Apple Health (Medicaid) Provider Alert
Ground Emergency Medical Transportation (GEMT)
providers who want to receive supplemental payments for the 2020 state fiscal
year service period must submit their cost reports to the Health Care Authority
(HCA) by November 30, 2018.
What
is the GEMT Program?
The Washington State Legislature created the GEMT program
through House Bill 2007. The
GEMT program makes supplemental payments to qualified publicly owned or
operated GEMT providers.
The supplemental payments cover the funding gap between a
provider’s actual costs per transport and the allowable amount received from
Washington Apple Health (Medicaid), and any other sources of reimbursement.
This supplemental reimbursement program is voluntary.
Who
can participate?
Publicly owned or operated ground emergency medical transportation
providers can participate in the supplemental reimbursement.
Eligibility
requirements
To be eligible for the GEMT supplemental
reimbursement program, you must:
- Provide
GEMT services to Medicaid clients
- Be
enrolled as a Medicaid provider, with an active Core Provider Agreement (CPA),
for the service period being claimed
-
Be owned or operated by a governmental entity, such as a state, city, county, special purpose
district, or other governmental unit in the state that has taxing authority,
has direct access to tax revenues, or is an Indian tribe
How
do I enroll as a provider in the GEMT program?
To enroll in the GEMT supplemental
reimbursement program, eligible providers who choose to participate in the 2020
state fiscal year service period must:
- Obtain an HCA ProviderOne ID number (if you don’t already have one)
- Agree to reimburse HCA administrative costs associated with the administration and management of the GEMT program
- Complete and submit the entire annual GEMT application packet to HCA no later than November 30, 2018.
- The application packet consists of the following:
-The Provider Participation Agreement (PPA)
-The annual cost report certifying public expenditures
You must complete the annual participation agreement
and cost report, print both documents in their entirety, and sign the agreement
and cost report certification page. Scan and email both the signed PDF and
Excel versions, in their entirety, to HCAGEMTAdmin@hca.wa.gov by November 30, 2018.
What
do I need to do once I am enrolled, or if I am already enrolled?
Once enrolled in the GEMT supplemental
reimbursement program, you must:
- Each
year complete a Provider Participation Agreement (PPA) and cost report
certifying public expenditures for this program
- Maintain
current provider contact information with HCA by
submitting Point of Contact information with the required documentation
When are cost reports due?
Cost reports are due five months after the
end of each state fiscal year. The state fiscal year ends each June 30. Cost
reports are due November 30 each year.
The due date for the state fiscal year 2020 claiming period is
November 30, 2018.
HCA will notify you when your cost report
has been accepted. HCA will establish the average cost per transport. Interim
payment rates will be effective July 1, 2019.
HCA will send you notification of
calculated average cost per transport at least 15 days before the effective
date.
Where
can I go for more information?
Electronic versions of the participation
agreement, cost report, cost report instructions, and other program related
documents and information can be found at: https://www.hca.wa.gov/billers-providers/ground-emergency-medical-transportation-gemt.
If you have any questions regarding the
GEMT supplemental reimbursement program, please contact us at HCAGEMTAdmin@hca.wa.gov.
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