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 State’s 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 (EMS) Fund with additional revenue for Ambulance Transportation expenditures incurred during the State’s Fiscal Year (FY) of July 2024 through June 2025, of up to $1,069,292.19.
• Funding for $32,078.77 for the contingency is included in the FY26 Adopted Budget for Safety and Emergency Services Department within the EMS Fund. Associated Revenue of $1,069,292.19 is also included in the FY26 Adopted Budget in the EMS Fund. Funding for future years is dependent on approval in the annual County Operating Budget.
Submittal to the State is required by December 30, 2025.
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Strategic Priorities:
2.1 Improve public health
4.2 Achieve and maintain a high level of customer satisfaction
Summary:
The Cost Report the County Administrator is signing is reflective of $208,352,882 of total EMS costs as determined by the States formula contained in the Cost Reports. Of these total costs, the cost report carves out uncompensated eligible costs directly related to emergency ambulance transportation provide to Medicaid recipients eligible under this program which equates to $1,868,739.54. The federal government, through the State, funds 57.22% of these uncompensated costs or $1,069,292.19.
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 drawdown 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 the Agency for Health Care Administration’s (AHCA) Florida State Plan Amendment (SPA) 15-0014 CPE Public Emergency Medical Transportation (PEMT) which added ambulance transportation.
Executed Certification of required document noted under “Recommended Action” is due to the State by December 30, 2025.
Background/Explanation:
Pinellas County Emergency Medical Services (EMS), dba Sunstar provides ambulance transportation to Medicaid recipients. The cost to provide these services of $1,042.23 per transport as determined by the State’s cost report exceeds the Medicaid reimbursement of $152.73 for a Basic Life Support transport and $213.37 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 $1,069,292.19 (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 $32,078.77
Net Revenue $1,037,213.42
The revenue and related expense are included in the FY26 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
FL EMS Cost Report - Pinellas 2023
Pinellas County FY23 PEMT Supporting Doc
PEMT Cost Report Instructions
Final Approval SPA-FL-15-0014 Approval of CPE PEMT Medicaid Program