Title:
Title
Agreement for Recovery of Administration Costs for Implementation and Recovery of Ground Emergency Medical Transportation (GEMT) Payments to the Sacramento Metropolitan Fire District (Two-Thirds Vote Required)
...End
FileID
File ID: 2019-00210
Location
Location: Citywide
Recommendation:
Recommendation
Pass a Motion: 1) authorizing the City Manager, or his designee, to approve payments that may exceed $100,000 under contract 2017-0495 with Sacramento Metropolitan Fire District (SMFD) for costs associated with Medi-Cal fee-for-service transports that will occur during the period July 1, 2017 through June 30, 2020; and 2) suspending the competitive bidding by two-thirds vote.
Contact: Iysha Jenkins, Senior Accountant Auditor, (916) 808-8569, Fire Department
Body
Presenter: None.
Attachments:
1-Description/Analysis
2-Contract 2017-0495 with Sacramento Metropolitan Fire District (SMFD)
Description/Analysis
Issue Detail: The Fire Department is a provider of ground emergency medical transportation (GEMT) and is eligible to participate in the Medi-Cal GEMT Supplemental Reimbursement Program. The State of California Department of Health Care Services (DHCS) is responsible for oversight of the program and has designated Sacramento Metropolitan Fire District (SMFD) as the “host” entity. As such, SMFD is responsible for collecting associated fees assessed from the participating agencies to reimburse DHCS for costs to administer the GEMT program.
Participating agencies pay SMFD a 1% administrative fee based on reimbursements received from the State. The reimbursements received by participating agencies are determined by the number of allowable transports. Additionally, participating agencies pay SMFD the transporter’s share of administrative costs, which are based upon the administrative costs per fee for service (FFS) Medi-Cal transport, multiplied by the GEMT transporter’s number of FFS Medi-Cal transports for each reporting period. The administrative costs per FFS is determined by the State based on the total administrative costs of the State administering the GEMT program divided by the total number of FFS Medi-Cal transports statewide by all participating agencies foreach reporting period.
As a condition of participating in the State’s GEMT program for receiving supplemental reimbursements, each eligible provider is required to pay these administrative fees to SMFD, pursuant to State Code.
In April 2017, the Fire Department entered into an agreement with SMFD (2017-0495) for payment of administrative fees. Although no payments have been made to date, payments to SMFD may exceed $100,000. Based on this information, staff is bringing this report forward for Council approval based on City Code 3.56.290.
The Department can be audited by DHCS for the period of July 1, 2017 through June 30, 2020 up to three years from the submission of the annual cost report. The outcome of an audit could result in additional payments to SMFD based on the number of allowable transports established by the California Medicaid Management Information System (CA-MMIS).
Staff is requesting approval to cover fees that may exceed $100,000 associated with the Medi-Cal fee-for-service transports occurring from July 1, 2017 through June 30, 2020 and approval to suspend competitive bidding by two-thirds vote since SMFD has been designated by the State as the “host” entity-the sole entity with whom the City can contract for payment of GEMT administrative fees.
Policy Considerations: The Fire Department’s participation in this program based on agreement 2017-0495 may exceed $100,000. Pursuant to City Code Section 3.56.090, contracts of $100,000 or more are to be approved by the City Council.
Economic Impacts: None.
Environmental Considerations: This report concerns administrative activities that do not constitute a “project” as defined by Section 15378 of the California Environmental Quality Act (CEQA) Guidelines and is otherwise exempt pursuant to Section 15061(b) (3).
Sustainability: None.
Commission/Committee Action: None.
Rationale for Recommendation: The amended agreement needs to be executed to ensure compliance with City Code 3.56.290.
Financial Considerations: Fees to SMFD are paid from reimbursements received through the GEMT program. Future audits of the program for the period covering July 1, 2017 through June 30, 2020 may necessitate payments to SMFD in excess of $100,000. Staff recommendation is to approve payment of fees to be paid to SMFD that may exceed $100,000 based on the number of allowable transports for the period of July 1, 2017 through June 30, 2020.
Local Business Enterprise (LBE): Not applicable.