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Blue Cross medical transportation change frustrates disabled, elderly

ST. PAUL — Carolyn Kile made 15 calls in an attempt to schedule a ride to a Jan. 2 medical appointment, a ride that never happened.

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“I felt like I hit a brick wall at 500 mph and went splat,” said the 72-year-old woman from Sebeka in central Minnesota.

Her ride showed up an hour-and-a-half late, too late to get to an appointment in Fargo, more than 100 miles away from her home 12 miles north of Wadena.

Kile said her driver started 188 miles away in Apple Valley, a southern Twin Cities suburb, and said that slow traffic caused by an accident slowed him down.

Before Jan. 1, her twice-a-month ride came from a few miles away and a single, simple call to Blue Cross and Blue Shield of Minnesota took care of the arrangements.

Since Jan. 1, disabled and elderly rural Minnesotans seeking transportation to medical appointments have expressed frustration and say lives are in danger after Blue Cross hired St. Louis-based MTM, Inc. to manage transportation needs for its Medicaid (also known in Minnesota as Medical Assistance) clients.

Kile said she already has made a half-dozen calls to arrange a ride to her Fargo appointment next week. She has doubts she will get the ride, but said it might happen because it is supposed to come from nearby Park Rapids.

“I don’t have any other choice,” Kile added, because Blue Cross requires everyone to use MTM, who contracts with transportation companies that are supposed to provide the rides.

Blue Cross handles Medicaid recipient rides for most of rural Minnesota, although other insurers take care of many in the northeast and southeast. MTM long has held the contract to coordinate Medicaid transportation in the Twin Cities area, where there are many more transportation options than in rural Minnesota.

Stories are piling up about drivers not showing up, causing people such as kidney dialysis patients to miss appointments; vehicles not being able to accommodate wheelchairs; health-care providers being forced to make numerous calls, and being placed on hold a long time, in attempts to arrange transportation; and long-time drivers saying they refuse to work with MTM, which would have reduced their pay 30 percent from what they got working directly with Blue Cross.

Drivers provided an average of 700 rides a day in rural Minnesota last year. On the first business day MTM coordinated transportation, it served 643 Medicaid recipients.

Rural transportation company officials said they provided much better service before MTM took over.

Jeff Nustad, who with wife Lori runs Lakes Medi-Van in Detroit Lakes, recited a long list of horror stories from his former customers.

The Nustads, whose business serves more than 50 counties, said they had a report of a patient in a Menahga nursing home who was supposed to have a ride to a dialysis session, but the driver never showed up. A Worthington patient confined to an electric wheelchair said a taxi cab ill-equipped to carry the device arrived to pick her up.

Phyllis Kiecker, who lives in a McIntosh nursing home, was supposed to receive a ride to a Fargo appointment, but her daughter said that even after four days of calling MTM, no driver came.

Stories like that surprise MTM Vice President Phil Stalboerger, who works with more than 60 MTM employees in West St. Paul. He said he hears few complaints, but problems do happen.

Stalboerger said MTM schedules transportation, then it is up to drivers under contract with the company to carry out the job.

Drivers often cancel, he added. “Many times, we are given virtually no notice.”

“We’re not hearing the complaints yet,” the former Blue Cross lobbyist said. “We do want to hear them. If something is not working, we want to know.”

So does the state Human Services Department, where interim Assistant Commissioner Nathan Moracco said some problems have been noticed. So far, he added, ones the state has heard about “have all been resolved quite quickly.”

Moracco said anyone with Medicaid transportation problems should call his office’s help desk at (800) 657-3739 or call the managed care ombudsperson at (800) 657-3729.

Blue Cross refused to make anyone available for an interview about the situation, but in a statement said it is working with MTM.

“Any reports or indications of mis-scheduled rides are absolutely unacceptable and acted upon immediately,” the Blue Cross statement said. “Providing a better and consistent transportation experience for our members was the primary reason behind our decision to contract with MTM.”

When MTM took over, Stalboerger said, each transportation company that had worked for Blue Cross was given a chance to sign a new contract. None of the members of the R80 Transportation Coalition of rural medical transportation services accepted the offer.

While Stalboerger said the contracts given to transportation companies were meant as opening offers, R80 members said they never got the feeling MTM was open to negotiations. Besides, Nustad said, R80 members do not like MTM’s style of business.

“Their contract is 59 pages long,” Nustad said. “It is almost impossible to go along with it.”

Nustad said he, like other companies, serves transportation clients other than just through Blue Cross. However, he added, with half of Medi-Vans’ business coming from the Blue Cross contract in the past, he likely will need to lay off employees.

“We don’t have this issue in any other state,” Stalboerger said about the mounting list of complaints, pointing out that MTM provides similar transportation services in many places across the country.

He said people used to dealing with Blue Cross may “get confused” now that they must work with a new company.

“I feel bad for customers that are scared,” he said. “We obviously don’t want that to happen.”

Kile, the woman who said it took 15 calls to arrange for a ride that in the end never showed up, said the changeover was not handled well.

“Surely BCBS could have at least told us, the insured, this change was coming so we could have been somewhat prepared, couldn’t they?” she asked.

Don Davis
Don Davis has been the Forum Communications Minnesota Capitol Bureau chief since 2001, covering state government and politics for two dozen newspapers in the state. Don also blogs at Capital Chatter on Areavoices.