Exclusivity clause: when a broker or facility contract limits who else you can drive for

What can an exclusivity clause restrict?

An exclusivity clause can restrict three things: who you serve, which vans or hours you commit, and who gets served first. The second shows up in the transit industry’s own vocabulary. TCRP Synthesis 183 (2025) describes dedicated service as vehicles dedicated exclusively to one service and its customers, not used for other riders, and non-dedicated service as vehicles that may also carry non-program riders.

Each form has a cost. Serving one buyer only cuts off revenue from everyone else. Reserved vans can sit idle. A first-call promise moves every other customer to second place. The multiple brokers guide covers the broker side, and the dedicated vehicle contracts guide covers pricing a reserved van.

Are broker agreements exclusive?

They do not have to be, and two published ones are not. MTM’s standard provider agreement says each side is free to enter into agreements with other entities or persons to provide the same or similar services (section 16). It also says you have no claim to any particular rider or any rider of a particular facility (2.Q), and it promises no minimum number of trips (14.C). So the agreement asks for no exclusivity and gives no volume. Two related terms are narrower:

• Equal priority. MTM’s agreement gives each trip you accept equal priority with your other day-to-day work, and member rides equal priority with rides for the general public (2.P).
• Limited non-compete. You may not use MTM’s confidential information, including member details, to start a competing business, or solicit or hire MTM employees while they work there and for a year after they leave (21.D).

WellTrans’s Indiana agreement has no exclusivity term either. It bars each side from soliciting the other’s employees for a year.

North Carolina writes the rule into policy. Its Medicaid managed care NEMT policy (amended January 1, 2025) says health plans and their subcontracted brokers shall not include exclusivity or non-compete provisions in contracts with transportation providers, and shall not otherwise prohibit a provider from contracting with another health plan. The same guide shows how companies run several payers at once.

Where does exclusivity show up?

It shows up where a buyer pays for your capacity, not per ride. Three forms:

• Exclusive vans. A facility that pays for a van’s hours expects it to carry only that facility’s riders during the block.
• First-call terms. The Monroe County, Florida, agreement posted for its September 9, 2026 meeting has the contractor serve the county and other governmental entities ahead of any private citizen or corporation, on a first-priority basis, before, during and after a public emergency, and keep a 24-hour phone number open. That is a priority term rather than exclusivity, but it puts the county’s rides first for the days that matter.
• Minimum volume. MTM promises none. A buyer that asks for exclusivity is asking you to give up other revenue, so ask for a minimum in return, as a monthly payment or a trip count.

Does Medicaid’s free choice rule protect you?

It protects the rider, not you. Under 42 CFR 431.51(b), a beneficiary may get Medicaid services from any qualified provider willing to serve that person. A state can run a non-emergency transportation brokerage program notwithstanding that rule (42 CFR 440.170(a)(4)), so a broker may send its members only to its own network. A provider’s right to work for several brokers rests on the agreement or a state policy such as North Carolina’s. The network adequacy entry explains why a broker may close its network once its members are covered.

What about referral deals and non-competes?

Two related subjects have their own pages. If a facility or an ambulance company offers exclusivity in return for patient referrals, read the anti-kickback guide before you agree. For limits on drivers working elsewhere after they leave, see non-competes for NEMT drivers.

Asking for a narrow version

When a buyer wants exclusivity, narrow it:

• Named vehicles, by plate or VIN, instead of your whole fleet.
• Named hours, such as weekdays from 6 a.m. to 6 p.m.
• A schedule of existing customers you may keep serving.
• A minimum guarantee, with your right to end the exclusivity if the buyer misses it.
• First call instead of exclusive: the buyer’s rides are offered to you first, you answer within a stated time, and you are free to decline when no van is open.
• An end date, with a way out that matches the minimum. The termination for convenience entry covers notice terms.

Weighing what you give up

Before accepting a limit, look at what the payers you would drop are worth. For each payer and any date range you pick, HealthRide’s payer summary tallies completed trips, cancellations, revenue billed and the amount still owed.