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Armstead wants to know impact of medical transport bids on locals

CHARLESTON, W.Va. -- A ranking legislator called Wednesday for the Department of Health and Human Resources to halt the bidding process for a contract to manage non-emergency medical transportation for Medicaid patients, so that its impact on local Emergency Medical Service providers and volunteer fire departments can be determined.

"I think there are a lot of questions about this," House Minority Leader Tim Armstead, R-Kanawha, told the Joint Committee on Government and Finance.

He said many local ambulance services rely on revenue from non-emergency transports to remain in business.

"I think it would be useful to this committee to request that, to the extent possible, that contract awarding be held up," he added.

Later Wednesday, Bureau of Medical Services Commissioner Nancy Atkins said she would relay Armstead's concerns to DHHR Secretary Karen Bowling.

Atkins told members of the legislative joint committees on Government Operations and Government Organization that hiring a broker to manage non-emergency transportation for Medicaid patients should resolve issues raised in a legislative audit released Wednesday.

The audit found that Medicaid costs for non-emergency transportation have jumped 74 percent in nine years, from $14.6 million in 2003 to $25.5 million last year.

Most of the increase, the audit found, is for reimbursements to Medicaid patients who make their own arrangements to get to clinics or doctors' offices.

Currently, the DHHR relies on caseworkers to sign off on the transportation reimbursements, and those workers are not required to verify trip mileage or even if there was a legitimate medical visit, the audit found.

Also, the audit found that a requirement that Medicaid recipients use the least-expensive transportation option available is generally not well enforced.

The audit noted that transportation reimbursement costs can vary widely. Costs for a 30-mile round trip for a doctor's appointment can vary from $14.10 -- the cost of mileage reimbursement if the patient has a friend or family member drive them to the appointment -- to as much as $72.80 for round-trip fare with a taxi service.

An audit by Public Works LLC released in April reached similar conclusions, calling on the DHHR to retain a broker to manage non-emergency transportation costs.

Atkins told legislators Wednesday the contract for a non-medical transportation broker would give the DHHR a way to verify and manage transportation expenses.

"The intent is to save money for Medicaid . . . and to make sure Medicaid members have safe and adequate transportation," she said.

As part of the bid package, Atkins said, the broker would be required to offer contracts to all EMS units and VFDs that currently provide non-emergency transportation, and at the current Medicaid reimbursement rate.

"Our proposal says the broker must offer contracts to these entities," she said.

In November, a group representing ambulance crews from around the state rallied at the Capitol to oppose the DHHR contract for a transportation broker and to seek an exemption for local EMS providers.

On Wednesday, several legislators, including Delegate Margaret Staggers, D-Fayette, pointed out that the Legislature soundly defeated a Tomblin administration bill to put the Medicaid transportation broker into law.

"We defeated a bill to do this, and I'm not really sure how you can just do this now," she said.

Atkins said DHHR attorneys concluded that the department has authority to contract with a transportation broker, as 41 other states already have done.

Sen. Ron Stollings, D-Lincoln, said he would think Medicaid expansion, covering those with incomes of up to 133 percent of the poverty level, should offset any impact on ambulance providers from the transportation broker contract.

Noting that about 75,000 West Virginians have already signed up under the Medicaid expansion, Stollings said, "If anything, you would think business would go up by necessity."

Three companies submitted bids Monday for the non-emergency transportation broker contract: Access2Care LLC, of Greenwood Village, Colo.; Logistic Solutions LLC, of Atlanta; and MTM Inc., of Lake St. Louis, Mo.

Reach Phil Kabler at philk@wvgazette.com or 304-348-1220.


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