Colorado Springs resident Jonathan Jones was surprised to find his ride to a colonoscopy appointment canceled the day before. He was informed that the free transportation service for Medicaid patients had been suspended over a funding dispute between the state’s Medicaid agency and the transportation company, MedRide. Jones managed to borrow money from a relative to take an Uber to his appointments, which cost about $70 round trip.
This is not something he can continue to afford, as he regularly uses the service due to ongoing gastrointestinal issues that necessitate frequent medical visits both locally and to Denver. MedRide, reportedly Colorado’s largest provider of non-emergent medical transportation, operates more than 300 cars and delivers over 420,000 rides annually, many of them across rural areas. The company has been caught in a tussle with the Colorado Department of Health Care Policy and Financing (HCPF), which administers the Medicaid program, over reimbursement documentation.
HCPF’s ongoing investigation began in the fall of 2023 due to alleged billing discrepancies. According to a letter from Medicaid Director Adela Flores-Brennan, MedRide’s claims for trips exceeding 52 miles exhibited significant deficiencies such as missing member signatures, dates, and times, and poorly scanned claim forms. HCPF suspended MedRide, alleging it was part of an “organized fraud scheme” exceeding $1 million.
“Our members’ safety is of paramount importance to HCPF,” said spokesman Marc Williams. He emphasized the need for reliable transportation for Medicaid recipients, reinforcing the agency’s commitment to integrity and accountability, especially against a backdrop of broader fraud issues in similar services across multiple states. Members relying on MedRide were informed of the suspension, with alternative arrangements provided via state resources.
MedRide spokesman Andy Boian stated that the company was cooperating fully with state requirements. “We comply with all state requirements, yet new ones keep arising,” Boian said. Jones, among many other Medicaid users, hopes for a quick resolution.
“Since they bill Medicaid directly, I don’t really have to do any paperwork. It’s been as smooth as possible,” he noted. As Medicaid recipients scramble to find a new nonemergency medical transport company, MedRide is taking legal action to continue serving them.
Funding dispute halts Medicaid transport
Boian spoke with the media to clarify some details from the company’s perspective. “We have not committed fraud,” Boian said.
“I know there are some bad actors in our industry who have in the past, so the state is doing its best to mitigate and control that.”
The investigation flags companies that meet certain criteria for involvement in alleged fraud, according to a suspension letter HCPF sent to MedRide. Boian stated the state has found that MedRide did not commit fraud but is still looking for certain requirements to be met in order to operate for Medicaid patients again, including locating missing signatures from drivers. In the meantime, Boian said the company is filing an injunction to prove to state courts that MedRide did not commit fraud and to try to get the court to agree to let the company operate while the state continues its investigation.
“We are by far the largest provider in Colorado for non-emergency care for Medicaid patients,” Boian said. “We have unintentionally stranded a lot of people as of this morning because we can’t operate.”
Boian expressed frustration with the process, which he said has taken at least nine months and still resulted in their suspension. “It’s a very frustrating process for us, and the people who suffer the most are our patients,” he added.
He emphasized that the issue lies with the state, not with the company. State officials provided a list of NEMT companies for Medicaid users to utilize as they wait for what Boian called a temporary, albeit disruptive, setback. Other NEMT providers expressed concerns about managing increased demand during the suspension, particularly in rural areas where MedRide was most active.
MedRide had accounted for about 69.5% of rural Colorado NEMT trips in the first half of 2024, according to court filings. Barb Sandoval, a Crowley County NEMT provider, said she has been receiving multiple daily calls from clients seeking alternative transportation. Limited by her single vehicle, she is unable to increase her capacity.
Sandoval noted that rural drivers must often travel more than 52 miles due to the geographic spread of specialized care facilities. Kelly Duncan, a receptionist at Cañon City Golden Age Council, which provides NEMT services for Fremont County, reported a spike in ride inquiries following the suspension announcement. Duncan explained that while they typically schedule rides weeks in advance, they are now trying to find drivers for urgent trips within 48 hours.
Medicaid members requiring rescheduled rides can contact Medicaid member assistance for further guidance.
