LeadingAge NY Meets with DOH Regarding Medicaid Transportation Concerns

LeadingAge NY received significant feedback from members regarding their challenges with Medicaid non-emergency medical transportation (NEMT) provided by Medical Answering Service (MAS) and fee-for-service (FFS) transportation vendors. We shared the information with Department of Health (DOH) Office of Aging and Long-Term Care (OALTC) leadership and Medicaid Transportation staff.

It appeared that DOH was unaware of the widespread trip cancellation and reassignment challenges outside of the Westchester County area. We provided them with an overview of the challenges listed below. Over 19 members and Managed Long-Term Care (MLTC) plans located across the state voiced concerns indicating similar challenges. DOH informed us that they have hired additional staff to address the wait times in scheduling appointments. There is a two-week lag time as staff undergo training, with the first staff onboarding this week. Further, the rule requiring scheduling trips 72 hours ahead of appointment times has been eliminated until further notice. DOH also stated that they would consider reimbursement of providers or plans who pay for transportation of a Medicaid enrollee to a critical medical appointment when a trip is cancelled at the last minute. Consideration would be on a case-by-case basis.

LeadingAge NY would like to provide DOH and MAS staff with the feedback members provided to us, including member contact information. We will be contacting members to ask for permission to share this information. In the meantime, if there are other members who wish to share their transportation concerns, please reach out to us.

Issues of concern mentioned in our meeting:

• Serious problems for both FFS beneficiaries and MLTC, but MLTC transition seems to have exacerbated problems.
• Problems exist in rural and non-rural areas; still major problems in Westchester.
• No-shows and trips cancelled at last minute; some examples include:
  • Scheduled surgery which required very early morning transport
  • Transportation to appointments from outlying suburbs or rural areas to metropolitan areas
  • Cancellations with no apparent justification
  • Trips are reassigned to a different company, but that company is not aware of the reassignment and is not open to accept the trip
  • Nursing home resident being discharged; ride home did not show
• Vendors have limited service areas and will not accept trips of longer distances.
• Late arrivals, resulting in missed appointments.
• Multi-hour waits for return trips.
• Some adult day health care (ADHC) Method 1 programs have registrants a significant distance away from program. Vendors are charging three times the amount to transport them. We requested a hybrid approach for Method 1 members for certain outlier registrants.
• Providers are paying out of their own funds when MAS is being paid to deliver this service.
• Some beneficiaries are paying privately for their own rides.
• Some residents with disabilities need staff to accompany them to medical appointments. This creates additional costs and staffing challenges.
• Some MLTC members or representatives do not know how to navigate the MAS website or cannot get on. When calling, they are on hold for hours. In some cases, plans are paying transportation cost as members are unable to get the transportation booked, so members do not miss critical medical and doctor appointments.
  • Plans have requested portal training
• Missing the three-day window for non-urgent ride scheduling – members cannot schedule a ride or cannot get through to MAS.
• NYC – MAS misreading mailing address versus physical address in ePACES.
• MAS denying trips for Medicare-related medical services (e.g., acupuncture) for Medicaid Advantage Plus (MAP) members.
• Members who are currently recertifying their Medicaid are being denied because they are not active in ePACES.

Members should contact LeadingAge NY with any additional information or concerns.

Contact: Meg Everett, meverett@leadingageny.org, or Karen Lipson, klipson@leadingageny.org