A transportation provider for Medicaid patients and the state of Colorado settled a lawsuit filed after Colorado canceled its contract.
Earlier this year, the state's Medicaid agency, Health First Colorado, first suspended, then terminated a contract with MedRide after finding it failed to meet a number of federal and state regulations, jeopardizing the health and safety of patients.
The company disagreed, saying the termination was wrongful and sued.
Now the state has reinstated the contract, while MedRide agreed to take several steps, according to a press release from the Department of Health Care Policy and Financing, which oversees the state’s Medicaid program. That includes maintaining all required documentation for credentialing that verifies driver and vehicle safety, creating and administering a driver training program and hiring and contracting with a third-party auditor to screen MedRide’s claims to ensure completion and compliance before they are submitted for reimbursement.
“We look forward to putting this behind us and continuing to operate as a fully compliant and good-standing provider of NEMT [non-emergency medical transportation] services for the Coloradans we are proud to serve,” said Greg Harriman, president and owner of MedRide.
“We are pleased to have reached this agreement so both MedRide and HCPF can focus our time and resources on providing safe, affordable transportation services to eligible Colorado Medicaid members,” said Medicaid Director Adela Flores-Brennan.
MedRide says it operates more than 300 cars for the service and gives more than 420,000 rides a year, many across rural Colorado.
A spokesperson for the state’s Medicaid agency confirmed MedRide is its largest provider of non-emergency transportation in the state, saying it is among the agency's top 20 highest-paid providers. The state paid it more than $57 million in claims in 2024.
MedRide provides rides to and from medically necessary services covered by Health First Colorado for its members who have no other way to get to those appointments.
The standoff involved a dispute over documentation for reimbursement payments between MedRide and the Colorado Department of Health Care Policy and Financing, which administers the Medicaid program.
In November, agency staff met with Harriman. In a letter, the department said it had pulled MedRide claims for reimbursement to the agency for trips longer than 52 miles. Initial reviews found things like missing signatures from Medicaid members requesting rides, missing dates and times, claims forms missing up to three columns due to poor scanning in nearly every claim, according to the letter from Flores-Brennan, which the department provided to CPR.
MedRide said the agency is withholding back “several million in claims,” leading to financial hardship.
The agency said MedRide would have to turn in “clean claims,” with supporting documentation, and confirm “driver background checks and vehicle inspections" by the start of February, or risk suspension and repayment of "identified improper payments.”
The disagreement had not been resolved by earlier this year, so the agency sent another letter saying the Department of Health Care Policy and Financing had identified that MedRide as being involved in “an alleged and ongoing organized fraud scheme,” totaling more than $1 million, and suspending the company.
MedRide vehemently denied the state’s findings, saying the state frequently made it tough to comply by moving the goalposts for revalidation, moved too quickly to penalize the company and left vulnerable patients without a viable alternative for transportation.
A judge ruled in February to allow MedRide to keep providing rides.
In a press release from Department of Health Care Policy and Financing, the agency said MedRide also agreed to:
- Make sure a customer is eligible for Medicaid coverage and that the trip is eligible for Medicaid NEMT reimbursement
- Using a compliance officer to ensure MedRide operates in compliance with regulations and guidance intended to protect members
- Limiting the number of rides MedRide can provide to Medicaid members until program compliance is established and maintained
