HARTFORD, CT – The Auditors of Public Accounts made 59 recommendations Wednesday about the performance of a state contractor responsible for providing non-emergency transportation to Medicaid patients.
The audit follows more than a year of complaints about Veyo, the company hired to a three-year, $140 million contract with the Department of Social Services in January 2018 to provide Connecticut’s 850,000 Medicaid patients with transportation to their doctors.
Veyo, which doesn’t own any fleet of vehicles, must contract with taxi and livery companies or independent drivers to offer rides to. The company also distributes bus passes and reimburses family and friends for mileage if they end up driving a patient to the doctor.
The auditors found that nearly two-thirds of trips arranged by Veyo occur by public transit. The audit also found there has been an increase in the use of independent drivers and a decrease in the taxi and livery services that have traditionally provided transportation to this population.
Approximately 59% of the trips are completed by bus, 32% by taxi or livery, 7% by wheelchair van, and 2% by mileage reimbursement, according to auditors.
On Wednesday, the Auditors of Public Accounts issued 59 recommendations, which included a reprimand of the Department of Social Services for its performance in overseeing the contract.
Veyo said it agreed with 60% of the findings in the audit and have already implemented 14 of the 59 recommendations. It disagrees with the findings about utilization, data collection, hiring, safety issues, and complaints.
The auditors found that Veyo changes statistics, sometimes retroactively, without explanation in its monthly reports to DSS, including its calculation of percent of on-time trips, which raises concerns about the accuracy of some of the reported information. It also found Veyo stopped providing certain data without explanation in its monthly reports to DSS, including detailed transportation provider performance and trip removal and data correction statistics.
“Veyo does not record all complaints, accurately substantiate certain complaints, or promptly resolve complaints,” auditors found.
Josh Komenda, CEO of Veyo, said he rejects the notion that any changes they made to the data were done with any specific intent. He said they aim for full transparency and accuracy. He said if data was changed it was to ensure it was more accurate.
The audit found that “Veyo changes statistics, sometimes retroactively, without explanation in its monthly reports to DSS, including its calculation of percent of on-time trips, which raises concerns about the accuracy of some of the reported information.”
The Department of Social Services said it neither agreed or disagreed with the recommendation that it amend future contracts to include a monthly report with detailed provider information; a daily computerized trip log’s member mobility status; a monthly report of member complaints from transportation subcontractors; a semi-annual transportation subcontractor report and Medicaid training for call center staff.
In asking for the audit Rep. Cathy Abercrombie said the monthly numbers Veyo reports don’t seem to match up with the anecdotal information they’re receiving from patients who use the service, which is federally mandated.
The auditors also found that in April 2019, Veyo retroactively decreased the number of booked trips, suggesting there are inaccuracies in the Veyo monthly reports provided to DSS.
Veyo said that the trip data was revised with input from DSS and the NEMT Working Group.
“DSS agrees that there is a need for advance, mutual agreement regarding any changes to previously reported data,” the agency told the auditors.
The timeliness of the trips has also been a concern for advocates of Medicaid patients.
The auditors found that DSS and Veyo changed the metric defining “on-time” trips 3 times without reporting the changes to the public.
“Those changes left the impression of improvements that did not occur,” the auditors concluded.
In July 2018, Veyo appears to have changed its on-time percent calculations to match the Veyo-provided raw data. In July 2019, Veyo retroactively increased the monthly ontime percentages reported for January-June 2019. “The monthly reports do not explain these changes,” auditors found.
The Department of Social Services neither agreed or disagreed with the recommendation.
“Veyo is adjusting data in an appropriate and acceptable manner, for valid reasons, including those noted above for updates to monthly reports,” DSS told auditors.
In a statement, Veyo said that the number of completed trips has increased 38% since January 2018.
“Veyo acknowledges that data integrity and interpretation are very complex and Veyo made and will continue to make adjustments to its data for valid reasons, but always in collaboration with DSS,” the company told auditors.
They noted that not all the changes made to the data resulted in a more positive metric related to Veyo’s performance. It also pointed out that all Veyo reports are available to the public.
The report also found an estimated 79% of members receiving Veyo services submitted medical necessity forms to override Veyo’s decisions about transportation to medical providers outside the permitted mileage range or in the assigned mode of transportation.
One of the recommendations was that DSS should require Veyo to reduce the percentage of members having to submit medical necessity forms to reduce the administrative burden on members and healthcare providers, while complying with federal guidelines
The audit was also critical of the oversight role DSS has over the contract. It said that DSS “imposes sanctions for a fraction of the times Veyo fails to meet contractual performance standards.”
Abercrombie requested the audit.
She said the audit validates some of the concerns they’ve been raising for the last three years.
She said she would expect DSS to use the audit findings to amend the contract given that they have a two-year extension that they’re probably going to exercise.
“My hope is DSS has really understood the challenges that we have faced with Veyo,” Abercrombie said.