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Ada County EMS plan amendment approved; county may seek retroactive Medicaid reimbursement
Summary
The Ada County Emergency Medical Services District reported approval of its GMT plan amendment, retroactive to Jan. 26, 2023, which staff said could allow the district to claim Medicaid reimbursement for paramedic and related EMS costs pending cost reports and clarification on eligible fire-department costs.
The Ada County Emergency Medical Services (EMS) District told the board on Jan. 21 that a state plan amendment for ground medical transportation (GMT) was approved last Friday and that approval is retroactive to Jan. 26, 2023. The district’s representative said the approval could allow the county to seek Medicaid reimbursement for EMS costs dating back to that retroactive date.
The district representative reported the county will now work with the consultant who prepared the state-plan amendment and with Medicaid to prepare and submit a cost report. The representative said Medicaid has indicated it can make an immediate payment and then perform an additional reconciliation by July 1. The board was told county staff expect to return with a resolution to open the EMS budget to receive the funds once the total amount is known.
Staff said the county appears able to include county paramedic costs — including logistics, administration and overhead — in its cost submissions. It remains unclear whether costs associated with fire-department responses will be eligible; staff said they will work with the consultant (PCG) and Medicaid to determine what fire-department costs, if any, can be included and to ensure compliance to avoid future repayment obligations.
Board members and the district representative described the approval as the result of multi-year work, with one staffer saying the effort began in 2019. The district representative said the county will follow up with a detailed cost report and a request for any necessary budget adjustments once reimbursements are quantified.
The board heard the EMS update as part of its session acting as the Ada County Emergency Medical Services District; no formal action on spending or budget adjustment was taken at the Jan. 21 meeting pending the cost-calculation step and further information from Medicaid.
