West Virginia has awarded non-emergency medical transportation (NEMT) broker Medical Transportation Management (MTM) the contract to coordinate non-emergency medical transport services for state residents under Medicaid. MTM replaces the West Virginia Department of Health and Human Resources (DHHR) as the “gatekeeper” between the State’s financial resources and the actual NEMT providers. Depending on the contract, which has not been produced, MTM must qualify each transportation provider before allowing the provider to transport West Virginia citizens.
West Virginia has taken this step in response to alleged fraud and mismanagement by NEMT providers on the DHHR. That this is alleged to have occurred is not, in my experience, a surprise. Most government agencies, especially dealing with public health, are not looking, nor are they set up to look for, contractor fraud. It should be recognized by West Virginia that MTM is not a non-profit organization, and has inserted itself into this situation because they believe they can make a profit. DHHR Deputy Secretary Jeremiah Samples claims to have the ability to terminate the broker contract after one year, but the reasons for termination have not been provided.
Unfortunately Mr. Staples has not elaborated on what steps, if any, MTM will take to provide safe transportation for West Virginia citizens. Additionally, there is no mention of training, drug screening, and criminal background checks for NEMT providers. If the entire focus is discovering fraud, and not on patient safety, MTM will not be incentivised to move in that direction. MTM is to begin its contract on June 1, 2014. It is too early to see if this will be a positive transition for West Virginia citizens.