CHARLESTON, W.Va. (AP) -- A West Virginia bill intended to streamline the way Medicaid patients get to the doctor's office would be more difficult to manage and less effective after amendments made by a senate committee.

The state reimburses Medicaid members for costs related to getting to the hospital, whether they drive themselves, get a ride from a senior center, take a bus or take an ambulance.

The bill proposed by Gov. Earl Ray Tomblin would create a broker that would guide Medicaid patients toward the most convenient and least expensive option.

On Thursday representatives for ambulance companies and public transit objected to being managed by the broker so a senate committee exempted them from the program.

The state agency in charge said the exemptions would make the program very difficult to manage.