ModivCare is the nation’s largest broker of non-emergency medical transportation (NEMT) services. NEMT services are provided to people who need transportation to and from medical appointments, but who are unable to drive themselves.

In 2021, the U.S. Department of Justice and the Ohio Attorney General’s Office filed a False Claims Act lawsuit against ModivCare. The lawsuit alleged that ModivCare submitted false claims for payment to Medicare and Medicaid by failing to ensure that the NEMT services it arranged in Ohio were medically necessary and eligible for payment.

The lawsuit also alleged that ModivCare failed to properly supervise its transportation providers, which resulted in patients missing appointments and being transported in unsafe conditions.

In 2023, ModivCare agreed to pay $3.75 million to settle the lawsuit. The settlement did not include any admission of wrongdoing by ModivCare.

Conclusion

The ModivCare lawsuit is a reminder that NEMT is a complex and often challenging system. Patients who rely on NEMT services deserve to know that they are being transported safely and efficiently.

FAQs

Q: What is non-emergency medical transportation (NEMT)?

A: NEMT is transportation to and from medical appointments for people who are unable to drive themselves. NEMT services are typically covered by Medicare and Medicaid.

Q: Who is ModivCare?

A: ModivCare is the nation’s largest broker of NEMT services. ModivCare contracts with transportation providers to arrange rides for patients.

Q: What were the allegations against ModivCare in the False Claims Act lawsuit?

A: The lawsuit alleged that ModivCare submitted false claims for payment to Medicare and Medicaid by failing to ensure that the NEMT services it arranged in Ohio were medically necessary and eligible for payment. The lawsuit also alleged that ModivCare failed to properly supervise its transportation providers, which resulted in patients missing appointments and being transported in unsafe conditions.

Q: How much did ModivCare pay to settle the lawsuit?

A: ModivCare agreed to pay $3.75 million to settle the lawsuit. The settlement did not include any admission of wrongdoing by ModivCare.

Q: What can I do if I think my NEMT provider is not providing me with safe and reliable transportation?

A: If you think your NEMT provider is not providing you with safe and reliable transportation, you should contact your state Medicaid or Medicare agency. You can also file a complaint with the U.S. Department of Transportation.

Q: What are my rights as a NEMT patient?

A: As a NEMT patient, you have the right to safe and reliable transportation to and from your medical appointments. You also have the right to choose your own transportation provider. If you are not satisfied with your transportation provider, you can request a change.

Sources

1. www.fcalawfirm.com/blog/modivcaresettlement/#:~:text=The%20settlement%20resolves%20allegations%20that,necessary%20and%20eligible%20for%20payment.

• Nation’s Largest NEMT Broker pays $3.75 Million to Resolve False Claims Act Allegations: https://www.fcalawfirm.com/blog/modivcaresettlement/
• ModivCare : SETTLEMENT AGREEMENT AND GENERAL RELEASE OF ALL CLAIMS: https://www.marketscreener.com/quote/stock/MODIVCARE-INC-10541/news/ModivCare-SETTLEMENT-AGREEMENT-AND-GENERAL-RELEASE-OF-ALL-CLAIMS-Form-8-K-43890134/