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MediCal Transportation Programs in the Monterey-Salinas area

MediCal Transportation Programs in the Monterey-Salinas area. Presented by Bill Lewis, VPO MV Transportation. The Private Sector Transportation Provider. Contracting Opportunities Central Coast Alliance for Health (CCAH) Partnership Health Plan Process Pre-Contract

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MediCal Transportation Programs in the Monterey-Salinas area

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  1. MediCal Transportation Programs in the Monterey-Salinas area Presented by Bill Lewis, VPO MV Transportation

  2. The Private Sector Transportation Provider • Contracting Opportunities • Central Coast Alliance for Health (CCAH) • Partnership Health Plan • Process Pre-Contract • CCAH and Partnership Health Plan Internal Process • Handled all Qualification • Provided MV with Rides Information • Encounter Data Worksheet completed by MV • MV submitted for payment

  3. Pre-Contract Rates / Basic Medi-Cal Reimbursement Rates • Response to call - $17.65 one way • Mileage – $1.30 for each mile • Night calls - $6.13 • Attendant - $5.52 • Wheelchair - $0.89 • Oxygen - $11.86 • Wait time - $5.65

  4. RFP - Contractual Agreement CCAH Process/ Changes • Provider CCAH Determines Internal Cost Controls Needed • CCAH Issues RFP • RFP Indicates • Contractor to perform all duties (CCAH Eliminates Internal Processes) • Screening • Qualifying – (Title 22 Eligibility) • Scheduling • Encounter Data Control/ Establish Electronic Transfer System

  5. Title 22 (Eligibility Requirements)

  6. RFP - Contractual Agreement CCAH Process/ Changes • Contract Rates – Capitated Rate Structure (Based on Membership in Providers Health Care System) • MV - No Longer Billing CCAH at Medi-Cal Rates (Per Member Rate Established) • All Dialysis Member Rides Handled (No Qualifying) • Created Higher Transportation Request than Anticipated • Excessive Volume in Ridership due to Non-Title 22 Eligible Rides Created MV Cost Overruns and Business Hardship

  7. END RESULTS • Contract ends • New Rate too high to continue • Local ADA Service • Rides now pushed onto local ADA service

  8. THANK YOU Bill Lewis Regional VP Operations blewis@mvtransit.com 916-215-4128

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