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Lancaster Council backs staff to pursue state ambulance supplemental payment program
Summary
Council heard an overview of South Carolina’s Medicaid-funded Ambulance Supplemental Payment Program, asked about costs and fraud safeguards, and directed staff to begin the opt‑in process; staff estimated roughly $245,000 in new federal funds net to the county annually against about $100,000 in local IGT transfers.
Clay Cato (identified in the record as an EMS director) and Garrett Abrahamson of PCG briefed Lancaster County Council on the Ambulance Supplemental Payment Program (ASPP), a Medicaid managed-care supplemental payment that uses intergovernmental transfers (IGTs) to draw down federal funds for participating counties.
Abrahamson explained the mechanics: the program applies an add-on rate ($325 per qualifying transport in the example) to Medicaid managed-care transports and requires participating local entities to make an IGT that the state pools to draw additional federal matching dollars. “If we take that thousand transports, $325 as an add on rate, that gross funding is $352,000,” Abrahamson said; with the federal share applied, he estimated roughly $245,000 net new federal funding could come to Lancaster County annually on the sample figures provided.
Council members asked whether the funds are truly new and what strings are attached. Abrahamson said the program brings new federal funding through Medicaid and emphasized the requirement for a retrospective cost report to document costs per transport; he described the IGT as approximately $26,000 per quarter in the sample (about $100,000 annually) and explained PCG’s contingency fee is paid only after the county receives federal funds. “It’s strictly a reporting mechanism,” he said, emphasizing that operations and clinical services would not change.
Questions about fraud and timing were addressed: participants must submit cost reports and documentation; draws and returns through managed-care companies typically take 4–6 weeks after the state processes transfers and draws. Council members asked whether opt-in is mandatory (it is not) and what cons exist; presenters cited an added reporting burden as the main downside.
After discussion the council directed staff to begin the process of participation, involving finance staff and county procurement as needed, and requested periodic updates (quarterly or semiannual) on program results and compliance. No final participation vote was taken at the meeting; staff were asked to prepare the necessary documentation and return with a formal item for council consideration.
