The MaineCare transportation program that came under fire in 2013 for missed rides and poor service cost $5.4 million more to operate in the 2014-15 fiscal year compared with previous years, according to state documents.

The $50.3 million spent in 2014-15 was 12 percent higher than the $44.9 million cost a year earlier. In 2012-13 – before the launch of the current ride brokerage system that prompted a wave of complaints, protests and state hearings – the MaineCare transportation system cost $44.4 million.

“You have to ask yourself, what was the point? What did people in Maine really gain when we did this?” said Rep. Drew Gattine, D-Westbrook, a critic of the new system who chairs the Legislature’s Health and Human Services Committee.

MaineCare is the state’s name for Medicaid, a federal program operated by the states and funded with a blend of state and federal funds. Patients who don’t have transportation are entitled to receive rides to health care appointments through Medicaid. About 40,000 to 45,000 Mainers use the ride service.

David Sorensen, spokesman for the Maine Department of Health and Human Services, said in a written statement to the Portland Press Herald that the cost of the service increased in the 2014-15 fiscal year because “both the number of rides and the cost per ride increased. This is in large part because the new brokerage system we implemented prevents drivers from denying rides, unlike the last provider.”

Gattine said there was no evidence that patients were denied rides under the previous system, which ended in 2013.


DHHS overhauled its transportation network that year, replacing a system in which local nonprofit transportation companies both arranged and provided rides with a new system in which a third-party broker booked rides with transportation companies.

The state claimed the change would be cost-neutral and provide Maine with cost certainty because the contracts with ride brokers paid them according to the number of people they served, not the number of rides they provided.

Under the previous system, the local nonprofits were paid through a fee-for-service system, which meant each ride was reimbursed. Theoretically, under a fee-for-service system, if the number of rides increased dramatically, costs to the state and federal government could skyrocket.

State officials said at the time that they also were pressured by the U.S. Centers for Medicare and Medicaid Services to change Maine’s system, in part to prevent potential abuse and fraud. Also, the new system required improved tracking of rides, giving the state and federal government more accountability and transparency.

By taking the job of booking rides away from transportation agencies, the system would prevent the agencies from potentially colluding with customers to go on non-medical trips, such as taking someone to the grocery store or the beach.

But thousands of consumers complained about missed or delayed rides in 2013 – including 4-year-olds or disabled people being left at the curb for hours, or being driven to wrong addresses. That prompted the state and the new ride brokers to correct flaws in the system. By January 2014, the service had improved.


However, the state did not renew contracts with Connecticut-based Coordinated Transportation Solutions, the ride broker that was paid to arrange rides for most of the state in 2013-14. Problems with service persisted longer with CTS than with the other ride brokers, state officials said.

In April 2014, Maine awarded contracts totaling $45.9 million to Atlanta-based LogistiCare for most of the state, and Maine nonprofits Penquis Community Action for the Bangor and Augusta areas, and Waldo Community Action for the midcoast region.

On Tuesday, Logisticare referred questions to DHHS and Penquis Community Action didn’t return a message seeking comment.

Barbara Crider, executive director of York Community Action, which lost work in 2013 when the state changed systems, said she’s not surprised the new system is costing taxpayers more money. It added a layer of bureaucracy to the system, she said.

“To me, it was always obvious it would add additional costs to the system,” Crider said. “How could it not?”

The cost increase was included in a monthly newsletter prepared by the Legislature’s Office of Fiscal and Program Review. When asked for a further breakdown of costs, Sorensen wrote that the Press Herald should submit a request under the Freedom of Access Act.


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