NPR / Kaiser Health News: Medicaid pays millions for patient transportation. Sometimes the ride never comes

Tranisha Rockmore and her daughter Karisma waited at an Atlanta children’s hospital in July for their ride home.

Karisma had been at Children’s Healthcare of Atlanta to have her gastrostomy tube fixed, Rockmore said. The 4-year-old, who has several severe medical conditions, has insurance coverage from Medicaid, which provides transportation to and from nonemergency medical appointments through private vendors.

After being told that a ride would not be available for hours, Rockmore said, she finally gave up and called her sister to drive them home to the South Georgia town of Ashburn, more than 160 miles away.

She said it wasn’t the first time she had run into trouble with the Medicaid transportation service. …

States are required to set up transportation to medical appointments for adults, children and people with disabilities in the Medicaid health insurance program. Transportation brokers — such as Modivcare, which Rockmore used — have subcontracts with local providers, often small “mom and pop” operations, to shuttle patients to and from needed appointments, including for dialysis, adult day care, and mental health and treatment for substance use disorders.

It’s a lucrative business, with transportation management contracts that can be worth tens of millions of dollars for companies. The two companies that have contracts in Georgia have given extensively to political campaigns of elected officials in the state. The firms, Modivcare and Southeastrans, have also faced complaints, lawsuits and state government fines in Georgia and elsewhere. The two companies maintain, though, that the complaints relate to a tiny percentage of rides provided. …

Modivcare, through LogistiCare, has given $48,350 to Georgia Republican candidates in state races since 2017, according to the Georgia Government Transparency and Campaign Finance Commission. It gave $750 to former Democratic state Rep. Pat Gardner, also according to the commission. Modivcare’s Zerone did not answer questions about the company’s political giving because she said it would be “competitive information.”

Such contributions can help companies buy access to government officials, said Paul S. Ryan, a vice president at the government watchdog group Common Cause.

“Anytime a special interest doing business with the government can make big contributions to public officials handing out contracts or making other government decisions, it’s a cause for concern,” he said. “Average, everyday Americans can’t buy the same influence.”