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C.121

To:	Board of Supervisors
From:	Lewis T. Broschard III, Chief, Contra Costa Fire Protection District
Date:	May 7, 2019

Contra

Costa

County

Subject:

GEMT QAF Payment to Department of Health Care Services 2018 Q3

APPROVE	OTHER
RECOMMENDATION OF CNTY ADMINISTRATOR	RECOMMENDATION OF BOARD COMMITTEE

Action of Board On: 05/07/2019

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
Karen Mitchoff, 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: May 7, 2019
David Twa,

BY:	, Deputy

RECOMMENDATION(S):

Acting as the Governing Board of the Contra Costa County Fire Protection District (District), APPROVE and AUTHORIZE the Auditor-Controller, on behalf of the District, to make a payment to the Department of Health Care Services in the amount of $475,207.05 for the Ground Emergency Medical Transportation Quality Assurance Fee for ambulance transports provided by the District in the months of July, August, and September (Quarter 3) of 2018.

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 per transport reimbursement from the historic base rate of $118.20 to $339.00.

FISCAL IMPACT: (CONT'D)

To fund this program, the Department of Health Care Services (DHCS) is assessing transport providers within the State of California a fee of $25.23 per transport effective July 1, 2018 (i.e., retroactively). 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. 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 $25.23 QAF the District has to pay on all transports.

The net revenue estimate (uplift less QAF) for the District for 2018 is $2 million under the current funding and fee parameters.

BACKGROUND:

The Centers for Medicare and Medicaid Services approved State Plan Amendment 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.

By separate Board order, the District requested approval for 2018 quarter one and quarter two payments.

This request is for 2018 quarter three (July-September 2018). The payment is due on or before May 15, 2019. The payment due date for quarter three was announced by the State on April 23, 2019. 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.

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.