Program that gives free rides to non-emergency medical visits under scrutiny
MINNEAPOLIS (KMSP) - A Minnesota taxpayer-funded program designed to give people free rides to non-emergency medical appointments is under scrutiny by state investigators.
People getting rides told the Fox 9 Investigators they were offered money to look the other way when they witnessed fraudulent activity by transportation companies.
Minnesota spends over a $100 million a year bankrolling rides for low-income people to get to medical appointments. There are 132,000 Minnesotans who received ride benefits, which is up 10,000 from a year ago.
More than 200 transportation companies in the state of Minnesota have contracts to provide the rides. State regulators believe most are reputable businesses, but a 2014 review of the program's books made them take a hard gulp.
"We found about 41 percent of them didn't have adequate documentation," said Minnesota Dept. of Human Services Inspector General, Jerry Kerber.
The claims examined by state regulators had such sloppy records they could not tell if trips the state paid for actually occurred. The potential theft of public dollars could be in the millions.
THE FOX 9 INVESTIGATORS UNDERCOVER
A man (who asked that Fox 9 disguise his identity) gets state subsidized transportation to a methadone clinic. Lots of companies want his business because he needs rides six days a week. He said some drivers offer bribes and kickbacks.
Rider 1: "The second day that I started riding with him he gave (me) a $100." "I don't see a lot of people who will complain about free money."
Fox 9 heard similar stories from other riders.
Rider 2: "We used to get a pretty good deal."
A man and woman told a Fox 9 producer they were paid $300 a month to ride with one company.
Rider 2: "But they came and offered to us, we didn't ask for money."
The kickbacks are a kind of hush money for riders to look the other way when they see fraud.
Rider 1: "Instead of bringing one person at a time, they can pick up three at a time."
An insider said sometimes his driver would transport three people, all going to the same clinic at the same time. Instead of billing the state for one 30 mile trip, the driver charged for 3 separate ones.
Rider 1: "Even though it was extremely illegal, I was getting free money."
Another fraud that happens, according to state regulators, is some drivers will pad the mileage or bill for trips that were never taken.
"That's the part that's going to be the most costly for us," said Kerber.
SYSTEM FOR TRACKING FRAUD IS CUMBERSOME AND CONFUSING
That hundred million dollars the state spends each year for medical transportation is divided up between health insurance companies who then administer the program for eligible clients. Those insurance companies do their own fraud investigations.
But when the Fox 9 Investigators asked to see cases, they didn't turn over any of their findings citing Minnesota's data privacy law.
According to Kerber, a recent change in state law will make those insurance company investigations public going forward. In the meantime, he said his office is also cracking down on transportation fraud.
"We don't really have the big results with the big numbers yet, but we are working on some cases," said Kerber.
Due to the way the billing system is set up for medical rides, state investigators have to wait a year before they can see all the claims that were submitted.
"If the year hasn't passed we can't be certain we have all the data," said Kerber.
Reviewing those records is critical to detecting any scams. The passage of time can work in the fraudster's favor.
The Fox 9 Investigators found the state had one case where a company was suspected of billing bogus trips. An investigator wrote "we would need to contact members to recall these dates, and the likelihood of them remembering that far back is low." "...I think at this point we just let it alone."
KICKBACKS DRYING UP?
Fox 9 Producer: "Do any companies offer money for riding?"
Rider 2: "Right now, no one is doing it."
The word is on the street that insurance companies and the state are getting serious about stopping the swindle. Some riders say kickbacks are drying up.
Rider 3: "When it went away, it hurts, that took how much money away from us a month, $300 a month."
But an insider said he found a new company that pays him $150 a month to ride. And he can earn bonuses if he can convince other riders to use the same service.
The state is hoping new documentation requirements that went into effect last year will curtail in some of the fraud. But a lot of the record keeping changes still depend on people being honest.
If you see abuse of a Department of Human Services program report it to DHS here.
Twin Cities metro: 651-431-3968
Toll-free line: 800-627-9977