The Indiana Health Coverage Programs began brokering nonemergency medical transportation services for most IHCP members served through the fee-for-service delivery system through Southeastrans Inc., effective June 1, 2018. Members receiving brokered NEMT services through SET are identified as such when verifying member eligibility through the IHCP Provider Healthcare Portal.
NOTE: NEMT services for certain FFS members are not brokered through SET and continue to be arranged directly with transportation providers. NEMT services for members enrolled in the Healthy Indiana Plan, Hoosier Care Connect, and Hoosier Healthwise continue to be managed through the member's health plan or the health plan's designated vendor.
NEMT providers rendering brokered transportation services - including common carriers (ambulatory and nonambulatory), taxis, bus services, and ambulance services - must be enrolled as IHCP providers. Additionally, providers need to contract with Southeastrans to be a part of their statewide NEMT network. SET will operate initially with an open network until an adequate statewide system of providers can be established.
Some transportation services are exempt from the requirement to broker the transportation through SET; services in these instances continue to be arranged directly with the transportation provider:
- Transportation services provided by family members enrolled as IHCP providers will not be brokered.
- Transportation for waiver services provided to members enrolled in IHCP home- and community-based services waiver programs will not be brokered. (Note: Medically necessary nonemergency transportation for HCBS waiver members for nonwaiver services will be brokered.)
- Transportation services provided by school corporations will not be brokered.
- Transportation for Medical Review Team services will not be brokered.
For more information about SET policy and procedures and contracting with SET, see the following resources: