Uber Health: A Unified Framework for Fraud, Waste, and Abuse Prevention and Rider Safety in NEMT

Executive Summary

As the healthcare landscape evolves under shifting macroeconomic pressures and new legislative scrutiny, fraud, waste, and abuse (FWA) in supplemental benefits such as non-emergency medical transportation (NEMT) is under sharper focus than ever. At the same time, ensuring patient and member (collectively referred to as "rider") safety remains a non-negotiable priority for NEMT brokers, providers, and payors.

Within the NEMT industry, FWA and safety are often treated as separate problems, yet both stem from the same root causes: limited technological resources resulting in a lack of real-time visibility. These gaps drive unnecessary costs, increase risk, and can lead to preventable harm.

Uber Health delivers a technology-enabled framework to address both risks at once. The Uber Health platform combines advanced FWA safeguards, risk logic, and automated fraud detection with robust safety features. The result: a more transparent transportation benefit that helps protect riders and funding alike.

The Industry Landscape

The NEMT industry is being reshaped by a mix of fiscal scrutiny, regulatory oversight, and rising expectations for rider safety. These forces are not operating in isolation; together, they are creating a tighter operating environment for payors, brokers, and transportation providers alike.

• Regulatory Pressure: Healthcare transportation sits squarely in the crosshairs of current cost-containment priorities. Federal agencies, including CMS, the Office of Inspector General (OIG), and even independent government oversight committees such as the Government Accountability Office (GAO), have stepped up enforcement against non-emergency medical transportation (NEMT) fraud.
  

Legislative interest in curbing “waste” is intensifying, raising the possibility that transportation benefits could be scaled back or eliminated if not clearly justified.

Because CMS covers roughly 70% of Medicaid spending (FY2023), any tightening of federal requirements or we funding rules cascades quickly to states. State agencies, dependent on federal matching funds, must adapt policies and compliance programs or risk losing essential funding.

• Safety Expectations: Alongside fiscal scrutiny, states and payors are under mounting pressure to enforce rider protection standards, particularly for at-risk populations. Some customers are requesting NEMT providers to have clear requirements for how safety is prioritized and monitored, raising the stakes for transportation providers to demonstrate robust safety systems.

  
  

• Why This Matters Now: These trends are converging: federal cost-cutting priorities, state reliance on federal funding, and heightened safety expectations are colliding in a way the industry has not seen before. This creates both a compliance imperative and a strategic opportunity. Those who can simultaneously control costs, detect FWA, and elevate safety will be best positioned to protect access to transportation benefits in the years ahead.

Why FWA and Safety Are Linked Risks

Both fiscal oversight and rider protection depend on trip integrity: proof that the right ride happened, with the right person, in the right way. Without reliable trip verification, the same operational gaps can simultaneously expose payors and providers to fraud risk and potentially compromise rider safety.

• Missing or Unverifiable Pickup: The absence of a confirmed pickup event may signal a “no rider on trip” scenario (billing for a trip that never occurred) and leave a rider stranded without transport, triggering rebooking delays and potentially missed appointments and safety concerns.

  
  

• Unmonitored Route Deviation: Unexplained changes in routing can inflate mileage and payment amounts and place riders on potentially unsafe or unfamiliar paths.

Trip integrity isn’t just a compliance metric, it’s a safeguard for both brokers’ and payers’ bottom line and the rider’s well-being.

A Unified Risk Framework

Uber Health’s framework combines real-time monitoring, data transparency, and driver screening standards into a cohesive system that helps to address both FWA and safety risks. By uniting trip verification with integrated safety tools, the Uber Health platform provides tools to help riders feel safe and help ensure that they get in the right ride, with the right driver, and with technology that helps mitigate FWA.

• Real-Time Trip Visibility: Uber Health provides GPS data that compares driver location in relation to the requested pickup and drop-off points, as well as matching to the suggested route. This information is accessible in real time via SMS to the rider and through the Uber Health dashboard for trip coordinators, ensuring visibility and control.

  
  

• Automated Trip Anomaly and Risk Flags: Location data feeds advanced fraud and risk detection logic that validates each trip’s time, distance, and fare against expected parameters. Trips with excessive duration, inflated mileage, or unplanned route deviations compared to the trip’s estimates are dynamically flagged to prevent overbilling. The system also can detect long stops, midway drop-offs, and crash signals - prompting riders*, when necessary, to confirm if they are ok. This proactive feedback helps contain costs while enhancing rider safety. Insights from these flags feed platform-level oversight, informing resources and eligibility criteria for drivers, which helps strengthen compliance and safety across the network.

  
  

• Trip Logs on Dashboard and CSV: Coordinators can access comprehensive trip details via the Uber Health dashboard, including exact routes and pickup/drop-off locations. Admins and coordinators also have visibility into when trip fares are adjusted by automated FWA logic or manual review, empowering coordinators to oversee and verify trip integrity effectively.

  
  

• Driver Screenings and Platform Oversight: Uber Health utilizes the same onboarding and driver screening standards applied to drivers accessing the Uber App and across billions of trips globally.** This includes collection and verification of identity documents, and screening of the driver's driving and criminal history. All drivers are expected to follow Uber’s Community Guidelines, and may lose access to the platform if they violate them, this includes engaging in potentially unsafe or fraudulent behavior. Additional healthcare screenings are applied to Uber Health trips and are designed for compliance with health-specific requirements.

  
  

• Integrated Safety Tools for Riders: For riders who also have the Uber app, Uber Health offers Health Trip Account Linking, enabling them to connect Health rides to their personal account on the Uber app, including its in-app safety and support tools. Trip Linking also provides a second GPS data source, reducing compliance risk and bolstering fraud detection.

Riders without the Uber app can access key safety features through an SMS-linked webview: calling their driver, sharing trip status, using one-tap-call or discreet text-to-911, and more. If they contact 911, riders are also connected with Uber’s dedicated safety response teams.