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Centers for Medicare & Medicaid Services says it sees problems in pay proposals

Submitted ground emergency medical transportation services should be only for covered services for Medicaid beneficiaries

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By Leila Merrill

BALTIMORE — The Centers for Medicare & Medicaid Services issued a bulletin earlier this month about federal guidance related to the reimbursement of ground emergency medical transportation services.

State plan amendments and other proposals need to meet federal requirements, and the CMS said it has discovered potential problems.

“In reviewing these proposals, CMS has identified potential issues with the scope of the costs that states have proposed as potentially allocable to Medicaid-covered GEMT services and the methods of allocation states have proposed to apportion GEMT costs for purposes of claiming Medicaid FFP. Cost identification and allocation methodologies should not shift costs to the Medicaid program that are not related to a Medicaid-covered service, such as GEMT, or allocate costs to Medicaid without using an appropriate allocation statistic to identify the portion of GEMT costs eligible for Medicaid payment.”

The bulletin provides detailed guidance and examples of costs that are allowed and not allowed.