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Assemblywoman Barbara Lifton (D/WF-125) wrote to Governor Andrew Cuomo identifying the many problems that continue with Medicaid transportation in her district and in rural Upstate New York as a whole.

"While we managed to secure some helpful funding for upstate rural transit – additional funding was added in both the 2014 and the 2015 budgets for rural transit – there continue to be ongoing serious problems with Non-Emergency Medicaid Transportation (NEMT), which has been managed by the brokerage firm Medical Answering Service (MAS) since late 2013," Lifton said.

Lifton catalogued problems stemming from the bulk of MAS rides being scheduled in taxis, which has created a bevy of problems in regard to traveling conditions for clients, as well as hurting the viability of local public transit, which is also a mainstay for Medicaid clients for the rest of their travel needs.  She said the lack of adequate response to these problems, which have been the subject of many meetings and conversations with the New York State Department of Health (DOH), is of serious concern.

"In Cortland County, MAS has been scheduling the majority of all ambulatory trips in taxis rather than using Cortland Transit's Dial-a-Ride," said Lifton. "The taxi service may not be of the highest standard. I've heard stories about Medicaid taxis that are smoke-filled and dirty, with drivers who are unprofessional. None of the taxis are accessible, but they are being used to transport those who are wheelchair-dependent, with the wheelchair being put in the taxi trunk.  Cortland Transit's buses, on the other hand, are fully wheelchair accessible," she pointed out.

"This has also left Cortland Transit in a tough position. They've increased their rates, cut back on routes, and looked for other funding streams to help stem losses, but the situation is still precarious, Lifton added.

A further problem, according to Lifton, "is that the brokerage system set up under MAS, which was originally intended to save the state money, appears to be costing more, at least in rural Upstate counties. NEMT costs have been trending upwards since February 2014, and some counties have reported NEMT costs as high as 40% above pre-MAS figures."   In Cortland County – a portion of which Lifton represents in the Assembly – the June 2015 cost for NEMT was the highest total ever reported: $84,091.

"I'm very concerned about these dramatic increases in spending, especially for what seems to be inferior services," Lifton said. "Given all of these factors, it's completely perplexing to me that MAS would continue to put vulnerable citizens in taxis. They are more costly, they are unregulated by the state, and by all accounts they are of questionable quality. At the same time, our struggling public transit systems are cost-effective, as well as appropriately-regulated and accessible for those with disabilities. So why isn't MAS making full use of them?"

At Lifton's request, the DOH agreed to form a working group in 2014 to address challenges that had arisen as a result of the switchover to the new brokerage system under MAS.   "A series of meetings was held, but serious problems, clearly, still remain," said Lifton.

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