Two companies will retain their newly awarded contracts valued at $233 million to drive Medicaid beneficiaries to medical appointments, despite complaints about the companies elsewhere and protests from smaller South Carolina groups that do the work now.

A state official rejected several appeals this week from South Carolina nonprofit organizations that provide nonemergency transportation for the state's elderly poor, saying the protesting groups failed to prove their claims.

The government said in November that the Medicaid contract covering the period from 2007 to 2012 should be split between LogistiCare Solutions LLC of Georgia and Medical Transporta- tion Management Inc., a Missouri company.

Under the terms of the deal, LogistiCare will be paid $180 million to handle Medicaid patient transportation in most of the state, including the Charleston area, starting in March.

MTM will get $53 million for nonemergency Medicaid trips in the Upstate.

The state will pay the companies about $47 million a year. That's $16.1 million, or 53 percent, more than it currently pays for nonemergency transportation for Medicaid patients.

Until now, nonemergency transportation for some of the state's poorest elderly patients has been handled by 25 to 30 South Carolina organizations, most of them nonprofits. Roughly 872,000 residents are eligible for the services, including almost 140,000 in Berkeley, Charleston and Dorchester counties.

LogistiCare and MTM hold similar contracts to transport about 9 million people in a number of other states. In some instances, their performance has triggered controversy and complaints.

Last year, the Missouri Attorney General investigated the two firms for price-fixing. In one case, a state audit found that MTM billed the state for three trips for a patient who had died days earlier.

'With hundreds and thousands of trips that we take, it's very hard to verify each and every one,' MTM spokesman Don Fisher said when asked about that specific incident Thursday.

The charges were settled, but not before the state terminated its contract with MTM and the company paid a $2.4 million settlement. LogistiCare agreed to pay $150,000 to the state of Missouri.

MTM also has drawn complaints in Minnesota. In October, several lawmakers called on the state to sever relations with the company.

Michael Weidner, executive director of the Minnesota Paratransit Providers Association, a trade group, said MTM has boosted profits by cutting door-to-door service for elderly patients.

'MTM pushed people into the most profitable rides for MTM,' Weidner said.

MTM's Fisher said the company has cut fraud from Minnesota's Medicaid system and moved more recipients by less expensive means. 'These nonemergency transportation contracts are often fraught with abuse, and that was the case when we took over in Minnesota.'

In addition to Missouri, LogistiCare has come under fire in Washington, where it has run a program called MetroAccess since 2000. According to a series of articles in The Washington Post, disabled residents are often left waiting for hours. And government officials investigated the company last year for allegedly falsifying drivers' logs in an apparent effort to secure bonuses for being on time.

In a written statement, Logisti-Care denied wrongdoing and blamed delays on a shortage of vehicles provided by the district. It also noted a huge increase in ridership during its years running the program.

South Carolina procurement officials were not alarmed by the investigations, terminated contracts and criticism of the companies' work in other states, said Jeff Stenslan, a Department of Health and Human Services spokesman.

'What we've understood, their overall track record has been good,' he said.

Stenslan noted that the state would be 'intimately involved' to make sure the companies deliver on their promises.

Senior Solutions, an Anderson- based nonprofit that drove 2,550 Medicaid patients last year, contended that South Carolina's elderly poor will see diminished service even if LogistiCare and MTM make good on their contracts. Doug Wright, chief executive of Senior Solutions, said more Medicaid patients will be forced onto buses and into taxis.

'We are an ant competing with giants,' Wright said. 'The difference would be that the nonprofits like us are here to serve. ... Price does not always enter the equation.'

Joel Sawyer, a spokesman for Gov. Mark Sanford, said the Medicaid business was won competitively and would be closely monitored. 'Like any contract, the state can sever ties if they don't hold up their end of the deal,' he said.

Reach Kyle Stock at 937-5763 or kstock@postandcourier.com.