The Legislative Committee found that roughly 5,100 people utilized the non-emergency transportation options through the Division of Medicaid monthly.
The Mississippi Legislative PEER Committee was tasked with providing a report which reviewed the non-emergency transportation use for Medicaid beneficiaries month-to-month.
Medicaid provides transportation assistance to eligible Medicaid beneficiaries for travel to and from scheduled medical appointments when there are no other means of getting to and/or from the appointment. A state can choose which delivery model to utilize to deliver NET services.
Mississippi uses a private brokerage model. Medical Transportation Management, Inc., (MTM) has served as the state’s NET broker for Medicaid fee-for-service beneficiaries since 2013.
The NET program offers multiple types of transportation modes, with vehicles that can accommodate any type of accessibility assistance beneficiaries may need (e.g., wheelchair access, ambulances with medical staff). MTM reported 58% of total NET trips for CY 2021 were related to dialysis appointments.
The PEER reports finding showed that the NET program provides non-emergency transportation for Medicaid beneficiaries to and from covered medical services, as required by federal law.
From February 2019 to February 2022, NET averaged 5,199 utilizers per month and 141,714 non-utilizers per month, a 3.5% utilization rate. Non-utilizers comprised 91.5% of NET costs compared to utilizers comprising 8.5% of NET costs over the period from February 2019 to February 2022. MTM reported 58% of total NET trips for CY 2021 was related to dialysis appointments.
Key findings included:
- In 2018, the Division of Medicaid (DOM) switched to a utilization-based contract, but this contract did not result in any direct cost savings due to how DOM weighted bid proposals using projected utilization levels and the lack of a cost cap for non-utilizer costs.
- Despite an increase in the number of eligible NET beneficiaries from 124,040 in July 2020 to 308,577 in May 2022, NET utilization declined from 5,925 (from February 2019 to June 2020) to 4,583 (from July 2020 to February 2022). NET averaged 5,199 utilizers and 141,714 non-utilizers per month, a 3.5% utilization rate.
- Non-utilizers comprised 91.5% of NET costs compared to utilizers comprising 8.5% of NET costs over the period from February 2019 to February 2022.
- In 2021, DOM negotiated with Medical Transportation Management, Inc. (MTM), to reduce the price per non-utilizer from $25 to $21. This renegotiation reduced the cost cap through September 30, 2023, from $169,358,094 to $156,720,628.
- DOM suspended payment to MTM in January 2022 to avoid exceeding the cost cap in place through September 2022. DOM has paid $119.9 million toward the $125.0 million cost cap in place through September 30, 2022.
- After not assessing liquidated damages in 2020 due to COVID-19, DOM assessed $1,027,750 in liquidated damages against MTM between January 2021 and May 2022. Over 60% of the liquidated damages pertained to late pickups from the home, medical provider, or hospital discharge.
- When procuring a new vendor for the 2023 NET contract, the Division of Medicaid should:
- consider altering the payment methodology to more align with services provided;
- address gaps in areas covered by liquidated damages;
- add a clause to permit the assessment of punitive damages;
- amend the beneficiary satisfaction survey process;
- add a method to obtain formal feedback from non-utilizers; and,
- add a method to obtain formal feedback from NET providers.
Read the full report below:
PEER on transportation DOM by yallpolitics on Scribd