Subject:
Title
Emergency Medical Transportation Integrated Disclosure and Medicaid Cost Report General Information and Certification
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Recommended Action:
Recommended Action
Approval and execution by the County Administrator via wet signature in blue ink, of the Emergency Medical Transportation Integrated Disclosure and Medicaid Cost Report General Information and Certification.
• Allows eligible health care organizations to submit certified public expenditures to draw-down partial reimbursement for eligible ambulance transportation costs from Federal funds for un-reimbursed medical costs provided to Medicaid recipients.
• The cost to provide these services per transport as determined by the States’ cost report exceeds the Medicaid reimbursement rates. The Certified Public Expenditure program facilitates the ability to drawdown Federal funds to partially mitigate these unrecovered costs.
• Participation in the Public Emergency Medical Transportation Program provides the Pinellas County Emergency Medical Services Fund with additional revenue for Ambulance Transportation expenditures incurred during the State’s fiscal year (FY) of July 2023 through June 2024 of up to $853,058.92.
Submittal to the State is required by December 13, 2024.
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Strategic Plan:
Deliver First Class Services to the Public and Our Customers
5.2 Be responsible stewards of the public’s resources.
Summary:
The Certified Public Expenditures (CPE) Program is governed by Federal Regulation 42 CFR 433.51. The program allows eligible health care organizations to submit certified public expenditures to draw-down partial reimbursement from Federal funds as compensation for un-reimbursed medical costs provided to Medicaid recipients.
On October 20, 2016, Centers for Medicare & Medicaid Services (CMS) approved AHCA’s Florida State Plan Amendment (SPA) 15-0014 CPE Public Emergency Medical Transportation (PEMT) which added ambulance transportation.
Background/Explanation:
Pinellas County Emergency Medical Services (EMS), dba Sunstar provides ambulance transportation to Medicaid recipients. The cost to provide these services of $940.00 per transport as determined by the States’ cost report exceeds the Medicaid reimbursement of $137.96 for a Basic Life Support transport and $192.73 for an Advanced Life Support transport. The CPE program facilitates the ability to drawdown Federal funds to partially mitigate these unrecovered costs.
Fiscal Impact:
Estimated Revenue of $853,058.92 (actual reimbursement will be based on the pro-rata share of CPE program funds available for distribution to participants)
Contingency fee consultant’s cost - 3.0% or $25,591.77
Net Revenue $827,467.15
The revenue and related expense are included in the FY25 adopted budget of the EMS Fund.
Delegated Authority:
Authority for the County Administrator to sign this certification is granted under Resolution 23-18.
Staff Member Responsible:
James Fogarty, Bureau Director, Safety & Emergency Services
Partners:
Agency for Health Care Administration (AHCA)
Centers for Medicare & Medicaid Services (CMS)
Attachments:
Cost Report Certification Page for County Administrator Wet, Blue Ink Signature
Pinellas County Final_FL-PEMT_AHCA_Cost Report_FY23-24 - 12.10.2024
Resolution 23-18
PEMT Cost Report Instructions
Final Approved SPA FL-15-0014 Approval of CPE PEMT Medicaid Program.