Agenda

Return

C.5

To:	Contra Costa County Fire Protection District Board of Directors
From:	Lewis T. Broschard III, Chief, Contra Costa Fire Protection District
Date:	December 8, 2020

Contra

Costa

County

Subject:

GEMT QAF Payment to California Department of Health Care Services CY 2020 Q1-3

APPROVE	OTHER
RECOMMENDATION OF CNTY ADMINISTRATOR	RECOMMENDATION OF BOARD COMMITTEE

Action of Board On: 12/08/2020

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: December 8, 2020
,

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 $1,683,735 for 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 through September (Quarters 1-3) of 2020.

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.

FISCAL IMPACT: (CONT'D)

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 to $26.07 effective July 1, 2019 through June 30, 2020, and the fee was increased again to $32.30 effective July 1, 2020 through June 30, 2021. The increased fee of $32.30 was approved by the Centers for Medicare & Medicaid Services (CMS) on October 15, 2020.

The District received the attached invoices from DHCS on November 25, 2020. The invoices are for the period January, February, March 2020 (Quarter 1), for $624,197.50; April, May, June 2020 (Quarter 2), for $502,620.30; and July, August, September 2020 (Quarter 3), for $556,916.60.

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 $32.30 QAF the District is required to pay on all transports.

The net revenue estimate (uplift less QAF) for the District for 2020 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.

CMS approved SPA 19-0020 in September 2019. SPA 19-0200 increased the QAF from $25.23 per transport to $26.07 per transport for ground emergency medical transports with dates of service beginning July 1, 2019 through June 30, 2020. SPA 20-0009 increased the QAF to $32.30 per transport for ground emergency medical transports with dates of service beginning July 1, 2020 through June 30, 2021.

This request is for calendar year 2020 quarters 1, 2, and 3 fees (for January-September 2020 transports). The payment for Q1 is due on or before January 1, 2021. State program representatives indicated there would be no exceptions and late fees may be assessed by the State for payments not received by the due date. Payments for Q2 and Q3 are due February 1, 2021, and March 1, 2021, respectively.

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.