Orange seeks taxi fare hikes for Medicaid rides

Aug. 29--GOSHEN -- Taxis and other businesses in Orange County were paid $21 million in public funds last year to drive Medicaid recipients to and from their medical appointments, but received far less for each ride than their counterparts in surrounding counties.

State lawmakers representing Orange County learned earlier this year that the state's $4.11 fee to pick up or drop off patients in Orange County was less than half what it pays taxis in Rockland, Ulster and Sullivan, and that Orange's $1.86-per-mile reimbursement lagged far behind as well. They wrote to state Health Commissioner Howard Zucker in April to try to correct that disparity, and county legislators plan to make the same request for higher fares with a resolution they are set to pass next week.

County Legislator Michael Amo said during a committee meeting last week that state Department of Health officials told Assemblyman Karl Brabenec that Orange County taxis were paid less than those in other counties for driving Medicaid enrollees because the county never asked the state to increase its reimbursement rate.

Brabenec, a Deerpark Republican, said by email on Wednesday that he started researching the payment differences in January after several ambulette services complained. Pickup and drop-off fees are $10.55 in Rockland, $10.37 in Ulster and $10.35 in Sullivan, according to the county resolution.

State officials already have made clear they won't raise Orange's fees during the current fiscal year, which runs until March 31.

In an Aug. 14 letter shared with the Times Herald-Record, the state's Medicaid director, Donna Frescatore, told Assemblywoman Aileen Gunther that any rate increases must be factored into the state budget, and that state lawmakers didn't request any for the current budget. She also said the state inherited counties' reimbursement rates when it took over the transportation system in 2011, and found that matching their fees "proved to be both difficult and expensive."

She suggested lower fares haven't reduced ride availability in Orange, saying her department has "no documented instances of Medicaid enrollees missing appointments because of a lack of taxi providers."

According to county data, about 103,000 Orange County residents, or 27 percent of the population, are enrolled in Medicaid, the health insurance program for the poor and disabled that is jointly funded in New York by the federal government, the state and its counties.

Orange County officials say increasing payments to taxis and ambulettes wouldn't increase Medicaid costs for county taxpayers because the state has capped counties' contributions to the program. Overall Medicaid expenses in Orange totaled $927 million in 2018.

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