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:	May 16, 2023

Contra

Costa

County

Subject:

PP-GEMT IGT Payment to California Department of Health Care Services for January through April, 2023

APPROVE	OTHER
RECOMMENDATION OF CNTY ADMINISTRATOR	RECOMMENDATION OF BOARD COMMITTEE

Action of Board On: 05/16/2023

APPROVED AS RECOMMENDED

OTHER

Clerks Notes:

VOTE OF SUPERVISORS

AYE:

John Gioia, Director
Candace Andersen, Director
Diane Burgis, Director
Ken Carlson, Director
Federal D. Glover, Director

Contact:

Regina Rubier, (925)265-3055

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 16, 2023
Monica Nino, County Administrator

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 $2,741,498 for the "PP-GEMT IGT" (Public Provider Ground Emergency Medical Transport Intergovernmental Transfer) for ambulance transports provided by the District during January 2023 through April 2023; and AUTHORIZE the Fire Chief to execute and submit the required IGT Certification Form.

FISCAL IMPACT:

The payment to the State of California Department of Health Care Services (DHCS) will be offset by increased anticipated revenue as a result of this new supplemental Medi-Cal reimbursement program for public providers. As a result, the fiscal impact is positive for the District’s ambulance transport program due to the significant number of Medi-Cal transports within the District's ambulance operating area. It is anticipated, net of all payments and fees paid to the DHCS, the District will receive $5 Million to $7 Million annually in additional supplemental reimbursements from this program.

BACKGROUND:

In 2019, Assembly Bill 1705 (AB1705) was passed and certain sections of the California Welfare and Institutions Code, related to Medi-Cal, were amended and added. In accordance with the passage of the bill, the Department of Health Care Services (DHCS) developed the Public Provider Ground Emergency Medical Transport (PP-GEMT) Intergovernmental Transfer Program (IGT) program to provide increased reimbursements, by application of an add-on increase, to emergency medical transports provided by eligible public GEMT providers. The non-federal share collected will be used to provide this add-on increase to the fee-for-services (FFS) fee schedule rate for the affected emergency medical transport billing codes and a rating increment that will be applied to primary capitation rates for contracted Medi-Cal plans. The new legislation requires the non-federal share of any supplemental reimbursement provided under this program to be derived from voluntary intergovernmental transfers of local funds. Known to us as the “PP-GEMT IGT” program, this program will replace the current Quality Assurance Fee (QAF) and Ground Emergency Medical Transport (GEMT) Medi-Cal supplemental reimbursement programs.

The bill requires eligible providers, including the Fire District, to receive an add-on increase to the associated Medi-Cal fee-for-service and managed care payments. The District has agreed to provide funding, along with all other public providers, to support the financial sustainability of the program for the non-federal share of the program. We anticipate the District will need to provide intergovernmental transfers to the state of approximately $10 million annually, which is currently scheduled to be paid in three installments of approximately $2.8 million per payment for calendar year 2023. The District anticipates total revenue from the program and the revised Medi-Cal reimbursements to be approximately $25 million annually, according to estimates provided by the District’s contracted medical billing firm. After accounting for the intergovernmental transfers and the dissolution of the QAF and GEMT supplemental reimbursement programs, it is anticipated the District will realize a net increase in total revenue in the range of $5 million to $7 million annually from the PP-GEMT IGT program.

The District received the attached invoice from DHCS on May 1, 2023. The invoice is for the period January through April of 2023 in the amount of $2,741,497.88. This request is for calendar year 2023 transports and the payment for this invoice is due on June 15, 2023. The IGT Certification form must be executed and submitted to the DHCS no later than June 1, 2023.

CONSEQUENCE OF NEGATIVE ACTION:

If this payment is not made the State may withhold supplemental provider payments for ambulance services provided to Medi-Cal recipients.