Texting riders legally: TCPA consent rules for NEMT reminders

Which rider messages the TCPA covers

The Telephone Consumer Protection Act’s consent rules apply to calls placed with an autodialer or an artificial or prerecorded voice, and the FCC treats a text message as a call. A dispatcher who dials one rider by hand is outside those rules. The case to plan for is a system that sends reminder texts on a schedule.

Two Supreme Court decisions shape how far the rules reach:

• Facebook v. Duguid (April 1, 2021). The Court limited the autodialer definition to equipment with the capacity to store or produce numbers using a random or sequential number generator. A system that texts numbers from your rider list may fall outside that definition. The prerecorded voice rule has no such limit, and state laws define automated systems in their own words.
• McLaughlin Chiropractic v. McKesson (June 20, 2025). District courts hearing TCPA enforcement suits are not bound by the FCC’s interpretation of the statute. FCC orders still carry weight, but a judge may read the law differently.

Consent is the one defense that holds up however a court answers either question. It is also cheap compared with the alternative. Under 47 U.S.C. 227(b)(3), a person can sue for actual losses or $500 per violation, whichever is greater, and a court may triple the award for willful or knowing violations. As an example, 40 riders who never agreed to texts, each sent 10 automated reminders, add up to 400 violations and $200,000 at the statutory minimum.

What each type of message needs

The consent you need depends on the channel and on whether the message sells anything.

Prior express consent can be oral. It usually exists when a rider knowingly gives you a number so you can reach them about rides.

Prior express written consent is stricter. Under (f)(9) it is a written agreement signed by the person, with electronic signatures valid where federal or state law recognizes them. It names the number, authorizes automated marketing calls or texts, and says signing is not a condition of buying anything.

That line decides which consent you need. “Your pickup is tomorrow at 9:15 AM” is informational. The same text with “Book your next ride and save 10 percent” added becomes telemarketing, and reminder consent does not cover it.

Who can give consent

Consent belongs to the person who receives the messages, and it has to come from that person or someone the rules allow to act for them.

• The rider. The FCC’s 2015 order treats a patient who hands a phone number to a healthcare provider as agreeing to healthcare calls covered by HIPAA from that provider and the business associates working for it, as long as the calls stay within what the patient agreed to and the patient has not said otherwise.
• A broker or facility, only as a messenger. The FCC has said an intermediary may convey consent the person actually gave but cannot give consent for them. A number on a broker manifest tells you where to reach the rider. It does not prove the rider agreed to automated texts from your company.
• A caregiver, during medical incapacity. The same 2015 order lets a third party consent to healthcare calls when the patient cannot consent because of medical incapacity. That consent ends once the patient can decide for themselves.
• A family member, for their own phone. A daughter who manages her father’s dialysis rides can agree to get the texts at her number. Her consent covers her number, not his.

Numbers change hands. When a rider’s number is reassigned, the new owner never agreed to anything. Section 64.1200(m) gives a safe harbor to a caller who checked the FCC’s reassigned numbers database and got a wrong “no” answer, and the caller carries the burden of proving it. The everyday fix is simpler: when a reply says “wrong number” or “who is this”, stop texting that number and correct the rider’s profile the same day.

The health care exemption and its limits

Section 64.1200(a)(9)(iv) lets healthcare providers text or call cell phones without prior express consent, but only when every message meets every condition:

1. It is free to the recipient and does not count against their plan limits.
2. It goes only to the wireless number the patient provided.
3. It states the provider’s name and contact information.
4. Its purpose is on the list: appointment and exam confirmations and reminders, wellness checkups, hospital pre-registration instructions, pre-operative instructions, lab results, post-discharge follow-up intended to prevent readmission, prescription notifications, or home healthcare instructions.
5. It contains no telemarketing, solicitation, or advertising, and no billing, debt-collection, or other financial content.
6. A voice message runs about a minute or less, and a text stays at 160 characters or less.
7. A patient receives at most one message per day, and three in any week.
8. Each message offers an easy opt-out. For texts, replying STOP is the exclusive way to opt out.
9. Opt-outs are honored immediately.

A transportation company should treat this as a backstop, not a plan. The FCC wrote the exemption for healthcare providers and limited it to messages with a healthcare treatment purpose, and a pickup reminder does not appear on the purpose list word for word. After McKesson, a court can decide for itself whether a ride reminder counts.

The weekly cap is also easy to break. A rider with appointments on Tuesday and Thursday who gets a booking confirmation, a day-before reminder, and an on-the-way text for each ride receives six messages that week, double the limit. And a text mentioning a copay or an unpaid balance fails condition 5. Consent collected at booking covers all of those messages without any of these arguments.

Opt-outs under the current rules

The FCC’s revocation rules, adopted in 2024, took effect on April 11, 2025, except for one piece. The rules in force on September 30, 2026:

• Any reasonable way of saying no counts. Seven reply words end consent on their own: stop, quit, end, revoke, opt out, cancel, and unsubscribe. Other wording counts too when a reasonable reader would take it as a wish to stop getting messages.
• You may not name one exclusive way to opt out.
• You have a reasonable time to act on the request, capped at 10 business days from receipt.
• A request made another way, such as a voicemail or an email to the office, creates a rebuttable presumption that consent is revoked.
• If your texts come from a number that cannot receive replies, each text must say so and list the other ways to opt out.

The delayed piece is the “revoke-all” requirement. It would make an opt-out sent in response to one type of informational message cover all of a caller’s robocalls and robotexts on unrelated matters. The FCC’s Consumer and Governmental Affairs Bureau pushed its effective date to January 31, 2027 in Order DA 26-12 (January 6, 2026).

More change is on the table. A draft order released September 9, 2026 (FCC-CIRC 2609-05) and set for a vote at the Commission’s September 30, 2026 meeting would let a caller treat an opt-out from one category of informational message as covering only that category. It would also let a caller name one exclusive opt-out method, such as replying with one of the seven words, as long as every call or text discloses it. Those changes would take effect 30 days after publication in the Federal Register and replace the January 31, 2027 date. Check the adopted text before you change your opt-out process.

For an NEMT company, one approach works under any version of the rule. When a rider opts out, stop every automated text and call to that number, and let a dispatcher call by hand when a ride needs attention. The rule allows one confirmation text with no marketing in it, and a confirmation sent within five minutes is presumed to fall within the rider’s consent (64.1200(a)(12)). CTIA’s industry guidelines also call for one final opt-out confirmation.

A rider who replies “cancel” to cancel one ride has, under the rule, opted out of your texts. Offer a different reply for ride cancellations, a trap the ride reminders guide covers in detail.

Quiet hours and state telemarketing laws

Federal quiet hours cover sales calls, not reminders. Section 64.1200(c)(1) bars telephone solicitations before 8 a.m. or after 9 p.m. at the called party’s location, and a telephone solicitation is a call or message meant to encourage a purchase. A pickup reminder does not qualify.

A sending window still makes sense. Schedule day-before reminders between 8 a.m. and 8 p.m. in the rider’s time zone. Send time-critical texts, such as an on-the-way notice for a 5:30 a.m. dialysis pickup, only when the driver is actually heading there.

Some states add their own rules for sales calls and texts, with tighter hours and their own lawsuits. Two examples:

These laws aim at selling. They come into play when an NEMT company texts riders about private-pay service, a new wheelchair van, or a referral reward, and the federal written consent rule for automated marketing texts applies on top of them. Keep every reminder free of sales lines and it stays on the informational side of these rules.

Consent wording at intake

Ask the same question on every booking and store the answer where every dispatcher can see it. The trip intake guide and the trip request form show where it fits in the call.

A phone script the dispatcher reads word for word:

“We text a reminder the day before your ride and again when your driver is on the way. Can we text you about your rides at this number? Message and data rates may apply, and you can reply STOP at any time to end the texts.”

On an online booking form, use an unchecked box beside the phone field: “Text me ride reminders and driver updates at this number. Reply STOP to end texts.” If you also want to send marketing texts, add a second unchecked box with the written consent disclosures from 64.1200(f)(9), and never make it a condition of booking.

CTIA’s guidelines list what to keep for each opt-in. Adapted to a ride booking:

After a rider opts in, the first text should confirm the enrollment. CTIA’s guidelines call for the program name, a way to get help, how to opt out, a note that messages recur and how often, and any charges. Ask again whenever a rider gives a new number, and treat any number that arrives on a broker file as unconfirmed until the first call.

Reminder texts in HealthRide

HealthRide can text riders the day before and again shortly before pickup. The texts can include a link that shows the driver’s estimated arrival. Those are the automated messages this guide covers, so the consent question belongs in every booking. The live map page shows what riders and facilities see.