The Free Press, Mankato, MN

January 6, 2014

Med transport changes leave clients rideless

Transport companies told to contract with Blue Cross/Blue Shield broker

By Tim Krohn
tkrohn@mankatofreepress.com

---- — Beginning last Wednesday, many people across rural Minnesota who needed a ride to a medical appointment found the medical transportation systems they relied on in the past were no longer available. Some were told no rides were available while others were promised rides that never came.

“I had a call from someone in Morristown who was crying because no one was picking up one of her clients for dialysis,” said Dave Pinske, owner of AmeriCare Mobility Van in Mankato. “Another one from Owatonna was waiting for a ride for dialysis, but no one came.

“This isn’t right. We take for granted how easy it is to go out to our car and go somewhere. These people can’t do that.”

The change came when Blue Cross/Blue Shield late last year announced it was canceling its contracts with all non-emergency medical transport companies in rural Minnesota on the first of this year. Those transport companies — including AmeriCare — were told they would have to contract with a company Blue Cross hired that serves as a broker that schedules medical transport rides.

But Pinske, president of a medical transport association that serves Minnesota’s 80 rural counties, said he and the other companies in the association could not and would not work with Missouri-based Medical Transportation Management because of MTM’s past “unethical behavior” and because the broker is ill-equipped to serve rural Minnesota. The association also said the contracts MTM was offering the medical transport services were at rates they received 20 years ago.

Attempts to reach MTM for comment were unsuccessful.

Pinske said that he and other transport companies have spent the past days fielding calls from hospitals, nursing homes, assisted-care facilities and other past customers looking for rides. “But we have to tell them we’re out of (the Blue Cross) network now and can’t provide the service.”

Sen. Kathy Sheran of Mankato said she’s concerned about the change and is looking at crafting legislation to address it.

“It’s too early to know exactly what I need to do, but I’m trying get a sense of what I need to do legislatively.”

In the past days Sheran has received emails from several nursing homes and assisted-living facilities complaining of clients who were not picked up for medical appointments.

She said rural medical transport services have already been at a disadvantage because state medical assistance programs don’t reimburse them enough to make up for the often long distances they must drive to deliver people to medical appointments.

Pinske said MTM has been scrambling to contract with other services, including cab companies, to pick up people. But he said those companies usually don’t have vans equipped with wheelchair lifts needed by many clients.

“There are people being transferred from wheelchairs into sedans,” Pinske said Friday.

He said he’s also received reports that MTM is sending transports from Iowa or the Twin Cities to make pickups in rural Minnesota. That, he said, leads to long delays. In a letter to the state attorney general, Pinske also questioned whether the vehicles coming from out of state had the proper permits from the Federal Motor Carrier Safety Administration and state transportation officials to legally do medical transports in the state.

Pinske, who had been a contract provider for Blue Cross since 1998, said he and the other transport providers took a moral stand in refusing to sign on with MTM.

“We’re familiar with their practices and it’s not something we want to be involved with. Our clients are our friends and neighbors. We grew up here and work here.”

The state of Minnesota has already been using MTM to broker non-emergency medical transport for those — mostly in the metro area — on state medical assistance programs. A legislative audit done in 2011 uncovered problems of people getting poor service and raised questions about the cost savings the state had hoped for.

Sheran said she doesn’t think the state handled the switch to a broker properly, which led to poorer service and likely didn’t save money.