Changes to Medicaid Transportation Leave Rural Patients Stranded

‍Getting to the doctor just got harder for many southwest Colorado residents.

Colorado’s Non-Emergency Medical Transportation (NEMT) program provides rides for Medicaid members to routine medical visits, such as doctor’s appointments, therapist visits, and pharmacies. For many in rural Colorado, it also provides transportation to specialists on the front range.

Of course, when I say “provides,” what I really mean is “funds.” Through the Medicaid program, the state pays for the costs of transportation. But they rely on private businesses or people to drive the vehicle.

This transportation generally happens in one of two ways. In one model, the Medicaid member can enlist the help of a family, friend, neighbor, or drive themselves, and Medicaid will reimburse the cost. The process for preapproval and payment goes through a statewide contractor, MediDrive (www.medidrive.com).

MediDrive does not provide or schedule transportation in our region at this time. They only process payments.

The second way to get NEMT transportation is through a business or organization who contracts with Medicaid. The transportation company provides the ride to the person and bills the State of Colorado directly.

This NEMT scenario has been the target of scrutiny over the last few years. There has been a freeze on enrollment of new NEMT providers in place since 2023 due to concerns of fraud, waste, and abuse in the service. In February 2025, Colorado suspended its contract with the previous transportation broker MedRide, also due to investigations of fraud.

Providers and clients alike were left in a lurch, unsure whether they would be paid for services or whether scheduled rides would occur.

Now in 2026, the Colorado budget has driven a significant decrease in the rate local transportation providers can charge for NEMT rides. For rural providers operating on thin margins, this may be the final blow.

Unlike metro transportation agencies, rural providers must travel long distances between stops. The ridership is lower, so the cost is not spread across as many people. And administrative costs of running a transportation business can be as high for a small rural provider as a large urban business.

As a result of these changes, one of the few NEMT providers in our region, Sunshine Rides, has terminated their NEMT services. This has left vulnerable people without rides to essential medical care. The remaining NEMT providers cannot fill in all the gaps and are struggling with the same rates reductions that drove Sunshine Rides out of this service.

Curently, the remaining providers include Southwest Rides in La Plata County, Montezuma County transportation in Montezuma County, the Dolores Senior Center in Dolores County, and Wilderness Journeys in Archuleta County. Riders are encouraged to schedule rides as far in advance as possible. Rides to front range specialists are not available through these providers.

Southwest Colorado Cares is attempting to coordinate information and provide advocacy for NEMT in our region. If you have questions or stories about how the lack of NEMT services is affecting you, contact connect@swcoloradocares.org or check the frequently asked questions at communityconnectionsco.org.