From Forbes McIntosh, Government Policy Solutions, WALA Lobbyist:
The Department of Health Services has issued a Request For Proposals (RFP) to seek an external advocate to assist with services and perform audits for its non-emergency medical transportation (NEMT) program.
The state’s NEMT program manager, MTM Inc., manages non-emergency transportation services for more than 900,000 participants eligible for covered services in the Wisconsin Medicaid and BadgerCare Plus programs. As part of its contract with the state, MTM is required to provide an ombudsman to help program participants resolve concerns or complaints with their transportation services to/from medical appointments through the program. Under this RFP, the external advocate will serve as an additional resource to Wisconsin Medicaid and BadgerCare Plus members whose complaints were not satisfied by the NEMT manager’s member ombudsman.
Services being sought include but are not limited to:
- Providing information, education and training about how to obtain NEMT through the NEMT manager;
- Working directly and collaboratively with third parties and the state regarding the adjudication of complaints;
- Working in conjunction with the NEMT manager, including but not limited to the member ombudsman, to investigate and resolve issues quickly;
- Performing research and providing recommendations to the state on the current state of the NEMT program;
- Performing semi-annual auditing services of the NEMT manager’s complaint reports.
This RFP is in addition to a separate audit that was authorized by the Legislature’s Joint Legislative Audit Committee in April to be conducted of the NEMT program by the Legislative Audit Bureau, with a report due back to the legislative committee by the end of 2014. Lawmakers have expressed concerns about continuing complaints about 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).