SUBJECT
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Approve Piggyback Agreement for Florida Certified Expenditure Program for Emergency Medical Transportation (PEMT) with Public Consulting Group LLC ($320,000 estimated recurring annual expense)
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DESCRIPTION
The Fire Rescue Division provides EMS transports to approximately 80,000 residents annually. After services are provided, the County uses a third-party administrator to bill the patient’s insurance company for the charges incurred. If the patient has Medicaid as their insurance provider, the County is only reimbursed approximately $190 for the services. The federal government has recognized this hardship on local governments and created the Public Emergency Medical Transport (PEMT) program, which is administered through the State of Florida, Agency for Health Care Administration (AHCA). This program allows for local governments to submit claims for the difference between the cost of the transport charges and the amount reimbursed by Medicaid.
The PEMT claims process requires the submittal of detailed data surrounding the services provided to the transported resident along with other County EMS billing calculations. This is a specialized, time intensive process resulting in governments utilizing a third party to submit claims on their behalf. Polk County has historically used the Public Consulting Group to provide these services. Public Consulting Group historically has submitted data for approximately 43,000 Medicaid transports claims to the PEMT program which has resulting in receiving approximately $3.5 million back from the program.
The previous agreement between Public Consulting Group and the County recently expired and the Fire Rescue Division has found another agreement between Public Consulting Group and Leon County they would like to use to continue to provide the services. The attached piggyback agreement will allow the County to use the current agreement between Leon County and the vendor.
The anticipated annual cost to pay the Public Consulting Group for their claim services in accordance with the attached agreement is $320,000. It is also anticipated based on historical claim submittals to receive $3.5 million in revenue back from the PEMT program, for a net revenue of $3.2 million.
RECOMMENDATION
Request Board approve the Piggyback Agreement with the Public Consulting Group, LLC to provide unpaid Medicaid EMS claims recovery assistance.
FISCAL IMPACT
Funds are available within Fire Rescue Division’s EMS budget.
CONTACT INFORMATION
Brad Howard
Sr. Procurement Analyst
(863) 534-6706
bradhoward@polk-county.net <mailto:bradhoward@polk-county.net>