Transportation Driver Enrollment Criteria and Forms

Revised: January 5, 2026

Individual transportation drivers must be enrolled with Minnesota Health Care Programs (MHCP). Drivers must meet the following requirements to enroll with MHCP, or to complete MHCP revalidation:

· Current license for state of practice (ambulance, air and other applicable licenses)

· Special Transportation Service (STS) certification and a current vehicle list from the Minnesota Department of Transportation.

· Proof that they have completed a background study through NETStudy 2.0.

· Nonemergency Medical Transportation (NEMT) drivers are required to complete fingerprint-based background studies through NETStudy 2.0

Publicly operated transit systems*, volunteer drivers**, not-for-hire vehicles*** and ambulance services are exempt from the enrollment requirement and do not need to enroll. Refer to Local County or Tribal Agency Nonemergency Medical Transportation (NEMT) Services in the MHCP Provider Manual for more information.

· *Publicly operated transit systems refer to bus, light rail, Americans with Disabilities Act (ADA) paratransit and air travel (private or commercial).

· ** A "volunteer driver" means an individual who transports persons or goods on behalf of a nonprofit entity or governmental unit in a private passenger vehicle and receives no compensation for services provided other than the reimbursement of actual expenses.

· ***Not-for-hire vehicles are private or non-commercial vehicles used for personal or business purposes and are not engaged in the transportation of goods or passengers for compensation.

How to Enroll

Individual Drivers

MHCP does not give individual transportation drivers access to MN–ITS.

Individual drivers can enroll with MHCP by faxing the completed enrollment forms to MHCP Provider Eligibility and Compliance at 651-431-7462.

· MHCP Individual Provider Enrollment Application (DHS-4016) (PDF).

· Complete all relevant fields including the Group Affiliation Information on page 6.

· The form must be signed by the driver.

· Individual transportation driver must read and sign the MHCP Individual Non-Pay-To Provider Agreement (DHS-4611A) (PDF).

· MHCP does not give individual transportation drivers access to MN–ITS.

· NETStudy 2.0 Background Study Number for individual transportation driver.

Medical Transportation Organizations

Medical transportation organizations may assist with the enrollment process for individual drivers.

You can enroll individual transportation drivers in one of the following ways:

· Use the Minnesota Provider Screening and Enrollment (MPSE) portal by logging into an enrolled Medical Transportation Organization’s portfolio and following the Organization to Individual Affiliations section in the MPSE manual. When using the MPSE portal to enroll transportation drivers, you will need to upload the following:

· Individual transportation driver must read and sign the MHCP Individual Non-Pay-To Provider Agreement (DHS-4611A) (PDF).

· NETStudy 2.0 Background Study Number or Application Number for individual transportation driver

Or

Complete and fax the following enrollment forms and required documents to MHCP Provider Eligibility and Compliance at 651-431-7462.

· MHCP Individual Provider Enrollment Application (DHS-4016) (PDF).

· Complete all relevant fields including the Group Affiliation Information on page 6.

· The form must be signed by the driver.

· Individual transportation driver must read and sign the MHCP Individual Non-Pay-To Provider Agreement (DHS-4611A) (PDF)

· MHCP does not give individual transportation drivers access to MN–ITS.

· NETStudy 2.0 Background Study Number for individual transportation driver

Affiliating Individual Drivers Already Enrolled with MHCP to an Organization

· Use the MPSE portal and refer to the step-by-step guide for Organization to Individual Affiliations.

Or

· Fax a completed copy of the MHCP Individual Provider Profile Change Form (DHS-3535) (PDF)

Review and keep a copy of the MHCP Data Privacy Notice (DHS-6287) (PDF).

Processing Timelines

· Applications are processed in order of date received, allow 30 days for processing.

· A request for more information letter will be sent through the U.S. Postal Service or your MN–ITS mailbox if more information is needed to complete your application.

· Incomplete applications will delay processing. Each corrected submission restarts the 30-day processing timeline.

Revalidation

MHCP is required to follow the Centers for Medicare & Medicaid Services final federal provider screening regulations.

Review the Revalidation subsection in the Provider Screening Requirements section of the MHCP Provider Manual for important information about the revalidation process and the impacts to your enrollment with MHCP. The section includes timelines, and providers who do not meet the revalidation timelines will have their enrollment terminated.

Reporting Changes

Report any changes made on a provider record to MHCP Provider Eligibility and Compliance. Refer to the Changes to Enrollmentin the Enrollment with MHCP section of the MHCP Provider Manual for details. MHCP must be notified of changes in ownership 30 days before sale or transfer of ownership.

Legal References

Minnesota Statutes, 256B.0625, subdivisions 17 – 18h (Transportation costs, Access to medical services)
Minnesota Rules, 9505.0315 (Medical Transportation)
Code of Federal Regulations, title 42, section 440.170 (other medical or remedial care recognized under State law)