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 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

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

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

Title 22 (Eligibility Requirements)   If you meet all the requirements of California Code of Regulations, Title 22, I will proceed to the screening questions, and you need to answer all the questions in a truthful manner. Non-emergency transportation is covered only when the patient has a medical, physical, and mental limitation that exclude the individual’s ability to be transported by private or public transportation such as auto, taxi or bus. We will also require your doctor’s prescription to justify your appointment and your health condition. For doctor’s appointments – you should call us one week before the appointment date and please provide us the information of your doctor such as name, telephone number, fax number, and address. We need these requirements before we give you transportation and must be in our office prior to your appointment date.

SCREENING QUESTIONS Medical ID# Member's County? Can you drive? Do you have any family to drive for you ? How did you get to your past appointment? Are you already or have ever been certified as an ADA passenger? How do you currently get out to other activities such as grocery store and church? Use of Arms Use of legs Ambulate? How far? Cane required? Walker required? Uses Wheelchair

MEMBER'S INFORMATION DOCTOR'S INFORMATION Name: Phone: Alternative phone# Social Security # Date of Birth Gender: Address: Is this address a ICF/Acute Hospital/home/Nursing Home   DOCTOR'S INFORMATION Purpose for request of transportation Name of Doctor to see Phone Number Fax Number

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

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

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