AUGUSTA, Maine — Finger-pointing over a troubled medical rides provider for Medicaid patients continued Thursday as lawmakers in the Legislature’s powerful budget-writing committee clashed about whether the Department of Health and Human Services was mismanaging the program.
Connecticut-based Coordinated Transportation Solutions was awarded a $28.3 million contract by DHHS to manage the state’s nonemergency ride program for Medicaid patients. The program is meant to provide rides to medical and nonmedical appointments alike, but it has come under siege after thousands of patients reported that they had missed appointments or been stranded because rides did not show up.
The company has submitted a corrective action plan to the state, and DHHS Commissioner Mary Mayhew said her agency is working with CTS to address problems, which were caused in part by the department underestimating the number of rides the company would have to provide. The state has said the underestimates were caused by flaws in the previous system of reporting rides scheduled versus those provided or missed.
Self-reported numbers from CTS show marked improvement from August to November. Clients are connecting with schedulers faster, and trip timeliness is up. The number of trips scheduled has grown from more than 25,000 per week in August to more than 32,000 per week in mid-November.
Most importantly, CTS reports that the number of trips “missed” has decreased from around 1,500 per week in early August to 116 weekly in mid-November.
But Peggy Rotundo, D-Lewiston, House chairwoman of Appropriations, said that’s not what she’s hearing from constituents, who tell her scheduled rides aren’t coming, or that they had given up calling CTS altogether.
That last claim is also backed up by CTS’ own numbers; The company reports that the number of trips canceled in advance has grown from 1,800 to 4,300.
Rotundo called for the administration to terminate its contract with CTS.
“I don’t know how long we continue to allow a system that’s not functioning to continue,” she said. “My question is, why isn’t the administration terminating this contract? Why aren’t we talking about that? Any progress that has been made does not really address the larger issue; People in the state who are very vulnerable are not being served.”
The state originally set a Dec. 1 deadline to see improvements in the system, or CTS would risk losing its contract. In a statement by Mayhew dated Dec. 12, the commissioner said the company’s improvements are still under review and no decision has been made regarding the contract.
Mayhew also criticized her detractors for playing politics with the transportation issue.
“Our approach to managing nonemergency transportation is the right one,” she wrote. “Oversimplifying this complex issue for political gain has created unnecessary noise, and we will not be distracted by it. We remain focused on sound management and decision-making based on analysis of the facts and thorough evaluation of the impact of our decisions on the members we serve.”
DHHS has also been criticized for not ensuring CTS had acquired an insurance bond, which could have been used to refund the state for services not provided. Still, Rep. Dennis Keschl, R-Belgrade, rejected assertions that DHHS has mismanaged the program, and resisted calls to terminate CTS’ contract.
“Big programs, big change, is wrought with difficulty. Just understanding the people who need the service, understanding what they need, is difficult,” he said. “I would encourage us to ask questions, to get good information, to try to make changes. But I’m not going to panic over this right now.”
Democrats were also aghast to learn that part of CTS’ corrective action plan included contract amendments that seem to be aimed at getting the state to give the company more money. That plan is meant to address the need for service that wasn’t anticipated when CTS won the contract earlier this year.
Mayhew wrote that contract discussions began in September, when it first became clear that more rides — especially for those who require wheelchair accessibility — were needed than anticipated in the bidding process. But, she said, no agreement had yet been made to amend the contract.
While Mayhew provided written statements to reporters, no one from DHHS fulfilled requests from Appropriations to speak with the committee. Democrats have bemoaned Gov. Paul LePage’s reticence to allow executive branch chiefs to attend legislative hearings for months.
Dawn Hill, D-Cape Neddick, Senate chairwoman of Appropriations, said Thursday that the written responses from DHHS to questions asked at the November meeting were not given to lawmakers until immediately before Thursday’s meeting began.
“When we receive a large packet of information, coming into a meeting, we have no time to digest it,” she said.
The administration has opted in most circumstances to communicate with committees in writing only, which LePage says is more efficient. His administration also says the ensuing paper trail creates additional government transparency.
Follow Mario Moretto on Twitter at @riocarmine.