PLATTEVILLE (WKOW) -- State Medicaid recipient Kathy Wilcox was simply planning to go from Platteville to Cuba City for a routine cleaning at her long-time dentist, when her state-provided ride arrived. From Madison.
"I thought, for heaven's sakes, they're really sending a cab out of Madison to take me to Cuba City," Wilcox told 27 News.
The distance from the city limits of Platteville to Cuba City is nine miles.
But Union Cab of Madison Cooperative business manager John McNamara told 27 News the charge for Wilcox's brief cab ride was $300.
The Union Cab ride was arranged through the state's contract with Atlanta-based LogistiCare.
McNamara said at least forty Union Cab rides for medical visits under LogistiCare's contract during January and February involved transportation entirely outside of Dane County, similar to Wilcox's ride in Grant County.
LogistiCare Senior Vice President of Operations Chuck DeZearn told 27 News his company arranges 200,000 non-emergency rides for Medicaid recipients per month in Wisconsin, and the high-cost variety are exceptions.
"We did about 400,000 trips (January-February), so even if it's forty outliers, and there may some examples in other areas as well, it goes into the total transportation-spend," DeZearn said.
The total transportation-spend has been such a problem for LogistiCare, it's leaving Wisconsin this year, after deciding to pass on submitting a bid on a new contract to arrange the rides to medical visits.
DeZearn told 27 News the firm's decision is based on the unanticipated, high volume of these rides in the state, and not the percentage of rides with exorbitant costs.
The formula used to calculate the state's contract with what's called a broker for these rides is based on the number of eligible state residents in Medicaid, and not the number of rides, or their cost.
LogistiCare's ride data over the past more than two years has been used to help state officials construct a contract process with interested companies.
But an alliance of state, non-emergency medical transportation providers questioned the reliance of LogistiCare's experience.
"Right now, the state is simply accepting LogistiCare's representations of inability to provide services at the current rate - the rate LogistiCare itself bid," alliance president Norah Cashin said in a statement.
DeZearn stands by LogistiCare's data. DeZearn also told 27 News a factor in high-cost rides is an insufficient network of transportation providers in some areas of the state.
State health services deputy secretary Kevin Moore echoed that factor. "There are certainly parts of the state, especially rural parts of the state, where transportation, it's not even about people on Medicaid, transportation in general is a challenge."
Moore told 27 News serving the travel needs of Medicaid recipients is a top priority. But Moore also said the replacement of county-directed, non-emergency medical transportation scheduling with a single, state-broker has addressed potential Medicaid fraud. Moore said some recipients were previously getting rides, even though their benefit eligibility was for food, and other, different benefits.
But neither Moore, nor DeZearn could produce proof, rides such as Wilcox's $300 cab fare for her ten minute ride to the dentist was the result of a less costly transportation option being unavailable. State records show Grant County is served by three, approved transportation providers in addition to Union Cab and another, Madison-based company.
Wilcox said LogistiCare-arranged rides have meet her needs, but said when the county previously arranged her non-emergency medical transportation, drivers came from much closer than Madison.
"I've had drivers from Montford, from Prairie du Chien, from Darlington, from Hazel Green," Wilcox said.
DeZearn said participating transportation companies in the broker model must carry certain insurance, and their drivers submit to drug screens, background checks, and possess certifications. State officials said quality and cost standards in connection with the previously county-arranged rides was not uniform, or readily accessible.
Moore told 27 News the state's current contract process is designed to build off LogistiCare's ride data and control costs, but he conceded providing an average of more than 900,000 annual statewide, none-emergency medical rides may be more expensive, than under LogistiCare's existing contract.