Switch to third-party vendor leaves MaineCare patients without rides

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LEWISTON — A change in the way MaineCare, the state’s Medicaid program, provides transportation for clients without vehicles has left many stranded or missing appointments in recent weeks.

On Monday, Tracy Bennett of Bethel said she’s been stood up for a ride at least 10 times in the last week.

Bennett, who is being treated for cancer and attends substance abuse counseling in Rumford, said she’s increasingly frustrated and worried about her health.

Equally frustrating is Bennett can’t get her driver’s license back until she completes the counseling, she said.

But Bennett is not alone. She’s among hundreds who have called to complain their rides aren’t showing up and appointments are being missed.

The change, which went into effect Aug. 1, saw the state shift the way rides were being assigned because of concern from the federal Centers for Medicare and Medicaid  that ride agencies, such as Community Concepts and Western Maine Transportation, were brokering their own rides.

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To alleviate those concerns over conflicts of interest, the state contracted with three agencies, including Coordinated Transportation Solutions of Ansonia, Conn.

With a staff of about 40 people in a Lewiston call center, CTS brokers the rides for six of the state’s eight health care transportation regions — including Aroostook, Washington, Hancock, Waldo, Knox, Lincoln, Sagadahoc, Cumberland, Androscoggin, Kennebec, Oxford, Franklin and Somerset counties.

Starting Aug. 1, CTS began brokering the rides but, because they must abide by strict federal guidelines, they also stopped paying volunteer drivers for “unloaded” miles.

Unloaded miles are the miles a volunteer driver travels from his or her home to the patient pickup point. That change saw many drivers decide they simply couldn’t afford to provided rides anymore so they dropped out of the system, according to state Sen. Margaret Craven, D-Lewiston.

Craven said she met with CTS President David White, DHHS officials and staff from some of the ride agencies in Augusta last Friday. 

In a memo to the Democratic caucus in Augusta, Ted Potter, a member of the Senate staff, outlined some of the details from that meeting,

“Drivers have abandoned volunteering in droves,” Potter wrote.

Meanwhile, Craven said she believed CTS was going to increase the amount it does pay drivers for loaded miles, going from 41 cents per mile to 56 cents per mile and as much as 67 cents per mile in certain instances.

DHHS has also said it is not satisfied with the work CTS has done in the first month of a contract that is valued at $28 million.

“The launch of this new system has not gone as planned and the performance has been both frustrating and unacceptable,” according to Sarah Cairns, a spokeswoman for MaineCare.

Cairns said the problems have been statewide and noted that rural areas have been particularly hard hit by the resignation of volunteer drivers.

“We are holding the brokers accountable,” Cairns wrote in an email to the Sun Journal on Monday.

Craven and Cairns said CTS had brought in additional staff, including for the call center and drivers.

“We are holding check-in sessions twice daily with the brokers and are continually reviewing contingency plans to assure that their performance improves.” Cairns wrote. “As we move into the second full week of this new system, we will remain vigilant in holding the brokers accountable for the provision of rides to Medicaid recipients.”

MaineCare made the switch to the brokered ride system because it risked losing a portion of the federal funds it receives for the transportation program, Craven said.

She said had the state not switched, it would have only received 50 cents for every dollar it spent on the program. Under the new system, the state is paid 67 cents for every dollar it spends on the program, she said.

Craven said lawmakers researched CTS and another company that was also awarded a contract for southern Maine prior to them being awarded the contract and discovered they had difficulties in the other states when they first started operations.

“We were a little disappointed but there wasn’t a lot of competition,” Craven said.

In a statement issued Monday, CTS’s White acknowledged the problems in Maine but did not detail their plan to compensate volunteer drivers at a higher rate for loaded miles.

“We have experienced problems with member pickups that have caused some members to miss appointments or be delayed in getting to or picked up from their appointments,” White said. “We have experienced much higher call volumes and wait times in our call center as staff has spent the time necessary to work with members on transportation problems, to familiarize them with the new transportation program and ensure that their trip reservations are taken accurately and with any special needs noted for each and every member. This has made it difficult for members to reach our customer service representatives in a timely manner.”

Craven did say Monday that those with the most critical medical needs were being prioritized so they would not miss appointments while CTS worked out the problems in the system.

“They did prioritize those kinds of services where people were going to literally die if they weren’t going to get the services,” Craven said.

Craven, the Senate chairwoman of the Legislature’s Health and Human Services Committee, said she and her committee would be keeping an eye on the issue.

Meanwhile, Bennett was still waiting for a ride in Bethel. She said she had a dentist appointment on Friday and hoped she would be able to get there.

sthistle@sunjournal.com

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