From Forbes McIntosh, Government Policy Solutions, WALA Lobbyist
The state Legislature’s Joint Legislative Audit Committee Thursday voted unanimously to authorize the Legislative Audit Bureau to conduct an audit of the Non-Emergency Medical Transportation (NEMT) program. The audit is in response to continuing complaints about services provided by the state’s current NEMT manager, Medical Transportation Management, Inc. (MTM). MTM manages non-emergency transportation services for more than 900,000 participants eligible for covered services in the Wisconsin Medicaid and BadgerCare Plus programs.
The Joint Legislative Audit Committee held a public hearing Thursday about the proposed audit and heard testimony from stakeholders about concerns with the transportation program, including drivers missing or showing up late to transport patients to/from medical appointments or inadequate vehicles dispatched (such as sedans for a wheelchair-bound patient).
The committee debated at length about the scope of the proposed NEMT audit. The initial scope that was discussed by the committee included:
- an evaluation of the process used to receive and resolve complaints from participants and providers;
- an analysis of complaints, including monthly complaint summary reports and corrective actions taken, to identify trends, patterns, and relationships; and
- a review of the efforts of Department of Health Services (DHS) to monitor and oversee non-emergency medical transportation complaints.
DHS reports that less than 1 percent of the approximately 200,000 rides performed each month result in a complaint, however some committee members noted that many people experience problems but don’t bother to complain. Many committee members, including State Rep. John Nygren (R-Marinette), said that rider complaints are just a symptom of larger problems within the NEMT system. Many committee members agreed that a larger, comprehensive audit of the NEMT program – beyond just investigating complaints – is in order. However, they also noted that a larger audit could delay the final report – and the committee members seemed to agree that they would like to use the audit findings in the next state budget process, which begins in early 2015. In supporting this audit, Nygren said that his primary concern is the quality of the NEMT service in Wisconsin – not the cost.
LAB auditor Joe Chrisman said during the hearing that the NEMT contract with MTM Inc. runs for three years – it commenced in August 2013 and runs through July 2016 – but could be amended with approval from both parties.
The Joint Legislative Audit Committee voted Thursday to approve an NEMT audit, beginning with an audit of the complaints (listed in three bullet points above) and asking the Legislative Audit Bureau to use its judgment in expanding the scope to include other data that would help the state Legislature in preparing its next biennial budget surrounding NEMT – such as examining non-reported complaints, outcomes of complaints resulting in emergencies, history of the program in Wisconsin and costs, comparison of MTM to its predecessor, LogistiCare, and looking at other states’ models.
The goal is to have a report completed by the end of 2014.