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Change in Medicaid transportation system has effect on Lewis County

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LOWVILLE — As a result of state Medicaid reform, nonemergency medical transportation for Medicaid patients has decreased for Lewis County public transportation, while rides with taxi companies and similar services have increased for these patients.

Sara S. Freda, planner with Lewis County Economic Development and Planning Department, on Thursday told the county Legislature’s Economic and Development Committee about the trend.

“It is costing the county a lot of money to provide the Medicaid rides, but we are mandated by federal law to do that,” Mrs. Freda said.

Before Sept. 1, 2013, the county brokered all of the nonemergency rides through a contract the Department of Social Services had with Birnie Bus Tours Inc. Birnie Bus did all of the scheduling, and it cost DSS about $3,000 a month for the service.

Birnie Bus, according to Mrs. Freda, did everything possible to put those Medicaid people on public transportation.

“That is a win-win. We would get the (Statewide Mass Transit Operating Assistance) money and they would get paid by the state for Medicaid service,” she said.

After Medicaid reform, the state contracted with Medical Answering Service out of Syracuse. The contract went into effect Sept. 1, according to Mrs. Freda. The company now brokers all of the Medicaid transportation for Central New York, including Lewis County, and the state pays.

“MAS, by no fault of their own, they do not understand the geography of Lewis County or any of the other counties,” Mrs. Freda said. “What has happened as a result is a lot of those rides that used to be on the bus now go to Yellow Cab in Watertown or some other cab-type services that have come now to answer that demand.”

Mrs. Freda said the patients used to ride the bus to their appointments and then would have the option to have the demand response/medical van pick them up.

The demand response/medical van was created to pick patients up after their appointments, so they did not have to wait hours to catch the bus again when it came back around on its cycle.

Since the change, if the transportation system cannot provide return service, the dispatch company will not use it. Mrs. Freda said it has to be all or nothing, and that precludes use of the buses. The company also has dropped the demand/response return bus.

“It is not necessarily a good thing or a bad thing, because that also was costing us $46 an hour to provide that service,” Mrs. Freda said.

She said she renegotiated the demand response/medical van rates with Birnie Bus and in June it decreased the cost to $27 an hour.

The change in the system has not had a huge effect on Lewis County, because the transportation system relies mainly on Arc riders.

However, other counties in upstate New York whose public transportation systems relied on Medicaid riders may be in trouble, Mrs. Freda said.

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