Agenda

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C.5

To:	Contra Costa County Fire Protection District Board of Directors
From:	Lewis T. Broschard III, Chief, Contra Costa Fire Protection District
Date:	October 8, 2019

Contra

Costa

County

Subject:

GEMT QAF Payment to California Department of Health Care Services CY 2019 Q1

APPROVE	OTHER
RECOMMENDATION OF CNTY ADMINISTRATOR	RECOMMENDATION OF BOARD COMMITTEE

Action of Board On: 10/08/2019

APPROVED AS RECOMMENDED

OTHER

Clerks Notes:

VOTE OF SUPERVISORS

AYE:

John Gioia, Director
Candace Andersen, Director
Diane Burgis, Director
Karen Mitchoff, Director
Federal D. Glover, Director

Contact:

Jackie Lorrekovich, Chief Admin Svcs (925) 941-3300

I hereby certify that this is a true and correct copy of an action taken and entered on the minutes of the Board of Supervisors on the date shown.
ATTESTED: October 8, 2019
David Twa,

BY:	, Deputy

RECOMMENDATION(S):

APPROVE and AUTHORIZE the Auditor-Controller, on behalf of the Contra Costa County Fire Protection District, to make a payment to the State of California Department of Health Care Services in the amount of $16,449.72 for the balance due on the Ground Emergency Medical Transportation Quality Assurance Fee for ambulance transports provided by the Contra Costa County Fire Protection District in the months of January, February, and March (Quarter 1) of 2019.

APPROVE and AUTHORIZE the Auditor-Controller to expedite the above-referenced payment.

RECOMMENDATION(S): (CONT'D)

FISCAL IMPACT:

The Ground Emergency Medical Transportation (GEMT) / Quality Assurance Fee (QAF) program increases the historic base rate of Medi-Cal reimbursement by $220.80 per transport. The GEMT/QAF program, therefore, increases the per transport reimbursement from the historic base rate of $118.20 to $339.00.

To fund this program, the State of California Department of Health Care Services (DHCS) began assessing all transport providers within the State of California a fee of $25.23 per transport effective July 1, 2018. The fee was increased (retroactively) to $26.07 for payments due on or after July 1, 2019. The increased fee was approved by the Centers for Medicare & Medicaid Services (CMS) on September 6, 2019. The District received the attached invoice from DHCS on September 18, 2019. The payment is due on or before October 1, 2019.

The fiscal impact will be revenue generating for the District due to the significant number of Medi-Cal transports within the District’s ambulance operating area. Medi-Cal is the second highest payer type (second to Medicare). The net revenue the District receives will be calculated by multiplying the $220.80 per transport uplift for Medi-Cal fee-for-service and Medi-Cal managed care transports less the (revised) $26.07 QAF the District is required to pay on all transports.

The net revenue estimate (uplift less QAF) for the District for 2019 is approximately $2 million under the current funding and fee parameters.

BACKGROUND:

CMS approved State Plan Amendment (SPA) 18-004 authorizing the GEMT/QAF program in March 2019. The Quality Assurance Fee (QAF) is an add-on fee used to increase Medi-Cal funding. Essentially, emergency medical transportation providers in California must pay this fee on all transports, and in return, providers will receive an uplift that increases the Medi-Cal reimbursement base rate for Medi-Cal fee-for-service and managed care recipients.

Transport providers were provided with very little advanced notice by the State to make quarterly payments after CMS approved SPA 18-004. Nevertheless, the Contra Costa County Fire Protection District (District) was able to get Board approval and make its 2019 Q1 QAF payment in a timely manner (i.e., on June 11, 2019). The amount of that payment was $494,079.09. The payment was due on or before July 1, 2019.

CMS approved SPA 19-0020 on September 6, 2019. SPA 19-0200 increases the QAF from $25.23 per transport to $26.07 per transport on all payments due July 1, 2019, and thereafter. This action retroactively increased the amount of the District's 2019 Q1 payment from $494,079.09 to $510,528.81. The balance due is $16.449.72. This payment is due October 1, 2019. The District received the attached invoice on September 18, 2019.

This request is for the balance due on 2019 quarter one fees (for January-March 2019 transports).

CONSEQUENCE OF NEGATIVE ACTION:

The QAF payment is mandatory for all providers (public and private) within the State. If not paid, the State can assess late payment penalties and withhold provider payments for ambulance services provided to Medi-Cal recipients.