In an uncertain economy, every dollar counts toward the continuing operation of vital state and local programs. PCG Health™ can help your state fill the gap between Medicaid revenue and the cost of providing emergency medical services with a sound supplemental payment program.

Outdated practices, incomplete data, or difficulty implementing policy changes may be hindering your state’s ability to optimize revenue for emergency medical services (EMS) to Medicaid clients. PCG Health™ has more than 20 years of experience with revenue enhancement projects for state and local government agencies across the U.S. and is well qualified to help your state develop a sound supplemental payment program that allows you to enhance payments for emergency medical services.

The PCG Health Approach

Experienced PCG Health professionals will work with you to develop an auditable supplemental payment program that is budgetneutral from a state Medicaid agency perspective and follows a careful methodology based on proven techniques. Our approach includes

• researching federal and state regulations that impact your state Medicaid program, including your state plan;
• assessing the gap between Medicaid payments and the true cost of providing emergency medical services to Medicaid clients;
• determining the potential revenue opportunity for you using Medicare, Medicaid, and commercial fees or cost information;
• preparing a supplemental payment methodology and supporting documentation to obtain additional reimbursement from the Centers for Medicare and Medicaid Services (CMS);
• developing and implementing an emergency medical services cost report that is compliant with CMS regulations and OMB A-87;
• developing cost reporting and expenditure data housing tools to meet all federal requirements and improve the supporting documentation process; and,
• developing a methodology to equitably redistribute funds received from the federal government.

Benefits

A sound supplemental payment program that will stand up to the scrutiny of an audit can help increase Medicaid reimbursement for providers. PCG Health will also evaluate your state plan with respect to this program and provide advisory services regarding any state plan amendment (SPA) that is necessary.

 

More Information

For more information about PCG Health's Supplemental Payment Program for Emergency Medical Services please contact us at info@publicconsultinggroup.com or 1-800-210-6113.