AUGUSTA — The Legislature’s Health and Human Services Committee on Thursday approved a bill that would revamp the state’s non-emergency medical ride program for those on MaineCare, the state’s Medicaid system.
The $40 million program has been fraught with problems since a trio of companies, at the behest of the federal government, were put in charge of arranging the rides with local transportation companies and nonprofit agencies.
In the past, the transportation agencies brokered their own rides, but the federal Centers for Medicare and Medicaid Services said that system was fraught with conflict of interest and insisted the state switch to a third-party brokerage system.
But chaos followed the change as the brokers were unable to effectively manage the system and patients missed appointments, and in some cases, were left stranded with no way home after appointments.
Throughout the fall, the committee held meetings to hear updates on the progress the brokers were making, but each meeting seemed to paint a picture of ongoing dysfunction.
In a party-line vote Thursday, Democrats on the panel approved the legislation, which directs the Maine Department of Health and Human Services to prepare a request for a federal waiver. It also requires it to essentially rebid the program with new requirements that would make it more advantageous for Maine-based companies to secure the work.
The final measure was an amended version of a bill, LD 1663, originally proposed by Sen. Troy Jackson, D-Allagash, that would have ended the contract with the worst-performing broker, the Connecticut-based Coordinated Transportation Solutions.
But in January, DHHS had already announced it would not renew the CTS contract.
CTS also operates a customer-service call center in Lewiston that employs about 45 people.
The company signed a $28.3 million contract with the state last year and began operating Aug. 1.
Almost immediately, MaineCare patients flooded the DHHS hotline with complaints about the company. Thousands of riders said they were stranded, delivered to the wrong places or unable to book rides.
Democrats supporting the bill Thursday said DHHS was slow to react to dysfunction in the new system and that they wanted to avoid a repeat of the problems that plagued riders and ride providers in 2013.
State Rep. Drew Gattine, D-Westbrook, expressed his frustration with DHHS. The agency has issued a new request for proposals for the program, but lawmakers were not being filled in on what that new request was going to look like and whether it would fix the ongoing problems in the system, he said.
“We are being told today that they can’t talk to us about that,” Gattine said. “I’m very frustrated that I am not getting the answers that I need. I watched this train wreck last summer, and I don’t want to watch this train wreck again this summer, and I have absolutely no confidence that I’m not about to watch the same train wreck, based on what I’ve heard from the department.”
Gattine addressed his comments to Maine Attorney General Janet Mills, who was called to the committee to advise lawmakers on what they could legally do with the brokers’ contracts or the new request for proposals.
Rep. Richard Farnsworth, D-Portland, House chairman of the panel, said after the vote he realized the Legislature didn’t have any power to administer the program directly, but what they could do was pass a law that would force DHHS’ hand in the matter.
“All we can do is pass a piece of legislation,” Farnsworth said. “And personally, I am still feeling very unsettled about it because we really haven’t resolved anything, and I know there are thousands of people out there who have both given up on trying to use the system or are finding alternative ways of getting transportation or are every day being subjected to gross improprieties.”
He said complaints from riders include preschoolers being transported without car seats and being required to double up on rides with other patients that may not be an appropriate match, as well as other safety concerns.
“Those kinds of things deeply distress me,” Farnsworth said. “And I’m finding we can’t do very much about it.”
He acknowledged that the bill, were it to pass the full Legislature, was likely destined for a veto by Republican Gov. Paul LePage.
Republican lawmakers on the committee said the measure appeared to be an attempt by the Legislature to micromanage DHHS. They said the problems in the ride program were improving and that CTS’ contract was already not being renewed.
“We know the one we’ve had the most trouble with we are not renewing,” said Rep. Deborah Sanderson, R-Chelsea. “But to just stop what we are going with, right now, and completely get rid of it, turn on a dime, is not going to fix things.”
Sanderson and Sen. Jim Hamper, R-Oxford, said the bill was largely a messaging effort by Democrats because they know it’s unlikely to pass into law.
Hamper refuted Gattine’s remarks.
“I thought it was most unusual to hear the concerns about how this has been a train wreck and, oh by the way, we are going to start it all over again and not expect another train wreck,” Hamper said.
Both he and Sanderson said it was clearly an overreach by the committee and a bill they, too, would expect LePage to veto.
“When the Legislature starts negotiating contracts,” Sanderson said, “I think we’ve got a problem.”
The bill will likely go to the full House of Representatives for a vote sometime in March.
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