neeD a LYft? nemt riDesharing: uBer heLpfuL/uBer riskY
Health Care law Section
Chairs: T.J. Ferrante – Foley & Lardner LLP & Kevin Rudolph – Shriners Hospital for Children
healthcare providers who
wish to schedule and pay
for transportation services
for their patients
O
ver three million
Americans miss
or delay medical
appointments each
year because of inadequate
transportation, 1 and an estimated
25 percent of patients miss an
appointment because of lack
of transportation altogether. 2
Ridesharing companies have
identified a need to be met and are
eager to break into the multi-billion-
dollar non-emergency medical
transportation (“NEMT”) industry. 3
As traditional public transit and
taxi cab services are fraught with
cancelations, delays, and lengthy
travel time, ridesharing platforms
appear to offer promising solutions
to access and continuity of care
issues, particularly for vulnerable
patient populations with limited
resources who often have the greatest
need for medical care. Just as ride -
sharing companies have aimed to
fill a need in the market for general
transportation, they see an opportu -
nity in the NEMT space as well.
Healthcare/NEMT partnerships
are proliferating in 2018. In early
March 2018, Uber announced its
latest initiative, Uber Health, and
Lyft announced a partnership
with AllScripts and a separate
partnership with Blue Cross Blue
Shield, CVS, and Walgreens.
Uber Health and Lyft’s partnership
with Allscripts will allow providers
to schedule — and pay for —
42
should be aware of potential
regulatory hurdles.
transportation for their patients,
and Lyft’s partnership with CVS
and Walgreens will offer Blue
Cross Blue Shield members
complimentary transportation to
CVS or Walgreens pharmacies.
While these novel transportation
platforms have the potential to
improve access to care, reduce
barriers to healthcare access,
and decrease no-show rates for
providers, ridesharing NEMT poses
significant legal and compliance
risks as well.
Healthcare providers who wish to
schedule and pay for transportation
services for their patients should
be aware of potential regulatory
hurdles, particularly fraud and
abuse concerns if providers offer
these services at little or no cost
to federal program beneficiaries.
Providing these services could
potentially violate the Civil
Monetary Penalties Law 4 and the
Anti-Kickback Statute 5 could be
alleged for the provision of these
services. Healthcare providers
should endeavor to meet codified
safe harbors to the Anti-Kickback
Statute 6 and exceptions to the
beneficiary inducement provisions
of the Civil Monetary Penalties
Law, 7 which address free and
discounted transportation.
In addition to Anti-Kickback
Statute and Civil Monetary
Penalties Law concerns, ridesharing
NEMT poses Health Insurance
Portability and Accountability Act
(“HIPAA”) and cybersecurity risks
as well. These ridesharing platforms
will be accessible by providers
online or integrated into a health
facility’s existing electronic medical
record system. Providers should
consider potential cybersecurity
exposure, including the risk for
a breach of patients’ protected
health information through the
ridesharing platform, and whether
the provider’s electronic medical
record system could be accessed
or hacked when linked to the
ridesharing platform.
While the logistical benefits to
provider-coordinated and funded
transportation may be significant,
the risks may be too. Providers
who are considering the use of
ridesharing platforms to coordinate
patient transportation should take
into account all legal risks and ensure
the relationships and transactions
are structured to comply with all
state and federal regulations.
Richard Wallace et al., Access to
Health Care and Nonemergency Medical
Transportation: Two Missing Links,
Transportation Research Record
Journal of The Transportation
Research Board, Jan. 2005, at 76.
2 Samina T. Syed et al., Traveling
Towards Disease: Transportation Barriers
to Health Care Access, J. Comm. Health,
Oct. 2013.
1
Continued on page 43
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HCBA LAWYER