Subject:
Title
Resolution authorizing the County Administrator to annually execute the Certification Statement of the Use of Certified Public Funds and Letter of Agreement with the State of Florida to participate in the Medicaid Public Emergency Medical Transportation and Medicaid Public Emergency Medical Transportation-Intergovernmental Transfer Programs.
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Recommended Action:
Recommended Action
Approval of a resolution delegating authority to the County Administrator to annually execute the Medicaid Public Emergency Medical Transportation (PEMT) Statement of the Use of Certified Public Funds and the Medicaid Public Emergency Medical Transportation-Intergovernmental (PEMT-IGT) Letter of Agreement which provides supplemental revenue to public ambulance transportation providers for services rendered to Medicaid recipients.
• PEMT provides supplemental revenue to public ambulance transportation providers for services rendered to Medicaid recipients.
• Application and approval are required annually with a very narrow application window timeline as per State requirement.
• The projected revenue is $5,100,000.00 per year; PEMT ($400,000.00) and PEMT-IGT ($4.7M). These funds are included and consistent with the Fiscal Year 2023 Adopted Budget.
• This authorizes the County Administrator to sign the agreement within deadlines.
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Strategic Plan:
Deliver First Class Services to the Public and Our Customers
5.1 Maximize partner relationships and public outreach
5.2 Be responsible stewards of the public’s resources
5.3 Ensure effective and efficient delivery of county services and support
5.4 Strive to serve the needs of all Pinellas County residents and customers
Summary:
Summary
The PEMT Programs were initiated to supplement public emergency transportation providers who render services to eligible Medicaid recipients. Medicaid’s fee schedule for ambulance transportation is minimal and does not cover the cost of providing these services; as an example, Medicaid’s current reimbursement rate for Advance Life Support (ALS) services is $192.78, compared to the County’s ALS retail rate of $828.99. PEMT is for Medicaid recipients who are exempted from enrolling in Medicaid The PEMT Programs were initiated to supplement public emergency transportation providers who render services to eligible Medicaid recipients. Medicaid’s fee schedule for ambulance transportation is minimal and does not cover the cost of providing these services; as an example, Medicaid’s current reimbursement rate for Advance Life Support (ALS) services is $192.78, compared to the County’s ALS retail rate of $828.99. PEMT is for Medicaid recipients who are exempted from enrolling in Medicaid Managed Medical Assistance (MMA) plans under Florid Statute 409.965. PEMT is a Certified Public Expenditure (CPE) Program that allows transportation providers to annually certify the cost of providing ambulance services that exceed the Medicaid reimbursement via the execution of a Certified Statement of the Use of Certified Public Funds. PEMT-IGT is for Medicaid recipients enrolled in an MMA Plan in which annually a portion of the unreimbursed cost is recouped via an intergovernmental transfer of funds through the execution of a Letter of Agreement. There is a short turn-around period in which these documents must be returned to the state to participate in the program. Assigning delegated authority to the County Administrator would expedite this process. The County’s participation in these programs have resulted in an average annual program revenue of approximately $5M.
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Background Information:
The PEMT program was implemented by the Agency for Healthcare Administration (AHCA) in 2016 through the lobbying efforts of the Florida Fire Chiefs Association (FFCA) to obtain the Federal Share reimbursement for local government’s ambulance transportation cost. PEMT was limited to Medicaid recipients that were exempted from enrolling in a Medicaid Medical Managed Assistance (MMA) plan under Florida Statute 409.965. Acknowledging that approximately 90% of Medicaid recipients are required to enroll in an MMA plan, the FFCA successfully lobbied the legislature to expand PEMT in 2019 to include this population, creating the PEMT-IGT. The PEMT-IGT differs from the initial PEMT program in that it is not a Certified Public Expenditure (CPE) Program that allows public entities to certify fee-for-service expenses associated with ambulance services to Medicaid recipients and involves the preparation of various cost reports. State distributions associated with PEMT IGT are derived from a calculation based on the number Medicaid recipients enrolled in MMA Plans in the region serviced by the providers. Given that the distribution is based on data provided by the Managed Care Organizations (MCOs), AHCA must be in possession of the physical dollars the service providers are projected to dedicate to this Medicaid population to draw down Federal program funds which requires an intergovernmental transfer of funds.
Fiscal Impact:
Projected revenue is $5,100,000.00 per year; PEMT ($400,000) and PEMT-IGT ($4.7M). These funds are included and consistent with the FY23 Adopted Budget.
Staff Member Responsible:
Jim Fogarty, Director, Safety and Emergency Services
Partners:
Agency for Healthcare Administration
Attachments:
Resolution