Medi-Cal Reimbursement Opportunities for Public Transit CalACT Spring 2014 Margaret Heath

Requirements - Getting Started Research Medi-Cal non-emergency non-medical transportation (NENMT) to determine how many of the trips your program provides may qualify. Learn what NENMT is from the prospective of Medi-Cal Administrative Activities (MAA). CMAA/CMAA%20Manual%20Revised% pdf 2

Activity D: Non-emergency non-medical transportation (NENMT). The term “non-medical” does not refer to the type of vehicle used, but to the condition of the transportation recipient. In contrast… “non-emergency, medical transportation” must be provided in ambulances or wheelchair vans, and be supported by a Treatment Authorization Request. 3

Non-Emergency, Non-Medical Transportation Non-Emergency, Medical Transportation 4

Question: How frequently does a trip provided by your transportation services fit this description? “Arranging and/or providing non-emergency, non- medical transportation of a Medi-Cal eligible person to Medi-Cal services, and when necessary, accompaniment by an attendant.” 5

Does your program provide transportation to:  Adult Day Healthcare Centers  Behavior Health Programs  Dialysis Treatment  To/From Nursing Homes 6

Medi-Cal Non-Emergency Non-Medical Transportation (NENMT) Reimbursement The actual cost of providing Medi-Cal Non-Emergency, Non-Medical Transportation may be charged for reimbursement through the Local Governmental Authority ‘s (LGA) MAA program. This is a source of revenue for both the LGA and the transportation provider to offset costs of NENMT 7

Medi-Cal Reimbursement Opportunities NENMT Costs Include: Tokens Taxi Fares Mileage Audited Trip Costs

The reimbursement Gold Coast Transit receives for NENMT Costs is … 50% of Audited Trip Costs In FY 12 our audited trip cost was $29.69/trip (Reimbursement was for qualifying trips) 9

Locate your local LGA (Local Governmental Authority) 10

Your local LGA is here information 11

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Strongly Recommended –  Patience  Learn the MAA acronyms/language  Be prepared to explain your current budget/operations in lay terms  Understand how your scheduling/reporting software works  Patience 13

MOA for MAA Claiming Revenue Compliance. Claiming Plan Approval Letter 14

Ventura County

Fixed Route Bus System – 1.85 million annual revenue miles – 3.6 million boardings in FY13 ACCESS Paratransit Services – 462,927 annual revenue miles – 70,927 boardings in FY13

GCT’s paratransit is contracted out. Contract invoiced on a vehicle revenue hour (VRH) basis Cost per trip verified (CAFR) 17

Patience. GCT’s first contact with the LGA was in October In FY 14 GCT successfully completed first reimbursement. FY 2011/12 Paratransit Operating Budget:  $2,037,193 Expenses  $ 243,898 Revenues (On-Board/Local Support) (per GCT CAFR for FY ending June 30, 2012) FY 12 reimbursement total added $96,217 18

Revenue may take awhile to be realized via reimbursement through the MAA MAA revenue WILL fluctuate. Recommend conservative MAA revenue forecasting. 19

Questions? 20

Margaret Heath Paratransit & Special Projects Manager 301 E Third Street Oxnard, CA , ext Thank you!