Nemt medical transportation

The South Carolina Department of Health and Human Services is requesting proposals for Non-Emergency Medical Transportation (NEMT) Coordinator Services statewide under RFP 5400029919, with proposals due September 14, 2026, at 11:00 p.m. EST and a pre-proposal conference scheduled for July 20, 2026, at 10:30 a.m. EST via Microsoft Teams. The State is transitioning from a fee-for-service broker model to a risk-based capitated payment structure, and offerors must acknowledge acceptance of the capitation rates and reimbursement methodology specified in Appendix B on a pass/fail basis.

Mandatory minimum qualifications require five years of NEMT experience operating a program of similar size and scope with successful prior implementation in a state environment. Offerors must complete a mandatory Service Provider Security Assessment Questionnaire supplement establishing compliance with NIST AI Risk Management Framework standards; full disclosure of any AI/ML components including decision-making workflows; prohibition on final eligibility, benefit, or claims decisions made solely by AI/ML without documented human review and override capability; restrictions on using protected health information or personally identifiable information for AI/ML model training without written SCDHHS authorization; and documented bias, fairness, and impact assessments for all decision-impacting models with logical and physical separation of SCDHHS data.

The contract covers comprehensive NEMT administration for eligible Healthy Connections Medicaid members, including member eligibility verification, transportation provider network development and credentialing, scheduling and dispatching, prior authorization, complaints management, website and mobile applications, and hazardous weather contingency planning. Historical service volumes total approximately 3.8 million rides across multiple treatment categories; call center operations handled 594,282 calls in fiscal 2024–2025 with 37-second average answer speed.

The initial contract term runs December 3, 2026, through December 2, 2031, comprising three years plus two optional one-year renewals. Evaluation criteria assign 1,000 points to technical approach, 250 points to qualifications, and 200 points to demonstrations (for up to three highest-ranking offerors); rates are evaluated on a pass/fail basis. The contractor must maintain Monday through Friday operations 8:00 a.m. to 6:00 p.m. Eastern Time with 24-hour toll-free contact center staffing and meet performance standards including 90% on-time arrival and 0.2% maximum missed trips. Written questions are due July 22, 2026, at 5:00 p.m. EST. Contract award is anticipated November 19, 2026.