NORWICH – State-wide changes in medical transportation for Medicaid recipients are pushing county officials to request increased state funding for public transportation, citing new mandates and contract deals that could cause First Transit, the county’s primary source of public transportation, to leave the area.
In 2010, the State Department of Health was authorized under social services law to assume administrative management of non-emergency transportation in counties, and has since required a private Medicaid brokerage system be implemented in each region of New York State.
Medical Answering Services, a Syracuse-based public transportation company, was awarded a state contract for the Central New York region, which encompasses 24 counties including Chenango. Changes went into effect in October.
Because Medical Answering Services was awarded the state contract, non emergency rides for Medicaid patients that would have previously been assigned to public transit were switched to taxis and ambulance providers – many of which are from outside the area, according to county officials.
“There’s potential this could effect the bottom line for First Transit,” explained Chenango County Department of Social Services (DSS) Director Bette Osborne.
Due to recent changes in Medicaid transportation, First Transit, a private company, will no longer receive state reimbursement for transport of Medicaid patients. That may drastically hurt the business since a bulk of their riders are Medicaid recipients, said Osborne.
“They went from approximately 30 or 40 Medicaid transports per month to maybe three or four,” she added. “The Medicaid transportation really underwrites the whole public transportation system in the county ... If First Transit is in the red over a number of years, I don’t think they will be able to stay.”
But a statement from First Transit says despite recent changes, there’s no sign of the company pulling out of the area right away.
“At First Transit, we remain committed to our vision of ‘keeping people moving and communities prospering,’ and we are committed to serving Chenango County,” said a spokesperson for the company. “Over the next few months, we will be investigating possible revisions in our fixed route schedules to alleviate any budgetary impact. However, Chenango County Public Transit will communicate with the community and riders should any schedule updates occur.”
More than 140,000 rides per year are provided to county residents via First Transit. Chenango County DSS has been provided funds by the New York State Department of Health to provide and arrange non-emergency Medicaid transportation services for medical appointments for more than 20 years.
The state’s takeover of Medicaid transportation is done in the effort to reduce Medicaid costs and payments. But without public transportation available in Chenango County, local officials say Medicaid recipients will no longer be able to pay for their own trips to medical appointments using the public system. Medicaid eligible riders are now forced to seek approval for taxi transportation from the state, which county leaders say will increase the overall costs of non-emergency transportation paid by Medicaid.
The issue poses a lot of “what if” questions, Osborne said. “If the state realizes they’re not saving money, will we have already lost our source of public transportation?”
“I worry about the state’s takeover of Medicaid transportation,” she added. “I think you need a local presence to understand the community and the community’s needs. With a big program like Medicaid on the state level, people can easily fall through he cracks.”
A resolution passed by the Chenango County Board of Supervisors opposes the new mandate to work with any out-of-county brokerage firm as it jeopardizes the local public transit system. Moreover, the board requested the state pay more money to support Medicaid recipients who rely on the system to get to medical appointments.
The county is currently working with several New York State representatives in hopes of repealing the new mandated brokerage service and restoring local control over non-emergency Medicaid transportation.