Subject:
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Centers for Medicare & Medicaid Services (CMS) Certified Public Expenditures (CPE) Public Entity Medical Transportation (PEMT) Program
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Recommended Action:
Recommended Action
The Division of Ambulance Billing & Financial Services recommends the County Administrator certify by signature (wet signature, blue ink as required) the Emergency Medical Transportation Integrated Disclosure and Medicaid Cost Report General Information and Certification.
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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 CPE Program is governed by Federal Regulation 42 CFR 433.51. The program allows certain health care organizations to submit certified public expenditures to draw-down reimbursement for eligible costs from Federal funds as compensation for un-reimbursed medical costs provided to eligible Medicaid recipients. On October 20, 2016, CMS approved AHCA’s Florida State Plan Amendment (SPA) 2015-14 CPE Public Emergency Medical Transportation (PEMT) which added ambulance transportation.
Background/Explanation:
With the approval of the SPA, the EMS authority is eligible to participate in the PEMT program. On November 4, 2016, AHCA released the SPA, instructions for the cost report and the report template. Given the date the program expansion was approved, the State Fiscal Year reporting period was condensed for PEMT to October 1, 2015 - June 30, 2016 as opposed to the State’s typical fiscal year of July 1st - June 30th; Pinellas County will be eligible for the entire fiscal year during the next reporting period. Additionally, ACHA approved an extension of the report’s annual due date of November 30th to December 31st to allow newly eligible entities additional time in which to obtain clarification and prepare the reimbursement request for submission.
Fiscal Impact:
Participation in PEMT provides Pinellas County EMS with additional revenue estimated at $40,000 for reimbursable EMS expense incurred in FY16. In subsequent years, this estimate should significantly increase due to a full 12 month period and projected program revisions to include Medicaid Managed Care enrollees; excluded for the current reporting period.
Delegated Authority:
Authority for the County Administrator to certify this reimbursement is granted under Pinellas County Code Section 2-62 (a) (1).
Staff Member Responsible:
Jodie Sechler, Division Director, Ambulance Billing & Financial Services
Partners:
Paramedics Plus, L.L.C.
Agency for Healthcare Administration (AHCA)
Centers for Medicare & Medicaid Services (CMS)
Attachments:
AHCA Cost Report
Cost Report Supporting Documentation
PEMT CR Instructions
Final Approved SPA FL-15-014