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To:	Contra Costa County Fire Protection District Board of Directors
From:	Jeff Carman, Chief, Contra Costa County Fire Protection District
Date:	June 13, 2017

Contra

Costa

County

Subject:

Medi-Cal GEMT Supplemental Reimbursement Program Provider Participation Agreement

APPROVE	OTHER
RECOMMENDATION OF CNTY ADMINISTRATOR	RECOMMENDATION OF BOARD COMMITTEE

Action of Board On: 06/13/2017

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 Services (925) 941-3312

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: June 13, 2017
David Twa,

BY:	, Deputy

RECOMMENDATION(S):

APPROVE and AUTHORIZE the Fire Chief, or designee, to execute the Medi-Cal Ground Emergency Medical Transportation Services (GEMT) Supplemental Reimbursement Program Provider Participation Agreement (Agreement) with the California Department of Health Care Services (State) with a term that stays in effect until the Agreement is terminated or the GEMT program ends pursuant to the repeal of State of federal statutory authority to make payments or claim federal reimbursement.

FISCAL IMPACT:

Participation in the GEMT Supplemental Reimbursement Program could have a potentially significant impact to the District's cost recovery efforts. The District collects a fraction of its actual costs to provide transportation services to Medi-Cal fee-for-service beneficiaries. The GEMT Supplement Reimbursement Program helps to bridge the financial gap between the costs of providing service and the Medi-Cal provider service rates.

FISCAL IMPACT: (CONT'D)

The amounts payable to a GEMT provider depend on the number of Medi-Cal fee-for-service transports during the reporting period and the amounts for which federal financial participation is available.

BACKGROUND:

California Welfare and Institutions (W&I) Code §14105.94, enacted October 2, 2011, authorized the Ground Emergency Medical Transportation Services (GEMT) supplemental reimbursement program. This voluntary Certified Public Expenditure (CPE) based program provides additional funding to eligible governmental entities that provide GEMT services to Medi-Cal beneficiaries. The Centers for Medicare and Medicaid Services (CMS) approved State Plan Amendment (SPA) 09-024 on September 4, 2013, authorizing the federal share of the supplemental reimbursement payments based on uncompensated costs for Medi-Cal fee-for-service transports, effective January 30, 2010.

For a publicly owned GEMT service provider to be eligible for the program, the following requirements must be met, as specified in Welfare and Institutions (W&I) Code §14105.94:

Provided GEMT services to Medi-Cal beneficiaries (further defined in SPA 09-024),
Be enrolled as a Medi-Cal provider for the period being claimed, and
Are owned or operated by an eligible governmental entity, to include the state, a city, county, city and county, fire protection district, special district, community services district, health care district, or a federally recognized Indian tribe.

Eligible providers who choose to participate in the GEMT program must also,

Enter into a Provider Participation Agreement (PPA) with the Department of Health Care Services (DHCS), and
Agree to reimburse DHCS for their allocated share of the administrative costs associated with overseeing the program (The provider’s allocated administrative share will be collected by Sacramento Metropolitan Fire District on behalf of DHCS).

GEMT service providers eligible to participate in this program will receive supplemental reimbursement payments by completing a CMS approved cost report form annually. The supplemental reimbursement payment is based on claiming federal financial participation on CPEs that have already been incurred by the public provider. The supplemental reimbursement amount is determined by the methodology approved by CMS in SPA 09-024.

CONSEQUENCE OF NEGATIVE ACTION:

The District will not be eligible to participate in the Medi-Cal Ground Emergency Medical Transportation Services (GEMT) Supplemental Reimbursement Program. This will result in a potentially significant loss of recoverable costs for providing transport services to Medi-Cal beneficiaries.