What NEMT Accreditation Means for Your Riders

What the Accreditation Review Covers

NEMTAC’s review covers seven areas, as listed in its published accreditation standard. For each area, the provider submits written policies and proof that staff follow them.

Organizational Management

This area checks how the business is set up. Reviewers look for a policy and procedure manual written for that specific organization, with policies for each level of service it offers, such as curb-to-curb or door-to-door. The provider must show its business licenses, Employer Identification Number (EIN), and National Provider Identifier (NPI).

Insurance must include at least $1 million in auto liability, general liability of $1 million per occurrence and $2 million total, sexual assault and molestation liability, and workers’ compensation where required. Insurers must hold an AM Best rating of A- or better. Hours of operation and contact information must be available to the public.

Human Resources

This area checks hiring and staff records. Reviewers look for a drug-free workplace policy and an exclusion screening policy that checks the OIG list, the federal System for Award Management (SAM), and the Treasury Department’s Office of Foreign Assets Control (OFAC) list. The provider must also show onboarding and training records, an ID badge policy, job descriptions that list lifting requirements, and a current roster of employees and contractors.

Driver Credentialing

This area checks that every driver, whether an employee or an independent contractor, is screened and trained. The standard requires:

• Criminal background checks before hire that cover at least 7 years and sexual offenses, done by a company that follows the Fair Credit Reporting Act.
• Drug screening before hire, after an incident or collision, on reasonable suspicion, and at random, using at least a 5-panel test.
• Motor vehicle record checks before hire and on a set schedule after that.
• A certified defensive driving course, renewed at least every three years.
• First aid and CPR/AED training, renewed every two years.
• Wheelchair, scooter, and stretcher securement training that includes a hands-on demonstration with the equipment used on real trips.

The drug policy covers every safety-sensitive role. The standard lists dispatchers, routers, and any staff member who deals with passengers as safety-sensitive, along with drivers.

Compliance Program and Ethical Business Practices

This area checks how the provider prevents fraud and protects riders. Reviewers look for a formal compliance program, a code of conduct, and a conflict of interest policy. Staff must complete fraud, waste, and abuse training.

The standard sets clear billing rules. Claims must show the correct level of service and correct coding, and they must match the service that was actually provided. Billing for services that did not happen is prohibited.

The provider must also show a HIPAA policy with a list of every organization covered by a Business Associate Agreement, an anti-kickback policy, and policies for complaints, critical incidents, contract compliance, and mandatory reporting of abuse, neglect, and exploitation.

Vehicle Maintenance and Inspections

This area checks the condition of the fleet. Records must show daily checks for damage and equipment problems, with fluid and tire pressure checks at least twice a week. Heating and cooling must be inspected and working.

Each company-owned vehicle must show a unique number that can be seen from three angles, along with the company logo. Vehicles not owned by the company can use magnetic signs or window clings. Providers must also keep equipment checklists and inspection logs for wheelchair securement, lifts and ramps, and stretchers where they apply.

Fleet Operations

This area checks how vehicles are driven and managed. The provider’s policy must cover accident reporting, a required drug test for the driver after any accident, and a plan for breakdowns. Vehicles must carry a flashlight and road markers such as cones, flares, or triangles.

The policy must also set driver on-duty and rest times, give drivers the authority to cancel a trip in unsafe weather, allow phone use only through hands-free systems, and ban texting while the vehicle is moving. Management must review driving records every year. The provider must keep a fleet list showing each vehicle’s year, make, model, VIN, and level of service.

Communications

This area checks how trips are tracked and how the call center and dispatch team work. Reviewers look for a trip tracking policy, a policy on GPS and camera use with sample data, and rules for radios and phones.

For call center, dispatch, and routing, the standard asks for:

• Set hours of operation, with advance notice of any changes.
• Minimum staffing levels that plan for peak demand and holidays.
• Backup plans for staffing shortages.
• Clear roles for answering calls, dispatching vehicles, and planning routes.
• Communication steps between call takers, dispatchers, and drivers.
• Training for each role and written procedures staff can refer to.
• Regular monitoring and quality checks.

As proof, providers submit staffing records and schedules, training records, performance reports, quality reviews, and records of how backup plans were used.