Presented by Department of Health Care Services Novato Fire Protection District Sacramento Metropolitan Fire District This presentation is for training purposes only. Please refer to appropriate legislation, SPA, and introduction packet materials.1

Before We Start Introduction of the Webinar Panel Webinar Questions Purpose of the Webinar Update to GEMT Reimbursement Program Not intended to be a detailed cost report training session Shake Out Drill 10:16a.m. This presentation is for training purposes only. Please refer to appropriate legislation, SPA, and introduction packet materials.2

Agenda Program Overview GEMT Program Updates SFY 13/14 Cost Report Changes Audit Update Q&A This presentation is for training purposes only. Please refer to appropriate legislation, SPA, and introduction packet materials.3

Program Overview – Authority State Authority: Assembly Bill 678 (Statute of 2011) enacted the California Welfare and Institutions (W & I) Code , on October 2, 2011 Federal Authority: State Plan Amendment was approved September Participation in this Program is Voluntary This presentation is for training purposes only. Please refer to appropriate legislation, SPA, and introduction packet materials.4

Program Overview – Reimbursement Reimburses eligible GEMT providers the federal match up to their actual costs of providing GEMT services to fee-for- service Medi-Cal beneficiaries only Example: $100 Medi-Cal uncompensated costs $100*50%=$50 (federal match) This presentation is for training purposes only. Please refer to appropriate legislation, SPA, and introduction packet materials.5

Program Overview – Submission Review of the acceptance process Cost Report Submission New: Added an automatic response to the GEMT submissions mailbox Rejections Notices New: More personal calling to address issues prior to sending out rejection notices (minimize these) Transportation Numbers (CA-MMIS Report) Acceptance Notices Did you receive? If not, please check on the status. Wrong submission. This presentation is for training purposes only. Please refer to appropriate legislation, SPA, and introduction packet materials.6

Program Overview – Payment Process Interim Supplemental Payment Interim Settlement (Reconciliation) Final Reconciliation (After Audits) Overpayments & Underpayments This presentation is for training purposes only. Please refer to appropriate legislation, SPA, and introduction packet materials.7

Program Update – Cost Reports Started accepting cost reports November 30, 2013 Reviewed over 700+ cost reports Processed $41m in payments to date Still processing cost reports that have been resubmitted due to rejection issues. This presentation is for training purposes only. Please refer to appropriate legislation, SPA, and introduction packet materials.8

Program Updates – Growing Pains Public Request Act Pending Payments Administrative Costs Contracting Arrangements Policy & Procedure Letters This presentation is for training purposes only. Please refer to appropriate legislation, SPA, and introduction packet materials.9

Program Updates – PPLs Policy & Procedure Letters (PPLs) PPL – Contracting Arrangements with private providers PPL – Contracting arrangements with public providers (pending) JPAs will not be part of this PPL. All JPA structures need to work with DHCS individually to review their eligibility. PPL – Administrative Costs (pending) This presentation is for training purposes only. Please refer to appropriate legislation, SPA, and introduction packet materials.10

Program Updates – Rejection Top 5 1. Incomplete Certification Page 2. No signature or does not match the signature authority form. 3. Incomplete Cost Report (all pages) Use N/A 4. Adding Medi-Cal payments instead of subtracting (Schedule 9) Corrected/CR SFY 13/14 5. Significant Transport Number Discrepancies Manual Adjustment This presentation is for training purposes only. Please refer to appropriate legislation, SPA, and introduction packet materials.11

SFY 13/14 Cost Report Changes Certification Page Schedule 8 Detail Revenue Entered Here Schedule 9 Revised to pull Medi-Cal Revenue from Schedule 8. This presentation is for training purposes only. Please refer to appropriate legislation, SPA, and introduction packet materials.12

Audit Overview When to expect an audit? What to expect while we are auditing your cost reports? What information to keep on file? This presentation is for training purposes only. Please refer to appropriate legislation, SPA, and introduction packet materials.13

Q & A Session This presentation is for training purposes only. Please refer to appropriate legislation, SPA, and introduction packet materials.14