Federal officials running dozens of overlapping programs that provide disabled or low-income Americans with transportation to and from doctor’s appointments have no idea how much they spend to do so.
A lack of coordination among the federal agencies that administer the programs means some may have spent millions providing the same people with the same services, according to a report Friday from the Government Accountability Office.
GAO said it was “unable to quantify the extent of duplication, overlap, and fragmentation” of the transit services after acknowledging that such flaws have existed for years, the report said.
“In at least one case, an agency did not think it was cost-effective to collect transportation expenditures,” GAO said, referring to Housing and Urban Development officials who claimed they didn’t have the resources to analyze spending data even if they did try to report it.
Forty-two government programs across six federal agencies are authorized to fund transportation services for people unable to drive themselves to receive nonemergency medical care.
The departments of agriculture, education, veterans affairs, health and human services, transportation and HUD all provide funding to the transit services.
Because none of their programs list nonemergency medical transportation as the primary goal, the amount spent is obscured by the costs of everything else those programs provide.
Just eight of the 42 programs could provide GAO with spending numbers on nonemergency medical transportation, the report said. As a result, the government spends a “significant but unknown” amount on such services, GAO said.
Officials at HHS estimated their department spent $1.3 billion on nonemergency medical transportation in 2012 through Medicaid. Even that amount is “incomplete” because it doesn’t include how much was spent on the service in states that simply listed it as another administrative cost.
A council created to help the agencies coordinate the disjointed programs hasn’t met in seven years, and there are no plans to address overlap and duplication of services, GAO found.
In some cases, programs focused so narrowly on a specific group of individuals that other disabled people couldn’t access the transit system due to “service gaps.” In others, multiple programs from the six agencies provided the same service to the same groups of people.
For example, VA and Medicaid offer transportation services to help disabled, low-income or elderly people get to their doctor’s appointments, and many beneficiaries may be eligible for both programs, the report said.
Medicaid-funded trips often transport just one person at a time because “providers are not coordinating trips for passengers going to the same place,” according to the report.
HHS officials expressed concerns that coordinating nonemergency medical transportation with other programs would force Medicaid to spend money on people who don’t qualify for benefits.
Efforts to implement cost and ride sharing policies were spread among a handful of states and locations. As many as 90 million people may be eligible to use the transit service under at least one of the federal programs, but agencies don’t keep track of how often it’s used.
Go here to read the full GAO report.
