Subject:
Emergency Medical Transportation Integrated Disclosure and Medicaid Cost Report General Information and Certification.
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Recommended Action:
Approval and execution by the County Administrator 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 as compensation 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 (CPE) program facilitates the ability to drawdown Federal funds to partially mitigate these unrecovered costs.
• Participation in Public Emergency Medical Transport (PEMT) provides the Pinellas County Emergency Medical Services Fund with additional revenue for reimbursable Ambulance Transportation expenditures incurred during the State’s fiscal year of July 2018 through June 2019.
• Submittal to the State is required by November 27, 2019.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) 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 November 27, 2019.
Background/Explanation:
Pinellas County Emergency Medical Services (EMS), dba Sunstar provides ambulance transportation to Medicaid recipients. The cost to provide these services of $631.00 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 the Pinellas County Emergency Medical Services Fund with additional revenue of up to $368,669 (actual reimbursement will be based on the pro-rata share of CPE program funds available for distribution to participants) for reimbursable Ambulance Transportation expenditures incurred during the State’s fiscal year of July 2018 through June 2019. The contingency fee is 6.0% or $22,120. The revenue and related expense are included in the FY20 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:
James G. Fogarty, Bureau Director, Safety and Emergency Services
Partners:
Agency for Health Care Administration (AHCA)
Centers for Medicare & Medicaid Services (CMS)
Attachments:
Certification Signature Page
AHCA Cost Report
Cost Report Supporting Documentation
PEMT CR Instructions
Final Approved SPA FL-15-0014