Grand County backs letter opposing proposed CMS GEMT payment cap

EMS Chief Austin Wingate presented a draft letter asking federal legislators to oppose a proposed Centers for Medicare & Medicaid Services (CMS) rule that would cap Ground Emergency Medical Transportation (GEMT) supplemental payments to a Medicare ambulance fee schedule. Chief Wingate explained Colorado's current cost-based reconciliation model and said the proposed cap would cut the county's portion of Medicaid reconciliation from about 54.5% of actual costs to roughly 26%.

"The proposed CMS rule seeks to aggressively cap that supplemental reconciliation using the static Medicare ambulance fee schedule," Chief Wingate said, adding that MedPAC data shows the ambulance fee schedule has not been updated since 2002. The Board directed county staff to finalize and distribute the letter to federal representatives and statewide county advocacy groups and authorized signatures to be applied outside the meeting once final details are populated.

Chief Wingate and commissioners emphasized the disproportionate impact on rural systems with high fixed readiness costs and low call volumes; public comment on the rulemaking closes July 21, 2026.