New York, October 31, 2026 — New York State is continuing to scrutinize non-emergency medical transportation (NEMT) under Medicaid, with its 2026 oversight priorities targeting transportation billing, provider compliance, and improper reimbursement claims.
The New York State Office of the Medicaid Inspector General (OMIG) has identified non-emergency transportation as an ongoing audit priority in its 2026 Work Plan. The agency points to significant billing activity, federal oversight, and turnover among transportation providers as reasons for maintaining its focus on the sector.
The announcement comes as federal authorities are also examining Medicaid transportation payments, adding another layer of scrutiny to a service used by eligible patients who need assistance reaching medical appointments.
New York Targets Transportation Billing Practices
According to OMIG’s 2026 Work Plan, fee-for-service audits will continue for two categories of transportation providers: ambulette operators and taxi/livery services.
Ambulette transportation generally involves vehicles equipped to accommodate passengers with mobility limitations, including individuals who use wheelchairs.
Taxi and livery transportation, meanwhile, provides another option for Medicaid members whose transportation needs do not require specialized vehicles.
The state’s oversight plan also identifies a specific billing concern: improperly claimed toll reimbursements.
OMIG says its transportation audit protocols will be updated to focus on toll claims that may not comply with Medicaid requirements.
The measure is intended to strengthen oversight of transportation-related expenditures and identify potentially inappropriate payments.
The agency has not presented the new audit focus as a suspension of Medicaid transportation benefits.
Federal Government Launches Additional NEMT Audits
New York’s oversight efforts coincide with a broader federal review of Medicaid transportation payments.
On May 28, 2026, the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) announced an audit project examining whether selected states complied with Medicaid payment requirements for NEMT services.
Federal officials noted that transportation providers must maintain appropriate records supporting the services they deliver and meet applicable authorization requirements.
The review is designed to evaluate compliance with Medicaid rules governing transportation payments.
The project remains active, with completion currently estimated for fiscal year 2028.
Although the federal review is not limited to New York, it reflects continued nationwide attention to the administration and financial integrity of Medicaid transportation programs.
Previous Audit Findings Remain Relevant
Concerns about Medicaid transportation spending in New York are not new.
A federal audit published in 2022 examined non-emergency medical transportation payments associated with New York City providers.
The HHS Office of Inspector General estimated that New York improperly claimed at least $84.3 million in federal Medicaid reimbursement for transportation payments that failed to meet certain requirements.
The audit also identified an estimated $112 million in federal reimbursement associated with payments that might not have complied with applicable requirements.
These were historical audit estimates, not figures for transportation spending in 2026.
The findings involved issues such as insufficient documentation and other compliance deficiencies.
The earlier report remains relevant as New York continues examining transportation billing practices and the accuracy of reimbursement claims.
How Medicaid Transportation Operates in New York
The New York State Department of Health administers a Medicaid Transportation program intended to help eligible members reach covered medical appointments.
The program provides authorized transportation at no cost to qualifying members.
Transportation arrangements can include public transit, taxis, livery vehicles, ambulettes, and other medically appropriate options.
New York contracts with Medical Answering Services (MAS) to coordinate transportation reservations, manage contact centers, and perform administrative functions.
The statewide arrangement is intended to connect Medicaid members with transportation options appropriate to their circumstances.
For patients requiring recurring medical services, such as dialysis, rehabilitation, or specialist consultations, transportation availability can be an important part of maintaining access to scheduled care.
Industry Faces Continued Compliance Pressure
The 2026 oversight priorities place renewed attention on the operational and administrative responsibilities of transportation providers.
Companies participating in Medicaid-funded transportation programs must follow applicable billing, documentation, authorization, and service requirements.
Accurate trip records and properly supported reimbursement claims are particularly important when public funding is involved.
At the same time, transportation organizations must manage scheduling, passenger assistance, vehicle availability, and communication with healthcare facilities.
The increased scrutiny does not mean that all transportation providers are suspected of improper activity. Rather, the state is continuing a risk-based oversight approach focused on areas where billing errors or unsupported payments may occur.
What the Developments Mean for Patients
For Medicaid members in New York, the current oversight activity does not itself change the basic purpose of the NEMT benefit.
Eligible patients who need authorized transportation to covered healthcare appointments can continue to use the state’s Medicaid Transportation program.
The New York State Department of Health says transportation is arranged using the most medically appropriate and cost-effective level of service.
Patients and healthcare providers should continue following the applicable reservation and authorization procedures.
Transportation oversight is primarily directed at program administration, provider compliance, and the proper use of Medicaid funds.
What Happens Next?
New York’s 2026 Work Plan establishes transportation as an ongoing area of regulatory attention.
The federal audit announced in May 2026 adds a separate review process that may produce further findings once the investigation is completed.
For transportation providers, the developments emphasize the importance of accurate billing and operational records.
For policymakers, the challenge remains balancing effective financial oversight with continued access to medically necessary transportation.
As Medicaid transportation programs face increasing scrutiny, New York’s approach may offer further insight into how states manage the financial and administrative risks associated with publicly funded patient transportation.
Sources and Further Reading
- New York State Office of the Medicaid Inspector General — 2026 Work Plan: https://omig.ny.gov/new-york-state-office-medicaid-inspector-general-2026-work-plan
- U.S. Department of Health and Human Services, Office of Inspector General — Audits of Medicaid Non-Emergency Medical Transportation Services: https://www.oig.hhs.gov/reports/work-plan/browse-work-plan-projects/audits-of-medicaid-non-emergency-medical-transportation-services/
- Sentry Management Solutions — Medical Transportation Industry Resource: https://sentryms.com/
