State Medicaid programs sign lucrative deals with transportation companies that are supposed to provide reliable free rides to and from medical care. But some shuttle drivers never show, or some patients have been injured during rides because their wheelchairs were not properly secured, according to lawsuits. Bouillante/Getty Images hide caption
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State Medicaid programs sign lucrative deals with transportation companies that are supposed to provide reliable free rides to and from medical care. But some shuttle drivers never show, or some patients have been injured during rides because their wheelchairs were not properly secured, according to lawsuits.
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Tranisha Rockmore and her daughter Karisma waited at an Atlanta children's hospital in July for their ride home.
Karisma had been at Children's Healthcare of Atlanta to have her gastrostomy tube fixed, Rockmore said. The 4-year-old, who has several severe medical conditions, has insurance coverage from Medicaid, which provides transportation to and from nonemergency medical appointments through private vendors.
After being told that a ride would not be available for hours, Rockmore said, she finally gave up and called her sister to drive them home to the South Georgia town of Ashburn, more than 160 miles away.
She said it wasn't the first time she had run into trouble with the Medicaid transportation service.
"Sometimes they don't ever come," said Rockmore, who doesn't own a car. Many rides have been canceled recently, she said; the company told her it couldn't find drivers. "Sometimes they make me feel like they don't care if my child gets to the doctor or not."
Rockmore's remarks would no doubt resonate with the Medicaid beneficiaries, relatives and advocacy groups across the country upset about problems patients have getting transportation for medical appointments. Not only are some shuttle drivers no-shows, but some patients have been injured during rides because their wheelchairs were not properly secured, according to lawsuits filed in Georgia and other states.
States are required to set up transportation to medical appointments for adults, children and people with disabilities in the Medicaid health insurance program. Transportation brokers — such as Modivcare, which Rockmore used — have subcontracts with local providers, often small "mom and pop" operations, to shuttle patients to and from needed appointments, including for dialysis, adult day care, and mental health and treatment for substance use disorders.
It's a lucrative business, with transportation management contracts that can be worth tens of millions of dollars for companies. The two companies that have contracts in Georgia have given extensively to political campaigns of elected officials in the state. The firms, Modivcare and Southeastrans, have also faced complaints, lawsuits and state government fines in Georgia and elsewhere. The two companies maintain, though, that the complaints relate to a tiny percentage of rides provided.
Medicaid nonemergency transportation "is absolutely a national challenge,'' said Matt Salo, executive director of the National Association of Medicaid Directors. "This is something practically all the states we talk to are dealing with. I don't think anyone has figured this out."
Beth Holloway, 47, of Wharton, New Jersey, said she has had multiple problems with rides. "Sometimes they arrive late, other times not at all," said Holloway, who has cerebral palsy and lives independently. "I've been stranded at doctors' offices for hours, sometimes out in the elements."
In Los Angeles, Rose Ratcliff and several other patients filed a lawsuit in 2017 against Modivcare, then known as LogistiCare; other local transportation brokers; and the insurers that run the state Medicaid program, known as Medi-Cal in California.
The pending suit alleges that Ratcliff and other patients like her missed crucial dialysis appointments and faced unsafe conditions during transport. It calls Modivcare the "broken link" in the Medicaid transportation chain and claims the company did not adequately respond to complaints from clients like Ratcliff.
Katherine Zerone, a spokesperson for Modivcare, said the company does not comment on pending litigation. In an initial legal response, it said the problems were linked to the independent transportation vendors and their employees, not Modivcare/LogistiCare.
After complaints were made about Southeastrans' service across Indiana, the state appointed a special legislative commission to review the company's performance. Indiana now publishes detailed complaint data for the Atlanta-based company each month.
In August, Timothy Mills, a Bloomington man who uses a wheelchair, filed a lawsuit alleging that the company had violated the Americans with Disabilities Act and other civil rights laws by not providing a wheelchair-accessible vehicle to transport him to and from his appointments. The lawsuit alleges that because of the lack of wheelchair accommodation, Mills missed needed medical care and was even kicked off the patient lists of some of his local doctors.
"While we're unable to comment on pending litigation, we're aware of the matter and strongly disagree with the allegations,'' said Christopher Lee, an attorney for Southeastrans, which operates in seven states and Washington, D.C.
Two decades ago, Georgia was one of the first states to start using transportation brokers to manage its Medicaid transportation program. The two longtime providers in the state — Modivcare and Southeastrans — will receive a total of $127.6 million from the state this fiscal year. They are paid a per-member monthly rate that averages $5.60 in Georgia, regardless of how many rides, if any, a Medicaid user takes. The state is expected to announce new contracts for Medicaid transportation in January 2022.
Georgia assessed a total of $4.4 million in penalties to the two companies over the period from January 2018 to December 2020 for failing to pick up patients on time and other problems. However, the state Medicaid agency essentially gave them discounts, charging the two companies only $1.2 million during that period, according to state Department of Community Health letters obtained through an open records request. In extending the brokers' contracts in the 2018 fiscal year, the state Medicaid agency agreed to cap damages at 25% of the assessed amount, Department of Community Health spokesperson Fiona Roberts said.
Modivcare said it's the largest transportation broker nationally, controlling about 40% of the market. The publicly traded company based in Colorado provides Medicaid transportation in more than 20 states.
Modivcare and other companies say only a tiny fraction of the rides they provide lead to complaints. "Our first priority is safe and reliable transportation," Zerone said. In Georgia, 99.8% of its trips are complaint-free, she said.
Andrew Tomys, Georgia state director for Southeastrans, said 99.9% of the trips his company services in the state are "free of valid complaints."
Both Modivcare and Southeastrans say they investigate each complaint to determine whether it's valid. In Georgia, Modivcare reported to the Department of Community Health more than 3,200 late rides or no-shows over a year out of around 2.3 million rides. Southeastrans reported just over 900 such problems out of around 1.4 million rides.
But patients and their advocates say that in many cases problems aren't reported, or complaints are ignored.
Georgia should peg any new contracts to timely rides, ease of use for beneficiaries and the overall ride experience, said Melissa Haberlen DeWolf, policy director of the advocacy group Voices for Georgia's Children.
In recent election cycles, Southeastrans and Modivcare — through its former corporate name LogistiCare — have been generous donors to Georgia Republicans, who have controlled state offices in the state for nearly two decades.
Southeastrans, as a company, has donated $126,000 to Georgia Republican campaigns and committees since 2017, according to documents on the Georgia Government Transparency and Campaign Finance Commission website.
Additionally, Southeastrans' co-founder and CEO, Steve Adams, has given at least $86,000 to Georgia Republican candidates for state office and to the state Republican Party since 2017, according to state filings. During that same period, Adams donated $3,800 to two state Democratic candidates.
"As a minority-owned business headquartered in Georgia for over 20 years, Southeastrans and its owner have contributed to a diverse mix of local causes and organizations," Lee said.
Modivcare, through LogistiCare, has given $48,350 to Georgia Republican candidates in state races since 2017, according to the Georgia Government Transparency and Campaign Finance Commission. It gave $750 to former Democratic state Rep. Pat Gardner, also according to the commission. Modivcare's Zerone did not answer questions about the company's political giving because she said it would be "competitive information."
Such contributions can help companies buy access to government officials, said Paul S. Ryan, a vice president at the government watchdog group Common Cause.
"Anytime a special interest doing business with the government can make big contributions to public officials handing out contracts or making other government decisions, it's a cause for concern," he said. "Average, everyday Americans can't buy the same influence."
Tranisha Rockmore said she's so fed up that she wants to get a car so she can avoid the transportation problems. "I'm to the point where I feel like they don't care about my daughter," she said. "You don't just do people's kids like that."
This story was produced by Georgia Health News and KHN (Kaiser Health News), a national newsroom and an operating program of KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.
FAQs
Does Florida Medicaid pay for transportation to doctor appointments? ›
It's easy and free to plan and get a ride: You can get a ride to your doctor, the pharmacy, or a healthcare visit. You can get as many rides as you need. You can plan a one-time ride, or you also can plan rides for regular doctor visits or other appointments.
Does Illinois Medicaid pay for transportation? ›Emergency transportation (ambulance) is covered when medically necessary. Non-emergency medical transportation to medical facilities can be covered when you do not have any way to get to your medical appointments.
Does Medi Cal pay for rides to doctor appointments? ›Medi-Cal offers transportation to and from appointments for services covered by Medi-Cal. This includes transportation to medical, dental, mental health, or substance use disorder appointments, and to pick up prescriptions and medical supplies.
Does Virginia Medicaid provide transportation? ›Overview. Transportation is covered by Medicaid when you do not have another way to get to your doctor appointment or other Medicaid services. It is available for Medicaid members who are part of our managed care health plans as well as members in our fee-for-service program.
How Does Medicare pay for transportation? ›Funding for Medicare, which totaled $888 billion in 2021, comes primarily from general revenues, payroll tax revenues, and premiums paid by beneficiaries (Figure 1). Other sources include taxes on Social Security benefits, payments from states, and interest.
Can you use Medicaid out of state? ›Can I use my Medicaid coverage in any state? A: No. Because each state has its own Medicaid eligibility requirements, you can't just transfer coverage from one state to another, nor can you use your coverage when you're temporarily visiting another state, unless you need emergency health care.
What does Illinois Medicaid pay for? ›Primary services funded through Medicaid are physician, hospital and long term care. Additional coverage includes drugs, medical equipment and transportation, family planning, laboratory tests, x-rays and other medical services.
How much does Medicaid pay for non-emergency transportation in Illinois? ›This service is limited to $500 per month and must fit within the AHBS individual's monthly budget. DDD will continue to conduct compliance reviews to ensure the integrity of paid bills and Medicaid claims.
How to become a Medicaid transportation provider in Illinois? ›How do I enroll my transportation company? Contact HFS Provider Enrollment Services at 217-782-5565 or 888-618-8078 for assistance with enrolling as a non-emergency transportation service provider.
How do senior citizens get around? ›Ride-sharing apps like Uber and Lyft give seniors access to a car, anywhere if they have a smartphone. If the senior isn't comfortable with a smartphone, their loved ones can order the ride from their smartphone.
Is Medi-Cal always free? ›
For many individuals who enroll in Medi-Cal, there is no premium, no co-payment, and no out of pocket cost. Some households will see affordable costs, such as a low monthly premium. For some Medi-Cal children, the monthly premiums are $13 per child up to a family maximum of $39 per month.
What is a litter van? ›"Litter van" means a vehicle which is modified, equipped and used for the purpose of providing nonemergency medical transportation for those patients with stable medical conditions who require the use of a litter or gurney and which is not routinely equipped with the medical equipment or personnel required for the ...
What is the number for Medicaid transportation in VA? ›Call 1-866-246-9979 to request a ride. The type of transportation available to members will depend on their location and condition but may include: public transit, volunteer driver, gas reimbursement, car, van, taxi, wheelchair transport, stretcher van, and non-emergency ambulance.
What is the Medicaid of Virginia transportation number? ›For Medicaid Travel non-emergency reservations, please call 1-866-386-8331; for Medicaid travel general information, please call 1-866-810-8305, extension 2604. To make a reservation for Fee for Service Medicaid, call 1-866-386-8331 or go online to https://member.logisticare.com.
Is Medicaid free in Virginia? ›Medicaid has health coverage programs for adults in Virginia who qualify. There are no enrollment costs and no monthly premiums for adults between 19-64 years old who qualify. Their income must be within the limits.
How Much Does Medicare pay for mileage? ›CMS computes the allowance per mile by using the Federal mileage rate of $0.56 per mile plus an additional $0.45 per mile to cover the technician's time and travel costs. MACs have the option of establishing a higher per mile rate in excess of the minimum $1.01 per mile, if local conditions warrant it.
How does Medicare work when traveling? ›Pay 80% of the billed charges for certain medically-necessary emergency care outside the U.S. after you meet a $250 deductible for the year. Cover foreign travel emergency care if it begins during the first 60 days of your trip, and if Medicare doesn't otherwise cover the care.
What are 3 ways Medicare is funded? ›Medicare is funded through a mix of general revenue and the Medicare levy. The Medicare levy is currently set at 1.5% of taxable income with an additional surcharge of 1% for high-income earners without private health insurance cover. Medicare funds access to health care in two main ways.
How to become a non emergency medical transportation provider in Florida? ›- Obtain a business license and/or provide proof of a business license.
- Register with the county or city in which you plan to do business.
- Provide proof of vehicle insurance.
- Provide registration of your vehicle(s).
- Provide photos of your vehicle(s).
- Have your vehicle(s) inspected.
Florida Medicaid's Covered Services and HCBS Waivers
Medicaid reimburses for medically necessary emergency ground or air ambulance transportation. This service is one of the minimum covered services for all Managed Medical Assistance, Long-Term Care, and Comprehensive Long-Term Care plans serving Medicaid enrollees.
What is the website for Florida Medicaid? ›
Individuals may apply for assistance online at: www.myflorida.com/accessflorida/ Additional information about Medicaid for low income families is available in the Family-Related Medicaid Fact Sheet.
What is Medicaid non emergency transportation card Alabama? ›The Alabama Medicaid Agency's Non-Emergency Transportation program helps eligible recipients pay for rides to dental and doctor offices, hospitals and other medical facilities when the service is also covered by Medicaid.
What qualifications do you need to work for patient transport service? ›- GCSEs grade 9 to 4 (A* to C) in English, maths and science.
- experience in a customer care role, like a call centre operator.
- a good knowledge of local geography.
- good keyboard and computer skills.
Non-Medical Transportation allows members to gain access to non-medical community services and supports, as required by the care plan to prevent institutionalization. Non-Medical Transportation services shall include, but not be limited to: Adult Day programs. Shopping.
What is non medical emergency transportation business? ›What's a non-emergency medical transportation business? NEMT services help people get to pre-scheduled healthcare appointments, including doctor visits, rehab, clinical testing, follow-up exams, and more.