Investigation: Medical pickup problems - Dallas News | myFOXdfw.com

Investigation: Medical pickup problems

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DALLAS -

Texas taxpayers are shelling out about $30 million annually to drive the state's sick and poor to the doctor. It is big bucks and big business but is the state getting its money's worth? Some complain they are not getting what the doctor ordered.

A Georgia company called LogistiCare took over the North Texas Medicaid contract this past April. Since then, almost 6,000 complaints have been filed. Those complaints includes everything from missed appointments because of no-show drivers, to injured passengers even the legally blind being left behind.

Jimmie Walker loves his quiet life out in the country. But in recent months, life has been anything but peaceful.

"I just had a really bad feeling, I just didn't want to go that day," said Carol Stephens, Walker's 24-hour caregiver. "I noticed his eyes were red and blood shot."

Walker is recovering from a broken hip and complications from being a paraplegic and diabetic. He depends on LogistiCare to get him to his doctor's appointments. Back in August, Stephens complained Walker's wheelchair was not tied down and when the driver took a sharp turn, the chair flipped.

"I think I was in shock," said Walker. "I was scared half to death I hurt my hip again."

"I screamed Jimmy," said Carol Stephens. "I saw him falling. I said call 9-1-1 now!"

But Stephens says the driver did not call 9-1-1 but instead drove Walker to his appointment. Days later, photos show Walker's bruised and battered body.

"Of four limbs, he had one good limb and that's the limb they've damaged, his right arm," said Stephens.

Walker's complaint is one of thousands filed with LogistiCare.

Hubert Sullivan can barely get in and out of bed. He's had bypass surgery, knee replacement and is now battling cancer. He has complained of no-shows and on one trip he says the driver drove on the wrong side of the highway, not able to understand his concerns in English.

"This lady comes across the hill, starts flashing her lights and waving," Sullivan said. "No more."

And Gary Parrish has complained he was stranded at the doctor's office. He's diabetic and legally blind. He says he had to walk because no one showed up to drive him home.

"Instantly I went off. I can't believe this is happening to me," Parrish said. "Ten miles is about what I walked that day."

Since LogistiCare took over the 13 county North Texas contract, the complaints have been rolling in. There have been about 6,000 in the first 5½ months of the program. And that is what LogistiCare has turned over to the state because LogistiCare takes the complaints. Who is complaining? That is all confidential. The state will only turn over broad complaint categories with no names.

Here is how it breaks down. Drivers showed up late, 1,922 times, there were 1,535 times the driver didn't show up at all. That means some clients never made it to the doctor. And there were 1,120 complaints about the driver.

The Texas Health and Human Services Commission oversees the roughly $30 million contract. The payments vary month to month because LogistiCare gets paid based on the number of Medicaid recipients eligible for rides, which means the company still gets paid the same even when trips are late or missed.

Stephanie Goodman is with Health and Human Services. She says that is the way the state wanted the contract.

"If they miss a trip, they risk a fine, which is a lot more than what they were getting paid for the trip," said Goodman. "We are really hard on our providers. We do not hesitate to fine them."

But Goodman admits the state has yet to fine LogistiCare even a dime for any incident since April and the state has no problem with LogistiCare self-reporting complaints.

"If they were not honest with those numbers, we are going to find that out," said Goodman.

"No, no. That is the fox guarding the hen house,"said Senator Jane Nelson. Nelson chairs the Senate Health and Human Services Committee.

"In private practice, if there was a company that just didn't show up 1,500 times, they would be out of business," said Nelson. "It is mind boggling to me that they are reporting that they did not show up on themselves 1500 times, so what is the real number?"

Fox 4 asked for an on camera interview with LogistiCare but the company said no. We were allowed to meet with a company representative but if we recorded it, LogistiCare said it "would require quote approval," if we used "any statements made by LogistiCare." Fox 4 would not agree to those terms. LogistiCare set the "ground rules: no filing whatsoever."

Off camera, the company representative told us LogistiCare makes 89,000 trips a month. It's complaint rate is about 1.2 percent. LogistiCare says that number is minuscule but still unacceptable. Nationwide the company says it has industry leading statistics. It calls these nearly 6,000 reports, transitional issue complaints and says the numbers are coming down each month.

Every week, I was having to call LogistiCare to complain, complain, complain," said Carol Stephens.

Stephens says she has been so vocal, the company now sends a bus service for Walker with lifts and drivers who carefully strap him in.

But she is wondering what happened to the complaint filed with LogistiCare. The company sent a letter promising to investigate. She has never heard back.

"My arm, you know, it hurts," said Jimmy Walker.

Walker says he has had to follow up with his doctor and says the taxpayers picked up the tab.

"I don't think they should pay for that guy turning me over in my wheelchair and hurting me," said Walker.

"LogistiCare should not be governing themselves," said Carol Stephens. " It does not matter if it is a poor person or a rich person, you don't deserve to be treated this way."

LogistiCare told Fox 4 it could not comment on any individual complaint but the state gave us copies of what LogistiCare reported.

In Walker's case, LogistiCare admitted the wheelchair tipped over but reported that Walker was fine and Carol Stephens never mentioned she was injured. Walker and Stephens say that is not true.

LogistiCare reported that Gary Parrish wasn't stranded, that his driver was just running 40 minutes late. Parrish says that is not true.

LogistiCare reported Sullivan's driver admitted he drove the wrong way on the highway. The driver was suspended for a week.

If you have a complaint about LogistiCare, you can contact your state representative, the Texas Attorney General or the Texas Health and Human Services Commission

Attorney General of Texas: https://www.oag.state.tx.us/forms/cpd/form.php

Texas Health and Human Services Commission:

Office of the Ombudsman MCH-700
PO Box 13247
Austin, Texas 78711-32471
877 787-8999

Public hearing information:
http://www.hhsc.state.tx.us/medicaid/index

Contact:
LeShawn Manus
Medical Transportation Program
1106 Clayton Lane, Austin, Texas 78723
(512) 706-4900, fax: (512) 706-4999, or e-mail leshawn.manus@hhsc.state.tx.us

November 6, 2012 from 1-4pm
Botanical Gardens
3220 Botanic Gardens Blvd
Ft. Worth, Texas

November 7, 2012 from 1-4pm
Center for Community Cooperation
2900 Live Oak Corner Room
Dallas, Texas 75204

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