Under pressure from lawmakers, Pa. puts off privatizing free doctor rides for Medicaid recipients
Secretary of Human Services Teresa Miller, foreground, with Gov. Tom Wolf, background. (Courtesy of Wolf administration)
The privatization of almost $150 million in free rides to medical appointments for Medicaid recipients will be pushed back for 18 months following pressure from local governments and lawmakers.
The reversal was laid out in a Dec. 13 letter to lawmakers from Department of Aging Secretary Robert Torres, Department of Human Services Secretary Teresa Miller, and acting Department of Transportation Secretary Yassmin Gramian.
The program — known as the Medical Assistance Transportation Program, or MATP — provided an estimated 11.5 million rides to Medicaid recipients in 2014 — at a cost of $148 million according to a Texas A&M University study.
A study of a similar program in Texas found the majority of rides are for dialysis, therapy, or specialist visits.
In 2018, a last-minute budget provision mandated the program, currently run by counties or associated transit agencies, would instead be contracted out to a private company on a regional basis. Such an arrangement is known as the brokerage model.
But in last week’s letter, the three appointees of Gov. Tom Wolf said a recently conducted study had given the agencies “a deeper understanding” that statewide, privatization “may not be the best solution to meet the needs” of Medicaid recipients, they wrote.
The study had only been conducted because of bipartisan legislative pressure, particularly from rural lawmakers worried about service cuts in their districts.
The prospect of a private company bringing patients from their doorstep to the doctor raised concerns for both the counties as well as patients, according to lawmakers.
For example, Texas’s brokerage increased both the cost and number of complaints from Medicaid recipients, according to a state legislative report.
Pennsylvania’s current program had the lowest costs out of seven reviewed states in 2018, according to Texas A&M.
In an email, Ken Kroski, spokesperson for the County Commissioners Association of Pennsylvania, pointed to these current success.
“We believe that with such diversity in the state, counties must retain the ability to decide how to operate transportation programs in order to maintain the efficiencies already achieved,” Kroski said. “County residents know the current model and are able to effectively utilize it.”
“The constituents who use the service have to be the main consideration for any change in delivery model that may be discussed in the future,” he continued.
Meanwhile, state public transit agencies warned that losing state MATP dollars would hurt seniors and the disabled, who also receive free or subsidized transportation for their medical appointments.
Public transit agencies also raised concerns that they’d lose out on federal transportation dollars awarded based on their annual mileage.
Torres, Miller and Gramian promised to study existing county programs before offering any more changes.
But both state agencies did not rule out privatizing regional services, citing a “positive experience using a broker model in Philadelphia.”
In Philadelphia, a private company — Logisticare — was providing rides while getting roughly $71.28 in public dollars each year per rider. That’s equal to the cost of five and a half rides at the statewide average.
Despite the delay, the House Transportation Committee voted unanimously Monday to advance a bill requiring the executive branch to seek legislative authorization if they ever decide to privatize the program.
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