In Veyo’s Sept. 6 termination letter to the state of Idaho, exercising an early out on its three-year, $70 million contract for non-emergency Medicaid transportation services, Veyo President Josh Komenda complains that the state placed “significant, non-contractual restrictions on Veyo’s model, at great expense to Veyo, before a single trip had been run.” You can read the full letter here; it was released under the Idaho Public Records Law by the state Division of Purchasing, but several portions relating to Veyo’s business model were redacted as trade secrets. You can read my full story here at spokesman.com.

Komenda writes that Veyo told Idaho its “proven, next-generation model would use a mixture of Independent Driver Providers (IDP) and traditional third-party providers to achieve substantial efficiencies,” resulting in lower costs and better service compared to traditional medical transportation providers. Veyo began brokering all non-emergency Medicaid rides in Idaho on July 1, 2016; those rides transport patients to doctor appointments, therapy sessions and the like. Veyo won the contract over several other bidders, including the previous provider, AMR. AMR didn’t use independent drivers.

When the Idaho House and Senate Health and Welfare committees held a joint public hearing on health and welfare issues six months later, people flocked from all parts of the state to complain about Veyo. Local medical transportation companies, care providers and clients all showed up at the hearing, saying rides were late or no-shows, vulnerable patients were left sometimes in the wrong place or alone for hours, and providers weren’t getting the business they need to get by, in part because Veyo sends independent drivers to take some of the patients, following an Uber-type model.

“It makes me mad when I drive through town and I see these Veyo drivers, yet I send two of my single moms home because I don’t have enough work to give them any more,” said Kleeta Newby, owner of KDN Transport in Boise. Jenna Dewitz, a social work intern with a Boise agency, told the lawmakers, “We have clients who are picked up and taken to the wrong place. We have refugee clients who can’t speak English and they are basically lost for hours. … We have had clients including children walk 2 to 5 miles home because they didn’t want to wait for Veyo any longer. … We recently had a refugee client from Afghanistan who had a 1:30 appointment and who wasn’t picked up until 7 p.m. and her family thought that she had been kidnapped.”

Darren Talley of White Tail Transportation in Priest River said his state reimbursements have fallen sharply since 2009. “Most businesses in Idaho cannot withstand a 31 percent cut in funding,” Talley said. “Just give us back the funding we had in 2009 before the brokerage system went into place.”

Komenda also spoke at the hearing. “We know there’s much improvement to be made,” he said. “We’re making great strides in that direction. Every single issue is investigated.”

Matt Wimmer, state Medicaid administrator, told the lawmakers the Department of Health and Welfare had asked Veyo to stop assigning independent drivers to patients with special health needs, and the company had agreed.

In his Sept. 6 letter, Komenda said constraints on its service include a prohibition on having its independent, Uber-style drivers transporting any patient with developmental disabilities; he said those drivers transport those passengers in other markets “with industry leading service standards and with an outstanding level of satisfaction from its customers.”

He also wrote that complaints and on-time ratios since January of 2017 have been nearly identical between the independent drivers and the traditional providers that Veyo has used in Idaho.

Komenda said he’d like to renegotiate the restrictions, but absent that, “Veyo finds itself in the unfortunate position of having to issue this termination letter.”

Health and Welfare announced yesterday that it will transition to a new provider in March. Wimmer said the department will ask the new provider to “work closely with the Idaho NEMT (non-emergency medical transportation) provider network in a collaborative and open manner as we work through this transition.”

Idaho Medicaid clients have about 100,000 non-emergency medical transport trips each month.

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