George Borrello was elected New York State Senator for the
57th District following his November 2019 victory in a special
election for the seat that had previously been held by Cathy Young. Encompassing 4,139 square miles, the 57th
Senate District is one of the state’s largest and includes Allegany,
Cattaraugus, Chautauqua counties plus eight towns in Livingston County.
ALBANY – Following his strong advocacy on the issue, Senator
Borrello has announced that among the Medicaid reforms passed in the state
budget are changes designed reduce excessive costs related to the Non-Emergency
Medical Transportation (NEMT) services by incentivizing efficiency among
transportation brokers, including greater utilization of public transit
systems. The reforms are projected to produce savings up to $93 million with
even greater benefits in subsequent years.
In early March, Senator Borrello went public with statistics
from Chautauqua County showing a staggering 1,300 percent cost increase in NEMT
spending between 2013 and 2019. The primary factor driving the increased
spending was a sharp rise in single-rider taxi service in lieu of public
transportation, following the state’s takeover of NEMT coordination from the
counties. Brokers under this system were reimbursed on a fee-for-service model
that incentivized volume rather than efficiency.
Under the new changes, the fee-for-service model will be
replaced with a per-member-per-month (PMPM) capitated fee or a combination of
capitation and fixed cost fee-for-service. Under a PMPM model, transportation
providers are paid a set amount for each individual they serve, regardless of
the costs each individual actually incurs. This model incentivizes brokers to
operate more efficiently and cost-effectively.
Other elements of the NEMT reforms would:
-Facilitate greater utilization of public transportation
providers in rural areas.
-Maximize use of public transit in New York City and other
urban areas.
-Implement new quality control standards.
-Reduce rates for taxi NEMT services by 7.5 percent.
“When the state took over the management of NEMT and contracted
with transportation brokers to execute these services, costs skyrocketed,
particularly upstate, as brokers rejected use of affordable, reliable regional
public transit systems in favor of higher-cost, single-rider taxi services,”
said Senator Borrello.
“That shift from public transit to taxi rides resulted in
millions of taxpayer dollars wasted on transportation services that could have
been delivered at a fraction of the cost. Stories of cash bribes paid by
drivers to Medicaid recipients and other illegal activities were common under
this flawed and wasteful program initiated by the state. It also had the
unintended consequence of jeopardizing the existence of critically-needed
upstate regional transit systems that relied on NEMT ridership to remain financially
viable. In order to help these transit systems survive, the state had to
provide additional subsidies to make up for the loss of NEMT ridership. The
whole situation was really emblematic of how Albany’s ‘solutions’ to issues
often create additional costly problems,” Senator Borrello said.
“The NEMT reform set to be implemented is a victory for
state and local taxpayers, regional transit systems and NEMT riders who will
benefit from new quality control standards that transportation providers will have
to meet. I am glad that our advocacy had an impact and will help ease some of
the financial strain placed on our local and state governments by our massive
Medicaid system,” Senator Borrello concluded.
