How did Medical Transportation Management (MTM), a company that has twice left Missouri seniors stranded for rides to doctor’s appointments get awarded another contract to…drive Missouri seniors to doctors’ appointments?
That is the question being asked by House appropriators, Senate appropriators, and nearly everyone in Missouri’s healthcare industry.
The first time MTM stranded Missourians
Currently, Missouri’s Medicaid program appropriates approximately 50 million dollars for Non-Emergency Medical Transportation (NEMT) services to transport patients to and from doctors’ visits.
In 2005 the state awarded MTM the contract to transport Missouri seniors to their non-emergency doctor’s visits. However, sixty days later MTM just walked off the job stranding Missouri seniors waiting to be picked up for doctors appointments.
The state scrambled to find someone who could come in and get the NEMT program back up and going, but most of all get senior citizens to their doctors so that they could receive the healthcare they rely on.
That is when the state reached out to Modivcare. Another large nationwide company in the NEMT field who came in and picked up the contract from scratch and rescued the Missouri seniors who MTM had stranded.
Fool the state once, shame on you, fool the state twice shame on the state
Then in 2011 just five years after MTM had walked off the job stranding thousands of Missouri seniors they were again awarded the NEMT contract for the State of Missouri.
The contract was again awarded to MTM after a slew of assurances that there was no way that MTM would walk off from the contract again.
However, just eleven months into their new contract MTM demanded a rate increase. When they didn’t receive an additional fee increase not even one year into the five-year contract MTM again defaulted on the contract and left Missouri seniors waiting for their rides to their doctors’ appointments stranded, again.
Again the State of Missouri was left desperately searching for someone to transport these stranded seniors to their doctor’s appointments, and again the state called Modivcare.
Once again Modivcare came to the rescue of these stranded Missourians and fulfilled the commitments that MTM had made and defaulted on.
In what must be seen as an act of incredible hubris MTM again bid on the NEMT contract in 2016. One observer of the current situation commented off the record that, “I guess they were just checking to see if we were the biggest suckers in the world.”
Modivcare received the NEMT contract in 2016 by a wide point margin. The committee’s stated rationale for this point gap was that ModivCare “submitted the best experience, reliability, and expertise of vendor’s personnel, and method of performance.”
As well as, “the evaluation committee has concerns with MTM’s “inability to reach agreement on contract rates” at the time of contract renewal.”
It seemed clear by all common sense that after 2011 MTM had burnt every bridge with the State of Missouri. After all, how could anyone trust MTM after twice stranding Missouri seniors?
Missouri’s RFP process
Currently, Missouri submits RFPs for major state contracts such as the NEMT contract. The bids received from the RFP are then reviewed by a procurement committee of state officials supervised by the Office of Administration.
The committee typically includes five people with officials from the department who will be implementing the contract as well as officials from the division of purchasing.
There is currently a point system in which each qualifying bid is scored. Most bids are scored on a 200-point system, with an opportunity for 18 bonus points.
The committee scores the bids based on their opinions of different evaluation points and awards the number of points they feel are appropriate. Vendor knowledge can be included in these evaluations.
Then the committee meets and the members discuss who they feel amassed the most points on their tally sheets and they come to a conclusion as to who should be awarded the state contract.
The tally sheets are only saved if the procurement committee’s recommendation is not unanimous.
There is also a file that each department can submit letters to either commending the vendor for tremendous service or pointing out a vendor who performed poorly. As in attempting to hold up the state for a fee increase and then twice stranding Missouri seniors.
Fool the state a third time…….
In 2021 the NEMT contract was again let out for bid. Modivcare had now been providing the state’s NEMT service for nearly ten years after stepping in after MTM’s second default.
It was assumed that either Modivcare or another one of its competitors would receive the contract.
Most thought the process was just a formality. After all, who would possibly trust their grandmother to be taken to the doctor by someone who had left her stranded twice?
However, on May 26, 2022, the State of Missouri shocked everyone by lining up Missouri seniors for a third time with MTM.
The fervor was loud. As the legislature had just adjourned the week before the bid was announced, the angry calls from state legislative appropriators’ complaints went to Medicaid and the Commissioner of Administration.
As details about MTM and Modivcare’s bids began to circulate the anger grew louder amid an appeal by Modivcare over the procurement committee’s decision.
During the appeals process, in what had to make Missouri procurement officials feel better, it became clear it was not only them that had been fooled by MTM.
MTM has not just defaulted or abandoned contracts in Missouri, but it has in other states as well.
In Rhode Island MTM left a blind, terminally ill man stranded overnight, stating “breakdowns in communication” was why he was stranded. Though the man had contacted multiple members of their team, all of which had assured him someone was coming to pick him up. Another problem MTM created in RI was a fatal accident resulting in the death of the passenger, in which the driver was charged with a DUI.
The list is lengthy, from a $1 million fine to being “beyond repair”, but the issues continued into Arkansas where the state saw it was necessary to cancel MTM’s four regional contracts.
In Arkansas, MTM had its contracts terminated after only 17 days, due to “too many missed appointments”, which then led to the state seeking $3.7 million in damages.
However, in Missouri, a bid protest is decided by the procurement committee that made the decision in the first place.
While the Missouri procurement process has by all accounts served the state well. It begs the question, what happened this time?
That leads to a few other questions: 1) Was the decision to award the NEMT contract to MTM after they had twice defaulted on it a unanimous one?
2) If the decision by the committee wasn’t unanimous, what is on the procurement committee’s tally sheets?
3) Did anyone with the state submit a letter for the file after either time MTM defaulted on the contract so that future procurement committees could avoid making the same mistake twice? Or in this instance a third time.
Neither MTM nor Modivcare responded to a request to comment on this story as there has been litigation filed over the bid.
Tomorrow morning at 10:00 A.M. The Missouri Times is submitting a sunshine request with the Office of Administration seeking the answers to these three questions. The state will have 72 hours to respond.
Once they respond we will hopefully be able to answer the question: How did MTM ever get another state contract?
Below is a copy of the sunshine request submitted to the Office of Administration.
RE: Sunshine Law Request
Dear Custodian of Records: I write to request copies of the following public records pursuant to Chapter 610 of the Missouri Revised Statutes:
- Was the decision to award the Non-Emergency Medical Transportation contract to Medical Transportation Management a unanimous decision? If the decision by the committee wasn’t unanimous, we would request the tally sheets of the procurement committee.
- Did anyone with the state submit a letter for the file after either time Medical Transportation Management defaulted on the contract?
I request these records in an electronic format if that format is available to email@example.com.
These requests seek documents that are in the public interest because they are likely to contribute to a better understanding of the operations and processes of certain state and state committee activities. For these reasons, pursuant to 610.026.1 (1), RSMo, The Missouri Times requests a waiver of any fees associated with processing this request for records. If that waiver is not granted please provide an estimate of the cost.
Thank you for your time and attention to this matter.
Scott R. Faughn;
Scott Faughn is the publisher of The Missouri Times, owner of the Clayton Times in Clayton; SEMO Times in Poplar Bluff; and host of the only statewide political television show, This Week in Missouri Politics.