Starting an NEMT Company in Massachusetts: How the Broker System Works

Massachusetts NEMT is broker-managed — and knowing that up front is half the battle.

If you want to start a non-emergency medical transportation company that serves MassHealth members in Massachusetts, the structure of the program shapes everything you do. Here's how the pieces fit and what you need in place before you carry your first rider.

MassHealth rides run through the HST Office and regional brokers

Non-emergency medical transportation for MassHealth members is overseen by the state's Human Service Transportation (HST) Office within the Executive Office of Health and Human Services. Members are matched to a regional transit authority broker — such as MART or GATRA — based on where they live, and that broker arranges their rides.

Get compliant before you approach a broker

Before you can carry riders, register your business, secure commercial auto and general liability insurance, and get your vehicles inspected. Your drivers must clear CORI criminal background checks and Registry of Motor Vehicles record reviews — and those checks are repeated every year. Vehicles are inspected at least annually.

Then contract with your broker

Once your operation is compliant, you contract with the regional broker serving your area to receive trips. Depending on the population you serve and your enrollment path, you may also enroll directly with MassHealth. Many new operators start with smaller-capacity vehicles to keep obligations and costs manageable, then scale.

Key takeaway: Register and insure your business, get vehicles inspected and drivers cleared through yearly CORI and RMV checks, then contract with your regional transit authority broker to start carrying MassHealth riders.

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