How to start a NEMT business in Idaho: MTM, DHW background checks, and IDAPA rules
Idaho Medicaid uses one statewide broker for non-emergency rides: MTM Health. The Department of Health and Welfare (DHW) pays MTM a fixed amount per member each month, and MTM contracts the providers, authorizes every trip, and pays for it. Drivers with direct member contact need a DHW fingerprint background check. DHW's September 2026 procurement schedule lists the current MTM contract through January 3, 2027, and Idaho plans to move Medicaid into comprehensive managed care on January 1, 2030.
Idaho NEMT at a glance
- Runs the program
- Idaho Department of Health and Welfare, Division of Medicaid (DHW)
- Program
- Idaho Medicaid Non-Emergency Medical Transportation (NEMT)
- How rides are arranged
- One statewide broker. DHW pays MTM Health a fixed amount per member per month. MTM arranges, authorizes, and pays for every non-ambulance NEMT trip statewide.
- Brokers you will contract with
- MTM Health
- State operating license
- MTM credentialing rather than a state NEMT license. Drivers with member contact clear a DHW fingerprint background check (IDAPA 16.05.06).
- EVV for NEMT trips
- Not required
- Medicaid enrollment
- 290,944 (May 2026, Medicaid only)
On this page
How Medicaid NEMT works in Idaho
DHW's Division of Medicaid covers NEMT under IDAPA 16.03.26, sections 340 to 343. The rule calls for a transportation broker under contract with the department to run a statewide network. The broker contracts with transportation providers, runs the call center, authorizes trips, pays providers, and makes sure rides are delivered safely and professionally. DHW pays the broker a fixed, actuarially sound amount per member per month.
MTM Health holds that contract and is Idaho Medicaid's transportation provider for all non-emergency, non-ambulance medical transportation. The current contract was signed January 4, 2023. DHW's Medicaid NEMT team oversees it and takes questions at 800-296-0509.
The broker pays for a trip only when the travel is essential to reach a covered service, uses the least costly appropriate mode, goes to the nearest appropriate provider by the most direct route, and was authorized and scheduled by the broker. A personal vehicle, family, friends, or charities must be unavailable or impractical. Meals, lodging, and a non-family attendant's wages are paid in the cases the rule defines, such as a trip that cannot be completed in one day.
Governing rule:IDAPA 16.03.26: Medicaid Plan Benefits, sections 340 to 343 (NEMT)
Who brokers Medicaid rides in Idaho
One broker arranges all non-emergency, non-ambulance Medicaid transportation in Idaho, so providers join a single network, MTM's, for Medicaid trips anywhere in the state.
| Broker | Serves | Provider sign-up |
|---|---|---|
| MTM Health | All Idaho Medicaid members who qualify for NEMT, statewide. Ambulance transport is billed separately.Since January 4, 2023 (current contract). DHW's procurement schedule dated September 8, 2026 lists the current contract ending January 3, 2027. | Provider pageTransportation provider line 888-828-1183 |
House Bill 345 (2025) directs Idaho Medicaid to move to comprehensive managed care. DHW has set the start for January 1, 2030, plans three managed care organizations, and expects to post the request for proposals in 2027.
IDAPA 16.03.26 lists contracted NEMT providers with direct participant contact among the providers who must clear a DHW background check. Individual contracted NEMT providers are excluded from that list.
How to become a NEMT provider in Idaho
In Idaho the path runs through MTM. There is one network to join, and MTM handles recruiting, credentialing, contracting, and training.
Form the business
Register the company with the Idaho Secretary of State, get a federal EIN, and hold the business license your city or county requires. MTM's provider audits check for a current, valid business license.
Apply to MTM
MTM's recruiting process has application, credentialing, and contracting phases, and a designated contract representative works with you through each one. MTM then trains you on its trip process and MTM Link before your first trip.
Clear DHW background checks
Drivers with direct member contact complete a DHW fingerprint-based criminal history and background check under IDAPA 16.05.06. The check can draw on FBI and Idaho State Police records, child and adult protection registries, sex offender registries, the OIG exclusion list, and Idaho Transportation Department driving records. The fee is up to $70 per person, and the fingerprints must reach DHW within 21 days of the application.
Insure the company
MTM requires general liability and automobile liability policies of at least $1,000,000 each, with MTM listed as certificate holder and additional insured on both. You also need workers compensation that meets Idaho requirements.
Pass the MTM vehicle inspection
MTM inspects each vehicle before approval. Any missing starred item on its inspection sheet fails the vehicle, including horn, mirrors, lights, turn signals, tires, wipers, seat belts, heat and air conditioning, current registration, a valid insurance card, and company placards on both sides. Wheelchair vehicles add lift, ramp, and securement items, and stretcher vehicles add restraint and anchorage items.
Run trips in MTM Link
MTM sends assignments through its Electronic Trip Download system. It does not pay for no-shows, so confirm each ride with the member the day before. MTM sets trip rates with each provider individually.
Vehicle and driver requirements in Idaho
Idaho's NEMT rule leaves vehicle and driver standards to the broker. The state sets the background check, and MTM's service agreement and handbook set the rest.
Vehicles
| Requirement | State rule | Broker contract |
|---|---|---|
| Operating approval | No NEMT license in IDAPA 16.03.26. The broker contracts transportation providers statewide. | MTM credentialing and a current local business license. |
| Vehicle inspection | No vehicle standard in the NEMT rule. | MTM inspection before approval. Starred items must pass, and wheelchair and stretcher vehicles have their own lift, securement, and anchorage items. |
| Timeliness | Trips go to the nearest appropriate provider by the most direct route (IDAPA 16.03.26.342). | Arrive within 15 minutes either side of pickup time, wait at least 15 minutes, answer will-call pickups within one hour, and keep ride time under twice the normal commute. |
| Paid mileage | The broker pays only trips it authorized and scheduled. | MTM calculates paid mileage with a GPS-based system on the shortest distance from pickup to destination, whatever route the driver took. |
Drivers
| Requirement | State rule | Broker contract |
|---|---|---|
| Background check | DHW fingerprint check under IDAPA 16.05.06 for contracted NEMT providers with direct participant contact (IDAPA 16.03.26.003). | MTM monitors background checks, and its provider audits review training records for at least 10 percent of approved drivers. |
| Training | No course named in IDAPA 16.03.26. | Fraud, waste, and abuse training and HIPAA training for every employee each year, plus accident, claims, MTM Link, and cultural competency training. |
| Company policies | Not set by the NEMT rule. | Written driver training, annual training, orientation, performance, incident investigation, and drug screening policies, checked at MTM audits. |
| Trip records | Trips must be authorized and scheduled by the broker. | A passenger signature and a trip log or voucher for every trip. |
Insurance minimums in Idaho
The NEMT rule sets no dollar minimum. Idaho's financial responsibility floor applies to every vehicle, and MTM sets the working minimums. The table uses MTM's current Idaho provider page, which requires $1,000,000 each. MTM's 2023 Idaho provider handbook still lists $500,000 combined single limits, so confirm the figure in your MTM contract.
| Coverage | Minimum | Set by |
|---|---|---|
| Auto liability floor, any vehicle | $25,000 per person, $50,000 per accident, $15,000 property damage | Idaho Code § 49-117 |
| General liability | $1,000,000, MTM named as additional insured | MTM contract |
| Automobile liability | $1,000,000, MTM named as additional insured | MTM contract |
| Workers compensation | Amount that meets Idaho requirements | MTM contract |
Does Idaho require EVV for NEMT?
No. Idaho requires EVV for home health, state plan personal care services, and attendant care, homemaker, and respite under the Aged and Disabled waiver (IDAPA 16.03.26.054). NEMT is not on that list.
MTM checks trips instead. It authorizes and schedules every ride, calculates paid mileage by GPS, requires a passenger signature and a trip log or voucher, and audits driver files and vehicles during provider visits.
What changed in Idaho in 2025 and 2026
Idaho Medicaid covered 290,944 people in May 2026, plus 19,456 in CHIP, according to preliminary CMS data.
DHW pays MTM a fixed amount per member per month under IDAPA 16.03.26.343, and MTM sets trip rates with each provider. MTM does not pay for no-shows, and providers whose late arrivals cause a missed appointment can face corrective action and liquidated damages under the MTM handbook.
Two dates shape the next few years. DHW's procurement schedule lists the current MTM contract ending January 3, 2027. Comprehensive managed care is set for January 1, 2030, with a blackout on bidder discussions from December 1, 2026 and the request for proposals expected in 2027.
DHW and MTM sign the current NEMT contract.
The Governor signs House Bill 345, which directs Idaho Medicaid toward managed care.
DHW opens a public request for information on comprehensive managed care.
The blackout period for the managed care request for proposals begins.
End date of the current MTM contract on DHW's procurement schedule.
Scheduled start of comprehensive Medicaid managed care in Idaho.
Frequently asked questions
- Who is the NEMT broker in Idaho?
- MTM Health is the statewide broker for all non-emergency, non-ambulance Medicaid transportation in Idaho. Transportation providers reach MTM at 888-828-1183. DHW's Medicaid NEMT team, which oversees the MTM contract, is at 800-296-0509.
- Do I need a license to run a NEMT business in Idaho?
- Idaho Medicaid's NEMT rule does not license transportation companies. You need a registered business, the local business license your city or county requires, an MTM contract with current credentials, and a DHW background check for every driver with direct member contact.
- How do I join the MTM network in Idaho?
- Complete MTM's application, then work with a contract representative through credentialing and contracting. Submit insurance certificates, pass the vehicle inspection, finish MTM's training, and MTM starts sending trips through its trip download system.
- What insurance does MTM require in Idaho?
- General liability and automobile liability of at least $1,000,000 each, with MTM named as certificate holder and additional insured, plus workers compensation that meets Idaho requirements. MTM's 2023 handbook lists $500,000 limits, so confirm the amount in your contract. Every vehicle must also meet Idaho's floor of $25,000 per person, $50,000 per accident, and $15,000 property damage.
- What background check do Idaho NEMT drivers need?
- A DHW fingerprint-based criminal history and background check under IDAPA 16.05.06. It covers FBI and state records, abuse registries, sex offender registries, the OIG exclusion list, and driving records. The fee is up to $70, and fingerprints are due within 21 days of applying.
- Does MTM pay for no-shows in Idaho?
- No. MTM does not reimburse transportation providers for no-shows. Confirm the pickup time with the member the day before, and cancel the trip if the member will not attend.
- Does Idaho require EVV for NEMT?
- No. Idaho EVV covers home health, state plan personal care, and attendant care, homemaker, and respite under the Aged and Disabled waiver. MTM documents NEMT trips with passenger signatures, trip logs, and GPS mileage instead.
- What happens to the MTM contract in 2027?
- DHW's procurement schedule dated September 8, 2026 lists January 3, 2027 as the end of the current MTM contract. Keep your MTM credentials current and watch DHW's NEMT page for an extension or a new award.
- Will Idaho's move to managed care change NEMT?
- Comprehensive managed care is scheduled for January 1, 2030, with three managed care organizations planned. DHW will set the program design in its request for proposals, expected in 2027.
Running NEMT in Idaho with HealthRide
Idaho fleets answer to one broker but cover long rural distances. Ryder Go plans the whole day in one click, and the live map shows every vehicle with ETAs and late warnings, which helps with MTM's 15-minute pickup window.
The driver app keeps working without cell service and records GPS-recorded miles, timestamps, and signatures on every leg, so signatures and trip records are captured as the trip happens.
Official resources
- DHW: About non-emergency medical transportation (NEMT)
- DHW: Managed care providers
- DHW: Medicaid contract procurement schedule
- DHW: The future of Idaho Medicaid is managed care
- DHW: Idaho Medicaid seeks public input on managed care (November 2025)
- Idaho Legislature: House Bill 345 (2025)
- IDAPA 16.03.26: Medicaid Plan Benefits
- IDAPA 16.05.06: Criminal history and background checks
- Idaho Medicaid Provider Handbook: Transportation Services (March 2026)
- MTM Health: Idaho transportation providers
- MTM Health: Idaho Transportation Provider Handbook
- MTM Health: Provider onboarding
- Idaho Code § 49-117: Definitions, including proof of financial responsibility
- CMS: State Medicaid and CHIP enrollment data
HealthRide plans the whole day in one click and bills every ride.
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