraska.gov your intention for a transition. 

If you do not send this confirmation:

• Your designation will not be automatically transitioned
• You will need to apply for a new license beginning January 1, 2027

What if I am currently applying for a Certificate or Permit with a DHHS designation?

You must also confirm in writing by December 9, 2026 that you want your pending application transitioned into a Medicaid NEMT License application.

Written confirmation can be done by emailing psc.motorfilings@nebraska.gov your intention for a transition. 

What happens on January 1, 2027?

If you submitted written confirmation by the deadline, the PSC will automatically transition your existing designation or pending application into the new licensing system.

If you did not submit confirmation:

• You may still apply for a Medicaid NEMT License beginning January 1, 2027
• Your transition will not be automatic
• You may experience a lapse in authorization until your new license is approved

Will I still need my Certificate or Permit?

It depends on the services you offer:

• If you only provide Medicaid NEMT services → You will likely only need the Medicaid NEMT License
• If you provide any other type of intrastate passenger service → You will need the Medicaid NEMT License and a separate Certificate or Permit

How will PSC enforce the new license requirements?

The PSC may suspend or revoke a Medicaid NEMT License if:

• You fall out of compliance with insurance or safety requirements
• You violate PSC rules or lawful orders

You will receive at least 15 days’ written notice before a suspension hearing.

Do rideshare companies (TNCs) need a Medicaid NEMT License?

Yes. Any TNC providing Medicaid NEMT services must hold a Medicaid NEMT License starting January 1, 2027.

What if I miss the December 9 deadline?

You can still apply for a Medicaid NEMT License beginning January 1, 2027. However:

• Your current authority will not automatically convert
• You may not be authorized to provide Medicaid NEMT services until the PSC issues your new license

Where do I get the application?

The application can be found here: Application - Medicaid Non-Emergency Medical Transportation License.docx

If you are seeking a transition of a current DHHS designation or application you do not need to file the application, just confirm your desire for a transition by emailing psc.motorfilings@nebraska.gov. 

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