---
kind: "section"
citation: "42 C.F.R. § 457.1206"
title: "42"
number: "457.1206"
heading: "Non-emergency medical transportation PAHPs."
url: "https://uscodex.org/cfr/42/457.1206"
---

# §457.1206. Non-emergency medical transportation PAHPs.

- (a) For purposes of this section Non-Emergency Medical Transportation (NEMT) Prepaid Ambulatory Health Plan (PAHP) means an entity that provides only NEMT services to enrollees under contract with the State, and on the basis of prepaid capitation payments, or other payment arrangements that do not use State plan payment rates.
- (b) The following requirements and options apply to NEMT PAHPs, NEMT PAHP contracts, and States in connection with NEMT PAHPs, to the same extent that they apply to PAHPs, PAHP contracts, and States in connection with PAHPs.
  - (1) All contract provisions in [§ 457.1201](/cfr/42/457.1201.md) except those set forth in [§ 457.1201(h)](/cfr/42/457.1201.md?p=h) (related to physician incentive plans) [§ 457.1201(l)](/cfr/42/457.1201.md?p=l) (related to mental health parity).
  - (2) The information requirements in [§ 457.1207](/cfr/42/457.1207.md).
  - (3) The provision against provider discrimination in [§ 457.1208](/cfr/42/457.1208.md).
  - (4) The State responsibility provisions in §§ [457.1212](/cfr/42/457.1212.md) and [457.1214](/cfr/42/457.1214.md), and [§ 438.62(a)](/cfr/42/438.62.md?p=a) of this chapter, as cross-referenced in [§ 457.1216](/cfr/42/457.1216.md).
  - (5) The provisions on enrollee rights and protections in §§ [457.1220](/cfr/42/457.1220.md), [457.1222](/cfr/42/457.1222.md), [457.1224](/cfr/42/457.1224.md), and [457.1226](/cfr/42/457.1226.md).
  - (6) The PAHP standards in [§ 438.206(b)(1)](/cfr/42/438.206.md?p=b-1) of this chapter, as cross-referenced by §§ [457.1230(a)](/cfr/42/457.1230.md?p=a) and [(d)](/cfr/42/457.1230.md?p=d) and [457.1233(a)](/cfr/42/457.1233.md?p=a), [(b)](/cfr/42/457.1233.md?p=b), and [(d)](/cfr/42/457.1233.md?p=d), excluding the requirement in [§ 438.242(b)(7)](/cfr/42/438.242.md?p=b-7) of this chapter to comply with [§ 431.61(a)](/cfr/42/431.61.md?p=a) of this chapter.
  - (7) **An enrollee's right to a State review under subpart K of this part.**
  - (8) Prohibitions against affiliations with individuals debarred or excluded by Federal agencies in [§ 438.610](/cfr/42/438.610.md) of this chapter, as cross referenced by [§ 457.1285](/cfr/42/457.1285.md).
  - (9) Requirements relating to contracts involving Indians, Indian Health Care Providers, and Indian managed care entities in [§ 457.1209](/cfr/42/457.1209.md).

## Notes

### Amendments

[81 FR 27897, May 6, 2016, as amended at 89 FR 8985, Feb. 8, 2024]

### Source

Source: 81 FR 27897, May 6, 2016, unless otherwise noted.

### Authority

Authority: 42 U.S.C. 1302.

### Source

Source: 65 FR 33622, May 24, 2000, unless otherwise noted.

### Amendments

[81 FR 27897, May 6, 2016, as amended at 89 FR 8985, Feb. 8, 2024]