In Focus

Elderly woman's nightmare sheds light on Medicare company

Thursday, April 05, 2012

One Bellville great-grandmother was hoping for a ride to the doctor. Your tax dollars paid for her trip, but she didn't get far. Her driver was arrested just blocks away from her home.

She told her story to us and we investigated the company and found it's not the first time it has been in trouble.

Dorothy Phillips told us she picked TexanPlus for her Medicare HMO because it offered free rides to her doctor's. She loved that idea, but had no idea the trip would end like this.

"I don't need a limousine," she said.

You wouldn't guess it, but Phillips is 78 years old. She's in great shape, but doesn't like to drive alone. So when she needed to go to a doctor's appointment 20 miles away, she called her Medicare insurance company, which offers free rides to the doctor.

"A wonderful option," Phillips said.

But when the driver showed up, wonderful isn't what comes to mind.

"Oh my word, the car," Phillips said.

Phillips tells us the car's windshield was broken in several places, the car was full of trash and the driver's side window wouldn't even roll down.

In fact the driver had to talk to Phillips through the back window, which did go down. Phillips got in anyway and she realized the driver didn't even know how to get to the doctor's office. She became nervous, and the problems kept happening.

"The noise was horrible," she said.

It wasn't noisy enough to drown out the police car that pulled them over three blocks later.

Bellville police say the window tint was too dark. But then it turned out the driver, Shatoy Ward, didn't have her license or insurance card with her. And to make it even worse, she was a wanted woman.

At that point, Phillips bailed and cops took her home; the driver went to jail.

"The last time I saw the driver, she was handcuffed behind the car," Phillips said.

Even after Ward was arrested, the driver's problems weren't over.

"Ms. Ward put up a struggle and had to be restrained while the officer received the information he needed to get his probable cause statement, as well as book her into jail," Bellville Police Department Lt. Jason Smalley said.

She spent the weekend and part of this week in the Harris County Jail after a plea on an old misdemeanor case for throwing a chair through someone's window. It's left the insurance company with a lot to explain.

Phillips had her coverage from TexanPlus, a company based here in southwest Houston.

"It's not acceptable, and we're not going to stand for it," said Erin Page with TexanPlus.

Page tells us they contract with a transportation company and do background checks but couldn't explain how Ward got through.

"I can't speak to what you're saying about the background check," she said.

More on that in a minute, but first, we should point out that federal records show the company has a complaint record worse than most Medicare Advantage companies and documents reveal the feds suspended TexanPlus from taking new members in 2010 for bad marketing practices and a lack of oversight on contractors.

"I don't believe they're connected," Page said.

In the end, Phillips drove herself to the doctor and told us she will never ask the insurance company for another ride.

"I'm so humiliated," Phillips said.

TexanPlus had their suspension lifted last year and said the problems were solved.

The subcontractor who sent Ward to pick up Philips has been fired, but tells us their background check only requires them to bar drivers with felony convictions or abuse charges, meaning Ward would've passed their background check.

Medicare told TexanPlus to investigate fully and make sure they have standards for transportation providers.

(Copyright ©2014 KTRK-TV/DT. All Rights Reserved.)

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