DENVER — Customers of MedRide, a non-emergent medical transportation (NEMT) service, opened the company’s website on Friday to find Medicaid transportation is “temporarily unavailable.”
The notice comes after Colorado’s Department of Health Care Policy and Financing (HPCF) suspended the company’s contract.
MedRide is used by tens of thousands of customers to transport patients to and from medical appointments. According to a spokesperson for the company, about 85% of their customers rely on Medicaid to use the service.
“I’m running around just scrambling for everything,” said Debra Newman, whose son, Ryan Roth, has been using MedRide since April 2024. The two live in Cañon City, Colorado.
Roth has a rare blood condition, Rosai Dorfman disease. He told Denver7 he has appointments every 21 days at CU Anschutz in Aurora for infusions, which is more than 100 miles from his home.
“When you have them and you start relying on them and then it gets taken away, it’s like, ‘Well, what do I do now?'” said Roth, conveying how heavily he relies on MedRide.
MedRide is still offering transportation for customers willing to pay out-of-pocket.
“There’s no way I can afford to do this there,” said Newman. “I got a vehicle, but it will not make that travel. There’s no way. I’ll be on the side of the road.”
HCPF issued the notice of suspension to MedRide on Jan. 31, alerting the company that the suspension would take effect on Feb. 7.
The letter from the state said HCPF may “suspend a provider’s enrollment if the provider is identified as participating in an alleged and ongoing organized fraud scheme that impacts the state medical assistance program” and meets some requirements. Those requirements include, but are not limited to:
• At least three providers are involved in the scheme
• The collective billing amount identified in the scheme exceeds $1 million
• The provider’s billing indicates a pattern of abuse or noncompliance
• The volume of claims has increased at a significant rate and there is no other reasonable explanation for the increase
Records show HCPF issued MedRide a corrective action plan on Nov. 5, 2024, citing “sufficient deficiencies,” including claims with missing signatures, dates, and times.
The state tightened requirements for NEMT providers following “fraud, waste, and abuse” concerns in 2023.
“There’s probably been people that have mistreated the system on it… and the rest of us are going to suffer for that, you know, and it’s sad,” said Newman, in response to the allegations.
In a statement to Denver7, HCPF said in part, “Our members’ safety is of paramount importance to HCPF. We must ensure that our members have the assistance they need to get to their appointments, and we must ensure they are transported safely with reliable drivers and safe vehicles.”
- Read HCPF’s full statement below
“The Department of Health Care Policy & Financing (HCPF) is suspending MedRide, a non-emergent medical transportation (NEMT) provider. NEMT is transportation to and from medically necessary services covered by Health First Colorado (Colorado’s Medicaid program) for members who have no other means of transportation. Colorado statute authorizes HCPF to suspend NEMT providers to give HCPF time to investigate provider behaviors typically associated with fraud, waste and abuse. This suspension of MedRide meets the criteria in state law for suspension at § 25.5-4-301(16) [leg.colorado.gov], C.R.S. HCPF previously provided MedRide with opportunities and extensions to come into compliance and to address identified concerns, and they have not done so.
Our members’ safety is of paramount importance to HCPF. We must ensure that our members have the assistance they need to get to their appointments, and we must ensure they are transported safely with reliable drivers and safe vehicles. Being sound stewards of taxpayer dollars is also a top priority for HCPF in administering Colorado’s Medicaid program. With that in mind, HCPF has implemented credentialing requirements for NEMT providers and their vehicles, as well as measures to improve integrity and accountability in the program overall, especially given the organized fraud identified within the NEMT industry here in Colorado, Arizona, New York and in other states across the nation.
The suspension is effective Friday, February 7. HCPF issued notice to MedRide of this suspension on Friday, January 31. We allowed MedRide to fulfill member appointments already scheduled for the week of Feb. 3 and gave them time to notify members with upcoming appointments that they will need to reschedule with another NEMT provider. We have also notified members who have used MedRide over the past month of MedRide’s suspension and provided them resources to reschedule with other providers. We are attaching a copy of HCPF’s January 31, 2025, Notice of Suspension to MedRide, along with HCPF’s November 5, 2024, Corrective Action Plan (CAP) letter. HCPF has met with MedRide several times in the last year to address questions and provide guidance in an effort to assist MedRide’s compliance with the CAP. Despite HCPF’s efforts, MedRide has failed to comply with state and federal regulations.”
MedRide has filed an appeal in court over the suspension.
“I believe the state is trying to make an example of my client because they are the biggest in the state,” said Henry Baskerville, the attorney representing MedRide.
The company has a motion hearing in Denver for a temporary restraining order against HCPF, hoping it will result in a 14-day pause in the suspension, allowing MedRide to continue operating as usual. The hearing is scheduled for Monday at 11 a.m.
“Our goal in the short term is to try to pause this suspension so that we can begin providing those services again, and then try to negotiate with the state and figure out a way to resolve this issue,” said Baskerville.
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