State must assure Medicaid patient transportation system works

It should be no great surprise that a new contractor, hired by the state to transport Medicaid recipients to medical appointments, had a tough start. This is a difficult service, provided to poor people living on the margins and more transient than the general population. With thousands of patients transported weekly to thousands of appointments, there are bound to be problems, particularly when a new outfit takes over.

The program provides about 4 million rides annually in Connecticut.

That being said, the number of issues documented last week in a story by Day Staff Writer Martha Shanahan about the company that won the transportation contract, Total Transit Inc. of Arizona, is cause for concern, both because missing medical appointments can be serious and because it suggests the state is not getting what it’s paying for.

The contract provides Total Transit and its subsidiary, Veyo, $7 million a year over the next three years to run the service, with another $140 million to be collected in Medicaid payments for the transportation itself.

Shanahan documented cases in which drivers showed up very late or not at all, of people waiting long periods on hold after phoning for service, and of vehicles not equipped to meet the disability needs of the patients. Interviews with medical and social service organizations, which work with this population, demonstrated the problem was widespread.

Veyo, which began services Jan. 1, was not prepared for the volume of calls it had to handle, did not have adequate information in place about the Medicaid patients it would serve, and fell far short in staffing its phones.

Finger pointing has ensued. Veyo contends it received incomplete and inaccurate information from LogistiCare, which had operated the service for six years only to lose its contract when the Department of Social Services put the program out to bid. LogistiCare insists the handoff was a clean one and that it supplied all the data to Veyo necessary to successfully manage the program.

DSS spokesman David S. Dearborn said the agency is not interested in settling that argument, but is insistent that Veyo meet its obligation to Medicaid patients and the state. Since the troubled start, said Dearborn, the department has seen improvement in the call center operated by Veyo. But providing prompt service remains a problem, including in the critical area of dialysis care, he said.

In seeming anticipation by both sides that things might not go smoothly, the contract states Total Transit cannot be hit with sanctions for service problems during the first 60 days. After that time, if systemic problems continue, the state can seek penalties to claw back some of the expenditures it made to pay for the service.

DSS officials need to stay on top of this, working with hospitals, social service agencies, medical groups and patients to document any problems that continue and pursue penalties if warranted. Three weeks in, however, is too soon to conclude how well the program will work. Veyo contends an online and mobile app appointment service will soon be fully operating, helping improve service.

This massive undertaking is a reminder of the breadth of services the state and federal government provide as an entitlement, not only paying for care but transporting patients to access it. Yet withholding such a service would not only be callous, but prove more costly as patients end up with more serious and costly medical conditions.

But if the state is going to provide this service, it must assure it works.

The editorial board is composed of the publisher and four journalists of varied editing and reporting backgrounds. The board's discussions and information gained from its meetings with political, civic, and business leaders drive the institutional voice of The Day, as expressed in its editorials. The editorial department operates separately from the newsroom.


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