Subject:
Title
Emergency Medical Transportation Integrated Disclosure and Medicaid Cost Report General Information and Certification. label
Recommended Action:
Recommended Action
Approval and execution by the County Administrator of the Emergency Medical Transportation Integrated Disclosure and Medicaid Cost Report General Information and Certification which allows eligible health care organizations to submit certified public expenditures to draw-down partial reimbursement for eligible costs from Federal funds.
Submittal to the State is required by November 30, 2017. Body
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) 2015-14 CPE Public Emergency Medical Transportation (PEMT) which added ambulance transportation. Executed Certification is due to the State by November 30, 2017.
Background/Explanation:
Pinellas County Emergency Medical Services (EMS), dba Sunstar provides ambulance transportation to Medicaid recipients. The cost to provide these services of $687.00 per transport as determined by the States’ cost report exceeds the Medicaid reimbursement of $136.00 for a Basic Life Support transport and $190.00 for an Advanced Life Support transport. The CPE program facilitates the ability to drawdown Federal funds to partially mitigate these unrecovered costs.
Fiscal Impact:
Participation in PEMT provides Pinellas County EMS with additional revenue of up to $453,328.00 (actual reimbursement will be based on the pro-rata share of CPE program funds available for distribution to participants) for reimbursable EMS expense incurred during the State’s fiscal year of July 2016 through June 2017. The contingency fee is 12% or $54,399.00. The revenue and related expense were not included in the FY18 adopted budget.
Delegated Authority:
Signature by the County Administrator certifying the information contained in the cost report is required by the Agency for Health Care Administration (AHCA).
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:
Certification
AHCA Cost Report
Cost Report Supporting Documentation
PEMT CR Instructions
Final Approved SPA FL-15-014