Agenda

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C.16

To:	Contra Costa County Fire Protection District Board of Directors
From:	Lewis T. Broschard III, Chief, Contra Costa Fire Protection District
Date:	March 7, 2023

Contra

Costa

County

Subject:

GEMT QAF Payment to California Department of Health Care Services CY 2022 Q4

APPROVE	OTHER
RECOMMENDATION OF CNTY ADMINISTRATOR	RECOMMENDATION OF BOARD COMMITTEE

Action of Board On: 03/07/2023

APPROVED AS RECOMMENDED

OTHER

Clerks Notes:

VOTE OF SUPERVISORS

AYE:

John Gioia, District I Supervisor
Candace Andersen, District II Supervisor
Diane Burgis, District III Supervisor
Ken Carlson, District IV Supervisor
Federal D. Glover, District V Supervisor

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: March 7, 2023
,

BY:	, Deputy

RECOMMENDATION(S):

APPROVE and AUTHORIZE the Auditor-Controller, on behalf of the Contra Costa County Fire Protection District (District), to make a payment to the State of California Department of Health Care Services in an amount not to exceed $547,586 for the Ground Emergency Medical Transportation Quality Assurance Fee for ambulance transports provided by the District in the months of October through December (Quarter 4) of 2022.

FISCAL IMPACT:

The fiscal impact is revenue generating for the Contra Costa County Fire Protection District (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 $34.02 Quality Assurance Fee (QAF) the District is required to pay on all transports.

FISCAL IMPACT: (CONT'D)

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

BACKGROUND:

The Centers for Medicare and Medicaid Services (CMS) approved State Plan Amendment (SPA) 18-004 authorizing the Ground Emergency Medical Transportation (GEMT) Quality Assurance Fee (QAF) program in March 2019. 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 receive an uplift that increases the Medi-Cal reimbursement base rate for Medi-Cal fee-for-service and managed care recipients. The GEMT 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 to $26.07 for FY 2019-20, to $32.30 for FY 2020-21, and to $33.42 for FY 2021-22. The current rate of $34.02 in effect for FY 2022-23 is assessed on ground emergency medical transports with dates of service beginning January 1, 2022 through December 31, 2022.

The District received the attached invoice from DHCS on February 14, 2023. The invoice is for the period October, November, and December (Quarter 4), for $547,585.92.

This request is for calendar year 2022 quarter 4 fees (for October-December 2022 transports). The payment for Quarter 4 is due on May 1, 2023.

Note that the GEMT QAF program ended December 31, 2022, so this will be the final payment under the "legacy" program. Pursuant to Assembly Bill 1705 (Bonta, 2019), a new Public Provider-Ground Emergency Medical Transportation Intergovernmental Transfer (PP-GEMT IGT) program went into effect on January 1, 2023.

CONSEQUENCE OF NEGATIVE ACTION:

The GEMT QAF payment is mandatory for all ambulance providers 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.