Some bumps with coordinating Medicaid rides


While the secretary of the Executive Office of Health and Human Services is happy with the first six-week performance of a national company selected to coordinate 88,000 rides monthly for people mostly on Medicaid, service providers say they haven’t been paid and that there has been an increase in cases where, because of improper scheduling, people can’t make their appointments.

Steven Costantino said there were a lot of missed rides and that's what prompted him to looking into making a change. He said since LogistiCare Solutions – which according to its website coordinates rides for 17 million people in 42 states – took over, the “rides fulfilled rate” in Rhode Island is 99.3 percent.

He said rides are provided for people undergoing methadone, dialysis and other medical treatments, meeting doctor’s appointments and taking trips for shopping and for adult day services. He put the cost at $24 million a year, of which half is federally funded.

“I’m concerned by the miss ride rate,” said Costantino. “This is our most fragile population.”

Even with the new system, rides are being missed, according to Almas Kalafian, who is blind and a retired teacher living in Providence. Kalafian attended a RIPTA board meeting earlier this week where the issue of LogistiCare’s operation was brought up during the public discussion portion of the meeting. She said she refuses to use LogistiCare, and related how three people needing transportation to Rhode Island Hospital for chemotherapy treatments were provided hospital vouchers for private service to ensure they made their appointments.

At the RIPTA meeting, the issue of payment to service providers that contract with LogistiCare was raised.

Robert Romano, president of Bay Taxi based in Warwick, said he is owed more than $57,000 for services provided since May 1. The company provides about 90 trips a day. Lillian, his wife, said she has sent all invoices to the company’s office in Atlanta by registered mail, and to her knowledge, fulfilled all the requirements needed for payment.

The Romanos are not alone.

Bryan L. Yemma Sr., president of B&C Transportation in Westerly, estimates his company is owed more than $20,000. He voiced his frustration with what he said is a 200-page contract. He said he was notified he was not in compliance with the paperwork. He re-filed the forms only for the company to find other issues. Yet, Yemma is willing to give the company more time, noting that the system is two months old.

But he does see problems, especially when he gets calls to provide rides to Central Falls clients who are 45 miles away and need to get a six-mile ride to an appointment.

William Legare, president of Valley Cab based in Woonsocket, said he hasn’t seen a penny since signing on with LogistiCare. He said he is owed thousands, and in order to meet salary and operating costs he has had to borrow from other companies. He said some of his drivers are working 55 hours a week to meet the demand, and that he is in the process of adding six vehicles. Bringing them online takes time, as they must meet state requirements.

Legare faults the Executive Office of Health & Human Services (EOHHS) for requiring LogistiCare to have the system operational in three to four weeks when the company was looking for a transition of three to four months.

“It was not done the way it should have been,” he said.

He said the system “was dumped in their lap … it is not their fault.”

David Burnett, deputy secretary at EOHHS, said a lot of rides were being missed when the system was operated by RIDE, and the decision was made to retain “experts” in the business.

“This is an important benefit,” he said of transportation services, “and we didn’t feel we could do it.”

In a March 17 memo posted on the EOHHS website, Costantino writes, “As you know, Medicaid NEMT services are necessary to ensure that Medicaid beneficiaries, in all of Rhode Island’s communities, who need transportation to and from Medicaid-covered services receive safe, reliable, efficient and cost-effective non-emergency medical transportation. LogistiCare will maintain a network of transportation providers and request an appropriate vehicle from one of the network providers to transport beneficiaries.”

In a telephone interview, Costantino said the state received four or five bids to operate the system.

According to Warwick Mayor Scott Avedisian, chairman of the RIPTA board, the agency was interested in running the system but told they were excluded from bidding. RIPTA does perform services for LogistiCare, but the number of trips provided by RIPTA have dropped from 2,000 to 900 a day, Avedisian confirmed.

He said RIPTA received some payment this week for rides provided when the service started.

Costantino said federal regulations prohibit RIPTA from operating the system.


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