MedRide and Colorado HCPF reach settlement after litigation, MedRide services will continue
Celeste Springer
COLORADO SPRINGS, Colo. (KRDO) — After a legal battle, a Colorado Non-Emergent Medical Transportation (NEMT) group will be able to continue giving rides to patients for the foreseeable future.
MedRide, which provides Medicaid patients with non-emergency rides to doctors’ appointments and other medical services, got into a legal battle with state officials earlier this year.
The Colorado Department of Health Care Policy and Financing (HCPF) accused the medical transport company of engaging in a “pattern of abuse.” According to documents, directors with the Colorado Medicaid program said claims had been missing member signatures, missing dates and times, or claims that were missing columns.
“For the last nine months we’ve been trying to remedy [this]. We were first accused of fraud, that’s been debunked by the State. We have not committed fraud. We have open books and [the State has] looked at our books, and we understand there’s some bad actors in our industry, but we’re not one of them,” a spokesperson for MedRide previously told KRDO13.
The spokesperson said that MedRide had been working to adjust to and satisfy several changes in policy and procedure by the HCPF over the last year. However, they said the state kept “moving its goalposts.”
In February, following efforts to suspend their contract, the HCPF opted to terminate its contract with MedRide entirely.
On Monday, spokespersons with both the HCPF and MedRide said they have reached an agreement, allowing MedRide to continue to provide non-emergent transportation to patients well into the future as long as the company meets several requirements.
According to a spokesperson with HCPF, the requirements for MedRide include:
Maintaining all required documentation to achieve successful credentialing that verifies driver and vehicle safety and fitness prior to transporting Health First Colorado members
Creating and administering a driver training program to ensure compliance with the Medicaid NEMT program
Reinforcing processes to ensure that the customer is eligible for Medicaid coverage and that the trip is eligible for Medicaid NEMT reimbursement
Employing a compliance officer to ensure MedRide operates in compliance with regulations and guidance intended to protect members
Contracting with a third-party auditor to screen MedRide’s claims to ensure completion and compliance prior to submission for reimbursement
Limiting the number of rides MedRide can provide to Medicaid members until program compliance is established and maintained
“We are pleased to have reached this agreement so both MedRide and HCPF can focus our time and resources on providing safe, affordable transportation services to eligible Colorado Medicaid members,” said Medicaid Director Adela Flores-Brennan.
“We look forward to putting this behind us and continuing to operate as a fully compliant and good-standing provider of NEMT services for the Coloradans we are proud to serve,” said Greg Harriman, president and owner of MedRide.