Colo. Medicaid suspends contract with MedRide, many now scrambling for rides to appointments
COLORADO, USA (KRDO) - Families across Colorado are now in a desperate search to find new ways to get to much-needed medical appointments, as the state's most popular company for those services, Medride, is set to have its contract with Colorado's medicaid program suspended starting this Friday.
Debra Newman and her son Ryan Roth live in the outskirts of Cañon City, where a long medical commute has become their new normal.
In February 2024, Ryan found a mass in the middle of his back, which later revealed that he had a rare blood disease, one that only affects 1 in 200,000 people. It left him in need of getting blood infusions every 21 days.
The disease is in fact so rare, that Newman says there is only one doctor in all of Colorado who can treat it. Unfortunately for them, that doctor is nowhere near their home in Cañon City, but instead more than two hours away at the UCHealth Anschutz Medical Campus in Aurora.
"[If] he misses three or four of these infusions, then this disease attacks his organs," explained an emotional Newman, who doesn't know where to turn to next for her son.
She claims that there are very few, if any, companies who will travel as far as MedRide does for Ryan's appointments in Aurora.
"If it comes down to it, I guess I'll just piggyback ride him on my back. You know, start the day before and I might get back, you know, three days later," said Newman. "To lose this transportation, is devastating." she added.
With Ryan's next transfusion in 12 days, both he and his mother worry about the timeline of finding a replacement.
He says without treatment, he loses energy very quickly, and physical exertion only worsens it. He says he already has nodules spreading in different parts of his body from the disease; right now they've been found in his arm and right leg. The treatment helps, he explains, but only when it's consistent.
"Like I said, the one week of missed infusions wasn't fun. I can only imagine missing more, it's just going to spiral," Ryan said.
Other clients in El Paso County, and Teller County, echoed similar sentiments, saying they use the MedRides to get to appointments in Denver for continued care after a double-lung transplant, while another says it's the only way her older son can get to the doctor, while she stays home with her youngest child that needs 24/7 surveillance while attached to medical devices.
KRDO13 Investigates was first to break the story after The Colorado Department of Health Care Policy & Financing (HCPF) said they were within their legal rights to suspend operations with MedRide. They say that state law allows them to suspend services with Non-Emergency Medical Transport providers (NEMT) in order to investigate concerns over waste, fraud, and abuse.
According to documents, directors with the Colorado Medicaid program said claims had been missing member signatures, missing dates and times, or they were missing entire columns.
On Thursday, a day after the announcement, a spokesperson for MedRide explained to KRDO13 Investigates that allegations of fraud, have already been tabled between the two groups.
"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." the spokesperson said.
Alternatively, a rep with HCPF stated on Wednesday that they have met with MedRide several times to address concerns to get them into compliance with their requests, but they allege that MedRide still failed to follow their regulations.
That contrasts with MedRide's explanation, who says they're not trying to be combative with the State, but rather collaborative. The spokesperson says that MedRide has been working to adjust to, and satisfy, several changes in policy and procedure by the HCPF over the last year.
MedRide says they're in the process of filing an injunction in court to keep their services going for the near 375,000 rides they facilitate every year, 80% of which are for medicaid participants.
One of those involved getting all of their MedRide drivers finger-printed, to be validated by the State, which the spokesperson alleges they did, and then re-did a second time at their own expense, however it still led to pushback from the state.
If you're also being impacted by MedRide's suspension, you can click here, for phone numbers to different NEMT's in Colorado, sorted by county.
