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Medicaid Transportation Update for Long Term Care

LeadingAge NY met with the Medicaid transportation staff of the Department of Health (DOH) on April 15th to discuss current Medicaid non-emergency medical transportation (NEMT) challenges since the move of the Managed Long Term Care (MLTC) transportation benefit to Medical Answering Service (MAS). A month ago, we shared this list of concerns.

Our meeting with the Department yielded reports that wait times have dropped considerably with their hiring of additional staff, including staff serving non-English-speaking populations, to handle trip reservations and questions by phone.

Many of LeadingAge NY's prior concerns included dropped trips, trips cancelled at the last minute and not reassigned, and late pickups from appointments in the community. The Department reported that those concerns have also dropped significantly. While this is encouraging, it should be noted that the Department receives most of its trip and complaint data from MAS. We are not certain that they are receiving the full picture of complaints and challenges. We urge members and plans, as they experience issues, to also send their concerns regarding MAS to the Department at medtrans@health.ny.gov or to fill out this form. Please feel free to copy LeadingAge NY as well. DOH stated that the late pickups from appointments were the result of members not scheduling return trips. They stated that MAS will be ensuring that their staff use protocols that include questions to flesh out the full trip scheduling needs of beneficiaries.

We previously reported that Westchester ambulettes were boycotting delivery of services in that county. The Department reported that vendors finally accepted the $12 one-way rate increase originally offered during negotiations.

Current concerns of plans and providers involve certain MLTC members and possibly other Medicaid beneficiaries being denied access to Medicaid NEMT if they are in a Medicaid "recertification pending" status due to paperwork or capacity challenges. DOH communicated in an updated Frequently Asked Questions (FAQ) document that beneficiaries in this "recertification pending" status will only be provided MAS transportation if the appointment provides life-sustaining services such as chemotherapy or dialysis. Members with this status who need transportation to other medical appointments and use their own transportation will be reimbursed for mileage after recertification. LeadingAge NY will advocate for reimbursement for transportation provided by a vendor, as many members in urban areas do not have a vehicle or family members to drive them to appointments.

Providers and plans should review the updated FAQ on MLTC NEMT posted here.

LeadingAge NY is trying to ascertain how many MLTC or fee-for-service (FFS) beneficiaries fall into this "pending certification" group and how long this status typically lasts. Providers and plans who might be able to offer this insight should contact us with feedback.

DOH stated that MAS will be setting up a coordinator role in MAS to help support members in arranging transportation. They also stated that they will be providing members and plans with tutorial webinars to help facilitate the reservation process.

Members should continue to share if they are experiencing trip cancellations, reassigned trips that do not show up, or other concerns regarding transportation, as LeadingAge NY has a regular standing meeting with the Department on this issue.

Contact: Meg Everett, meverett@leadingageny.org, 518-867-8871