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State cuts ties with Medicaid ride provider; too many missed appointments in first month of contract, letter says

by Andy Davis | January 18, 2019 at 4:30 a.m.

After receiving more reports of patients who had missed appointments, a state agency on Thursday canceled its contracts with a company that just this month became responsible for providing nonemergency medical transportation to Medicaid recipients in 32 counties.

The Department of Human Services' announcement of the cancellation came after the agency last week notified Medical Transportation Management that it would seek damages against the company for failing to meet the terms of its contracts.

One contract, which could have been renewed for up to seven years, called for the St. Louis-based company to receive about $13.1 million a year for arranging rides to medical appointments for Medicaid recipients who lack other forms of transportation.

Under another, one-year contract, the company would have been paid about $7.7 million to take recipients with developmental disabilities to programs that provide speech, occupational and physical therapy.

Sarah Collins Linam, the Human Services Department's chief procurement officer, complained in a letter to the company last week that it had failed to provide rides for patients, "including high-priority dialysis beneficiaries, resulting in some beneficiaries missing their scheduled appointments."

The company also hadn't submitted applications for criminal background checks on its drivers, despite repeated requests from the department; had failed to ensure that its vehicles meet contract-specified requirements; and hadn't been meeting requirements for quickly answering recipients' calls, Linam said.

In a separate letter the same day, Linam listed 14 treatment centers for the developmentally disabled that complained that the company had failed to provide rides for their clients. Providers also had complained that the company didn't have enough wheelchair-accessible vans, she said.

At Linam's request, the company submitted proposals for meeting the contract terms.

But as of Thursday, "there was not satisfactory corrective action and [was] inconsistent performance, including continued missed rides," Human Services Department spokesman Amy Webb said in an email to the Arkansas Democrat-Gazette.

Linam notified Medical Transportation Management in a letter emailed Thursday that the state would cancel its contracts with the company for cause effective Jan. 31.

Atlanta-based Southeastrans, which provides the transportation service in an 11-county region in western Arkansas, on Saturday will begin transporting patients for dialysis and other urgent needs in the area now served by Medical Transportation Management, the department said in a news release.

Southeastrans will begin transporting other patients in the service area on Feb. 1.

Medical Transportation Management in October was awarded the contract for the four-region area in northern, central and eastern Arkansas, including Pulaski County, after submitting the lowest bid. Southeastrans had submitted the second-lowest bid for the same area.

Noel Lindsey, 69, of Newport said Medical Transportation Management called her two hours before her scheduled appointment with a neurologist in Searcy last week and told her it didn't have a driver available to take her there.

She rescheduled the appointment for next week. When she called Medical Transportation Management on Wednesday to see whether it would be able to arrange a ride, she said, the company told her it no longer served the area.

She said her son, who lives an hour and a half away, is going to take off work to drive her to the appointment.

Meanwhile, she's putting off making other appointments because she doesn't have a way to get to them.

"It seems like a pretty untenable situation," she said.

Medical Transportation Management spokesman Michelle Lucas said her company is still scheduling trips through the end of the month and would contact Lindsey, who she said had received inaccurate information.

Lucas blamed the company's performance on the short amount of time it had to prepare to take over the service and the refusal of the Area Agency on Aging of Western Arkansas, which previously served much of the area, to enter into a contract with it.

She said the company didn't receive data from the state on Medicaid recipients and recurring trips the company would be providing under the larger contract until Dec. 21, the day the contract was reviewed by the Legislative Council.

It didn't sign the other contract -- which came in response to a federal lawsuit -- until 6 p.m. on Dec. 28.

"You can't operate a program getting data that late in the game," Lucas said.

She said the company is continuing to improve its service and will "work very diligently to make a smooth transition" to Southeastrans.

Rep. Michelle Gray, R-Melbourne, said the change in vendors will be a "huge" improvement for her constituents, several of whom complained about missing scheduled surgeries and doctor's appointments.

One man ended up getting a ride from Southeastrans to a chemotherapy appointment on Thursday after he was unable to schedule a ride with Medical Transportation Management, she said.

Webb said Southeastrans arranged transportation for some patients in urgent cases in Medical Transportation Management's service area on Thursday.

Gray said she wants to find out how Medical Transportation Management was found to be a qualified bidder. She's considering sponsoring legislation that would prohibit such contracts from being awarded solely on price, she said.

"When you're talking about human life, you've got to look at things like quality, past performance, references," she said. "You can't just go on dollar amount alone."

The state had planned by Jan. 1 to stop allowing recipients with developmental disabilities to use nonemergency transportation as a way of getting to day treatment centers .

Instead, it said the centers could provide transportation themselves and seek reimbursement from Medicaid.

But the centers sued, and in response, the state shifted course, agreeing to seek emergency contracts with the transportation providers to continue providing the service for an additional year.

Meanwhile, Webb said preparations to implement the contracts for transportation for other Medicaid recipients was delayed by a protest filed by Southeastrans on Nov. 9.

Southeastrans said Medical Transportation Management's bid should have been disqualified because it had checked a box indicating it did not plan to use any subcontractors. It also argued that Medical Transportation Management should not be considered a "responsible" vendor based on its performance as a Medicaid transportation broker for the state from 2004-2007.

Southeastrans also said that the Human Services Department didn't investigate whether Medical Transportation Management met the requirements listed in the bid solicitation.

State Procurement Director Edward Armstrong dismissed the protest on Nov. 28, saying the state could seek clarification on Medical Transportation Management's use of subcontractors and that Southeastrans hadn't provided any evidence its competitor should have been disqualified.

The Area Agency on Aging of Western Arkansas previously held a contract to arrange transportation for Medicaid recipients in four regions encompassing 30 counties, but didn't submit the winning bid to serve any of the regions starting Jan. 1.

Medical Transportation Management won the bid to serve two of the regions previously served by the aging agency, and Southeastrans won the bid for the other two, which were combined into one region under the new contract.

According to news reports, the agency on aging laid off hundreds of drivers in December, but later hired some back after agreeing to be a subcontractor for Southeastrans.

Jennifer Hallum, the agency's chief executive, didn't return calls seeking comment on why the agency declined to enter a similar contract with Medical Transportation Management.

Benjie Alexander, chief administrative officer for Southeastrans, said he's confident his company will be able to hire enough transportation providers to cover the area it is taking over.

"It's all hands on deck right now to get things ready," he said.

A Section on 01/18/2019

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