Ambulette reimbursement dispute forces Westchester County seniors to miss or skip medical appointments
MOUNT VERNON, N.Y. -- It has been a difficult week for thousands of low-income Medicaid recipients in Westchester County.
They've missed or skipped medical appointments due to a dispute over ambulette reimbursement rates.
"Seniors don't like changes," Pamela Demont-Sims said.
She said change this week has been stressful and expensive. She uses a wheelchair and needs an ambulette company to pick her up in Mount Vernon and take her to medical appointments.
For years, she has used Premier Ambulette, but Premier is one of seven firms no longer accepting Medicaid patients due to low reimbursement from New York state.
Manager Jake Ninan told CBS New York earlier this week, "Gas is up. DOT expenses are up. Labor costs are up. Everything is up except for our reimbursement."
The company managing Medicaid transport for the state is casting a wide net for replacement ambulettes.
Demont-Sims said it means long wait times.
"I can't get them on the phone. I spent three days, spending an hour each time on the phone waiting," she said.
Then on Wednesday, in order to go for an important medical test, she paid Premier out of pocket "$120, so I said okay."
"People could actually die. We have dialysis patients who aren't getting to dialysis," said Assemblywoman Amy Paulin, who chairs the Health Committee.
Paulin said she believes the Westchester ambulette firms have a strong point in their dispute over reimbursement rates.
"Nassau and Suffolk get much higher rates than we do in Westchester, much higher rates. The Department of Health needs to step in and resolve it, and that's what needs to happen," Paulin said.
When asked if it's fair to say she and her colleagues are pushing the Department of Health to be more proactive in finding a resolution, Paulin said, "Yes, we are."
Demont-Sims is among the many who are anxious to see the ambulettes back in action.
Some of the ambulettes sent to Westchester are licensed only for the five boroughs. The state Health Department says it is working to assure all providers are "fully compliant."
